24 hour recall24 hour recallThe 24 hour recall is a The 24 hour recall is a

retrospective assessment retrospective assessment method in which an method in which an

interviewer prompts a interviewer prompts a respondent to recall and respondent to recall and

describe all foods and describe all foods and beverages consumed.beverages consumed.

24 hour recall steps24 hour recall steps The 24 hour recall is a listing of all the foods The 24 hour recall is a listing of all the foods

and beverages a person consumed within the and beverages a person consumed within the previous 24 period. previous 24 period.

The nutrition counselor may ask a person to The nutrition counselor may ask a person to recall the first thing he or she ate or drank recall the first thing he or she ate or drank the previous morning.the previous morning.

The counselor then records the estimated The counselor then records the estimated amounts of all foods and beverages the amounts of all foods and beverages the person consumed the rest of the day.person consumed the rest of the day.

The 24 hour recall can be used to provide an The 24 hour recall can be used to provide an estimate of energy and nutrient intake.estimate of energy and nutrient intake.

Advantages & Advantages & disadvantagesdisadvantages

The 24 hour recall method is more The 24 hour recall method is more appropriate for assessing the intake of appropriate for assessing the intake of large populations than of individuals large populations than of individuals

Usual intake of an individual cannot be Usual intake of an individual cannot be captured by one day recallcaptured by one day recall

People tend to over – or underestimate People tend to over – or underestimate intake of certain foods, and food intake intake of certain foods, and food intake on one day may not accurately on one day may not accurately represent typical food intakerepresent typical food intake

Example of 24 hour recallExample of 24 hour recall1.1. What time did you get up yesterday?What time did you get up yesterday?2.2. What did you eat for the first time What did you eat for the first time

yesterday? How much?yesterday? How much?3.3. When was the next time you ate? What When was the next time you ate? What

did you eat ? How much?did you eat ? How much?4.4. What did you eat next? What did you What did you eat next? What did you

eat? How much?eat? How much?5.5. Did you eat or drink anything else Did you eat or drink anything else

between meal times?between meal times?6.6. Did you add condiments, butter, salad Did you add condiments, butter, salad

dressing, sugar?dressing, sugar?7.7. Was the intake different from usual?Was the intake different from usual?8.8. Was this a weekday or a weekend day? Was this a weekday or a weekend day?

Procedures for collecting 24 hour food Procedures for collecting 24 hour food recallsrecalls

That all foods and beverages That all foods and beverages consumed are listedconsumed are listed

That amounts of foods are as That amounts of foods are as accurate as possibleaccurate as possible

That homemaker is not influenced to That homemaker is not influenced to say she/he ate that were not eatensay she/he ate that were not eaten

Setting the stage for the interviewerSetting the stage for the interviewerThe following steps will help in eliciting The following steps will help in eliciting

truthful and complete information:truthful and complete information:

1.1. Explain to homemaker that you need to know what Explain to homemaker that you need to know what she/he actually ate. She/he should not feel embarrassed she/he actually ate. She/he should not feel embarrassed about any food , as there are no “good” or “bad” foods. about any food , as there are no “good” or “bad” foods. No one eats just the right foods all the time.No one eats just the right foods all the time.

2. Do not express in words or facial expressions either 2. Do not express in words or facial expressions either approval or disapproval of foods which homemaker approval or disapproval of foods which homemaker mentions.mentions.

3. Do not ask leading questions that would lead 3. Do not ask leading questions that would lead homemaker to feel she/he “should” have had a certain homemaker to feel she/he “should” have had a certain item and, thus, say she/he did.item and, thus, say she/he did.

During the food recall interviewDuring the food recall interview

1.1. Use the FOOD RECALL KIT to determine the Use the FOOD RECALL KIT to determine the amounts of foods consumes. Homemakers may not amounts of foods consumes. Homemakers may not be able to give amounts of ingredients in their be able to give amounts of ingredients in their portions of mixed dishes, salads and casseroles. If portions of mixed dishes, salads and casseroles. If a home recipe was used, obtain a recipe. If a food a home recipe was used, obtain a recipe. If a food was eaten in a restaurant or take away food, was eaten in a restaurant or take away food, record the name or type of restaurant.record the name or type of restaurant.

