Energy intake by multiple pass 24 h recall and total energy expenditure: acomparison in a representative sample of 3-4-year-olds

The accuracy of the multiple pass 24 h recall for assessment of habitual en ergy intake in pre-school children is unclear. The primary aim of this stud y was to assess its accuracy by comparison with measurement of total energy expenditure by doubly-labelled water in a representative sample of forty-o ne 3-4-year-olds. The recall method was well tolerated by subjects and was administered quickly and easily. However, it produced estimates of energy i ntake which significantly exceeded measures of total energy expenditure fro m doubly-labelled water, mean paired difference 660 kJ/d (P <0.01). Agreeme nt between the two methods was poor at the individual level: limits of agre ement 660+/-3018 kJ/d. Error and imprecision in both methods contribute to individual differences, but the present study suggests that the multiple pa ss 24 h recall does not provide accurate estimates of dietary energy intake in individual children.