A virtual workshop series titled Approaches to Assessing Intake of Food and Dietary Supplements in Pregnant Women and Children 2 to 11 Years of Age was convened in May 2021 by the Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. The workshop series included four virtual workshops (held May 6, May 17, May 19, and May 24) that explored the evidence on methodological approaches to assessing intake of food and dietary supplements in pregnant women and children 2 to 11 years of age.1 The workshop’s Statement of Task is in Box 1-1.2
Obtaining reliable and valid dietary intake information for these population groups is particularly difficult—in pregnancy, rapid changes in nutrient needs and dietary intakes occur, and in young children, much of dietary intake is consumed outside the home and is often misreported by the children or their proxy reporters. To advance the quality of the science in these areas, the workshop had four goals: identify the suite of current
1 The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop Series was prepared by the workshop rapporteur as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants, and are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine, and they should not be construed as reflecting any group consensus.
2 The workshop agenda, presentations, and other materials are available at https://www.nationalacademies.org/our-work/approaches-to-assessing-intake-of-food-and-dietary-supplementsin-pregnant-women-and-children-2-to-11-years-of-age-a-workshop-series (accessed August 30, 2021).
methods used in dietary assessments, including food and dietary supplements, in pregnant women and children 2 to 11 years of age; identify the methodological challenges and opportunities in improving current methods; explore methodologies in other disciplines and their application in dietary assessments in those populations; and discuss factors to consider when implementing dietary assessment tools in those populations.
The workshop series began with introductory remarks from one of the workshop’s sponsors,3 followed by the planning committee chair’s review of the series’ schedule and format along with a brief overview of dietary assessment methods.
Nancy Potischman, nutritional epidemiologist and director of the Population Studies Program in the National Institutes of Health (NIH) Office of Dietary Supplements (ODS), welcomed participants and explained ODS’s interest in the topics to be discussed during the workshop series.
The ODS mission,4 Potischman began, is to strengthen knowledge and understanding of dietary supplements by evaluating scientific information, stimulating and supporting research, disseminating research results, and educating the public to foster an enhanced quality of life and health
3 The workshop gained a second sponsor after the first workshop was held; therefore, that sponsor (the Academy of Nutrition and Dietetics) did not provide remarks at this time.
4 See https://ods.od.nih.gov/About/MissionOriginMandate.aspx (accessed August 23, 2021).
for the U.S. population. She elaborated on ODS’s Population Studies Program, which evaluates dietary supplement use by the U.S. population and its specific subgroups and assesses dietary supplements’ contribution to nutritional status. The program also leads efforts to address methodologic issues in assessing dietary and dietary supplement intakes relative to epidemiologic and other large studies.
Potischman explained that experts at ODS and other NIH institutes, as well as the Dietary Guidelines Advisory Committees, have identified pregnant women and children 2 to 11 years of age as two groups from which it is particularly challenging to obtain reliable, reproducible, and valid intake information. She conveyed ODS’s intent for the experts featured in the workshop to summarize the challenges and suggest best practices for assessing food and dietary supplement intakes among these two groups, with the hope that more robust data on total nutrient intakes from these sources would be available for the next (2025–2030) iteration of the Dietary Guidelines for Americans.
Overview of Dietary Assessment Methods
Cheryl Anderson, professor and dean of the Herbert Wertheim School of Public Health and Human Longevity Science at the University of California, San Diego, and member of the workshop series planning committee, explained that the workshop content would be distributed across four 2-hour virtual workshops that each include speaker presentations, panel discussions, and question and answer periods.
Anderson also provided an overview of the landscape of dietary assessment, referencing traditional tools (e.g., direct observation, duplicate diet samples, subjective reports such as recalls or records, and close-ended surveys such as food frequency questionnaires) and emerging tools (e.g., mobile techniques, photography, ecological momentary assessment, and other technology that provides passively collected objective data). All dietary assessment tools have strengths and limitations, she emphasized, and listed key factors to consider when choosing a tool for a given research objective. These include the tool’s accuracy; feasibility of administration in the study context; burden to complete (for respondents) and to administer and analyze (for study staff); financial costs; applicability to diverse populations (e.g., availability in multiple languages, level of literacy required to complete); and time frame of interest (i.e., acute versus chronic or usual intake), which Anderson pointed out influences the level of detail requested from respondents; and analytic capabilities required of the study team to accurately interpret and translate the data collected.
This proceedings follows the order of the four workshop agendas (see Appendix A), chronicling each workshop in a single chapter. Chapter 2 explores methods for dietary assessments during pregnancy (workshop 1); Chapter 3 examines methods for dietary assessment in children 2 to 5 years of age (workshop 2); Chapter 4 reviews methods for dietary assessment in children 6 to 11 years of age (workshop 3), and Chapter 5 discusses innovations and special considerations in assessing dietary intake during pregnancy and 2 to 11 years of age (workshop 4). Appendix B is a list of acronyms and abbreviations used in this proceedings, and Appendix C provides biographical sketches of each workshop’s speakers and the planning committee members.