2.2. Start with the most recent meal or snack that the Start with the most recent meal or snack that the home maker consumed. Work backwards to cover home maker consumed. Work backwards to cover all foods and beverages eaten or drunk in the last all foods and beverages eaten or drunk in the last 24 hour.24 hour.

3.3. First,First, get a complete list of all foods eaten without get a complete list of all foods eaten without trying to determine amounts. Use the following trying to determine amounts. Use the following types of probes to find what foods were eaten.types of probes to find what foods were eaten.

Probing questionsProbing questions

The first type of probing is related to The first type of probing is related to TIME.TIME.

Examples:Examples:

At what time was this? Did you eat or At what time was this? Did you eat or drink anything before or after that?drink anything before or after that?

What did you have at that time? What did you have at that time?

At what time did you go to bed? At what time did you go to bed?

The second type of probe is related to The second type of probe is related to the homemaker’s the homemaker’s activities.activities.

Examples:Examples: What did you do this morning?What did you do this morning? While you were working around the While you were working around the

house, did you take a break to have house, did you take a break to have something to eat or drink?something to eat or drink?

Did you watch TV last night? When you Did you watch TV last night? When you watched TV, did you eat anything?watched TV, did you eat anything?

Did you have anything to drink with Did you have anything to drink with this?this?

The third type of probe tries to get more The third type of probe tries to get more complete complete information about foods information about foods already reportedalready reported..

Examples:Examples: ““Do you remember anything else that Do you remember anything else that

you ate or drank with this food?”you ate or drank with this food?” ““What else did you eat at this meal?”What else did you eat at this meal?” ““Was the (bread, vegetable) eaten plain Was the (bread, vegetable) eaten plain

or did you put something on it?”or did you put something on it?” ““Did you have anything in your coffee?”Did you have anything in your coffee?” ““Did you have a second helping?”Did you have a second helping?”

cont. during the food recall interviewcont. during the food recall interview

4. After all the foods are named 4. After all the foods are named by the homemaker, go back by the homemaker, go back over the list to get additional over the list to get additional descriptions and amounts of descriptions and amounts of the food. Also determine if all the food. Also determine if all of the food was eaten or if of the food was eaten or if some was left on the plate.some was left on the plate.

To get more information on the type of food:To get more information on the type of food:

A. Encourage the homemaker to describe A. Encourage the homemaker to describe foods as clearly as possible. The interviewer foods as clearly as possible. The interviewer may have to restate questions to get more may have to restate questions to get more information.information.

B. Describe combination dishes carefully. B. Describe combination dishes carefully. Mixtures such as sandwiches, soups, stew, Mixtures such as sandwiches, soups, stew, curries, casseroles etc can be prepared in curries, casseroles etc can be prepared in many ways.many ways.

C. Ask to see packages, if available, on C. Ask to see packages, if available, on prepackaged foods, and other related prepackaged foods, and other related information.information.

To determine the amount of food eaten:To determine the amount of food eaten:A. Amounts of a food may be given in:A. Amounts of a food may be given in:1. Numbers, such as eggs, rotis, apples1. Numbers, such as eggs, rotis, apples2. Shapes, such as a pat of butter, packet of 2. Shapes, such as a pat of butter, packet of

noodlenoodle3. Dimensions, such as size of models in Recall 3. Dimensions, such as size of models in Recall

Kit, or size of bread, cake etc. using a ruler.Kit, or size of bread, cake etc. using a ruler.4. Volume, such as liquids, cooked vegetables, 4. Volume, such as liquids, cooked vegetables,

pudding, ice cream.pudding, ice cream.5. Weight, such as meat, cheese, candy bar 5. Weight, such as meat, cheese, candy bar

(meat equals size of deck of cards, or palm (meat equals size of deck of cards, or palm of woman’s hand)of woman’s hand)

B. In determining amounts, use food B. In determining amounts, use food models, measuring cups, measuring models, measuring cups, measuring spoons, ruler, raw rice, beans, etc. in spoons, ruler, raw rice, beans, etc. in Food Recall Kit. Have homemaker Food Recall Kit. Have homemaker show you how much they had by show you how much they had by pouring raw rice or dry beans on a pouring raw rice or dry beans on a plate or by identifying some item in plate or by identifying some item in your Food Recall Kit. A ruler can also your Food Recall Kit. A ruler can also be used to show size of certain items. be used to show size of certain items.

C. When appropriate, ask homemaker C. When appropriate, ask homemaker to bring in the serving container to bring in the serving container (bowl, cup, glass, etc.) that was used (bowl, cup, glass, etc.) that was used and determine the amount it holds by and determine the amount it holds by using rice and a standard measuring using rice and a standard measuring cup.cup.

5. If nutrition questions are 5. If nutrition questions are being asked by the being asked by the homemaker during the time homemaker during the time the recall is being taken, ask the recall is being taken, ask homemaker if you may homemaker if you may answer them later when you answer them later when you have completed the recall.have completed the recall.

6. After the homemaker has given a 6. After the homemaker has given a recall of foods and amounts for the recall of foods and amounts for the entire 24 hours, read the list back to entire 24 hours, read the list back to her/him and ask homemaker to tell you her/him and ask homemaker to tell you anything else that she/he may have anything else that she/he may have forgotten before.forgotten before.

7. Thank the homemaker for her/his 7. Thank the homemaker for her/his cooperation. Do not comment on the cooperation. Do not comment on the recall at this time, unless homemaker recall at this time, unless homemaker asks a specific question. Wait and asks a specific question. Wait and address deficiencies, excesses, etc. address deficiencies, excesses, etc. when lessons are taught that deal with when lessons are taught that deal with that area of the diet. that area of the diet.

24 Hour Food Recall Kit24 Hour Food Recall Kit Purpose of the Food Recall KitPurpose of the Food Recall Kit : :

To assist To assist paraprofessional/interviewer in paraprofessional/interviewer in taken the food recall and taken the food recall and estimating the amounts more estimating the amounts more accurately.accurately.

The Food Recall Kit should contain the The Food Recall Kit should contain the following items:following items:

Cup – one 250 ml, plastic measuring cupCup – one 250 ml, plastic measuring cup Bowls – 2 different shapes – holding 2 Bowls – 2 different shapes – holding 2

cupscups Small sauce dish - about ½ cupSmall sauce dish - about ½ cup Standard measuring spoons:Standard measuring spoons:

- 1 tablespoon- 1 tablespoon - 1 teaspoon- 1 teaspoon - ½ teaspoon- ½ teaspoon - ¼ teaspoon- ¼ teaspoon

Plastic Container of 2 to 3 cups rice Plastic Container of 2 to 3 cups rice (with tight fitting lid)(with tight fitting lid)

Plastic Container of 2 – 3 cups dried Plastic Container of 2 – 3 cups dried beans (with tight lid)beans (with tight lid) Rice will be used as an example to Rice will be used as an example to

measuring more dense foods such as measuring more dense foods such as mashed potatoes and oatmeal. Beans may mashed potatoes and oatmeal. Beans may be used for foods that are loosely packed, be used for foods that are loosely packed, such as cereal or vegetables.such as cereal or vegetables.

To reduce the weight of the Food recall Kit, To reduce the weight of the Food recall Kit, dry cereal may also be placed in tightly dry cereal may also be placed in tightly covered plastic container or plastic bag for covered plastic container or plastic bag for use in determining size of servings.use in determining size of servings.

Group 24-Hour Dietary Group 24-Hour Dietary RecallRecall

The purpose of the group administered The purpose of the group administered 24-hour recall is to expedite the process 24-hour recall is to expedite the process of dietary assessment of a group of of dietary assessment of a group of individuals while continuing to obtain individuals while continuing to obtain accurate and reliable dietary intake accurate and reliable dietary intake information. This information will be used information. This information will be used to determine the nutritional and to determine the nutritional and educational needs of the participants. educational needs of the participants. Food recalls are also used to evaluate the Food recalls are also used to evaluate the effectiveness of nutrition programs.effectiveness of nutrition programs.

Materials NeededMaterials Needed1. 1. Group 24-hour form/pencilsGroup 24-hour form/pencils2. Posters of the group 24-hour recall form 2. Posters of the group 24-hour recall form

(Fijian/Hindi/English)(Fijian/Hindi/English)3. Poster of probing questions3. Poster of probing questions4. Food Recall Kits: 4. Food Recall Kits:

- Measuring cups and spoons- Measuring cups and spoons- Deck of cards or the palm of your hand- Deck of cards or the palm of your hand- Food models- Food models- Plastic containers of 2 to 3 cups of rice- Plastic containers of 2 to 3 cups of rice- Plastic containers of 2 to 3 cups of dried beans - Plastic containers of 2 to 3 cups of dried beans or dry cerealsor dry cereals

ProcedureProcedure1. Assemble the group. Then ask the 1. Assemble the group. Then ask the

participants to divide into smaller groups. participants to divide into smaller groups. Alternative method: Do not divide the group.Alternative method: Do not divide the group.

2. Introduce and explain the purpose of the 2. Introduce and explain the purpose of the group 24-hour recall. Inform participants group 24-hour recall. Inform participants that they will be completing a form detailing that they will be completing a form detailing their intake from the previous 24-hour their intake from the previous 24-hour period. The participants should be assured period. The participants should be assured that help will be provided to them as they that help will be provided to them as they complete the group 24-hour recall form.complete the group 24-hour recall form.

3. Display a poster of the group 24-hour 3. Display a poster of the group 24-hour recall form, and distribute forms to recall form, and distribute forms to participants.participants.

4. Provide a thorough explanation 4. Provide a thorough explanation requested on the form. Explain to the requested on the form. Explain to the participants that they will complete the participants that they will complete the form in three different steps: quick list, form in three different steps: quick list, detailed description, and review. Inform detailed description, and review. Inform them that you will guide them through the them that you will guide them through the process. Ask them to write as clearly as process. Ask them to write as clearly as possible. Be sure to tell the participants to possible. Be sure to tell the participants to only write one food per line.only write one food per line.

5. Display and explain the use of food 5. Display and explain the use of food models and measuring utensils as visual models and measuring utensils as visual memory aids for determining portion memory aids for determining portion sizes. Each group should have a set of sizes. Each group should have a set of the food models.the food models.

6. If there are no further questions, allow 6. If there are no further questions, allow participants to begin recording their participants to begin recording their food recall information. Group leaders food recall information. Group leaders should be free to circulate around the should be free to circulate around the room to provide assistance to subjects room to provide assistance to subjects especially those subjects who appear to especially those subjects who appear to be having difficulty reading or writing.be having difficulty reading or writing.

7. 7. Quick list:Quick list: To begin the recall process, ask To begin the recall process, ask participants to list all the foods and beverages participants to list all the foods and beverages they have consumed in the past 24 hours by they have consumed in the past 24 hours by any method they feel comfortable using. They any method they feel comfortable using. They need only to list the foods as they remember need only to list the foods as they remember them; portion sizes and preparation methods them; portion sizes and preparation methods will be recorded in the next step.will be recorded in the next step.

8.8. Detailed Description:Detailed Description: After participants After participants have completed their quick list, they will begin have completed their quick list, they will begin to complete the detailed description of foods to complete the detailed description of foods consumed. This will include recording consumed. This will include recording preparation method, brand name, portion size, preparation method, brand name, portion size, and the time the food or beverage was and the time the food or beverage was consumed. consumed.

9. Display transparency or poster of 9. Display transparency or poster of probing questions.probing questions.

10. 10. Review: Review: As participants begin to As participants begin to complete their recall form, ask them complete their recall form, ask them to review their list again to make to review their list again to make sure that their recalls are complete.sure that their recalls are complete.

11. Once all participants have 11. Once all participants have completed their recall, they may completed their recall, they may turn in their form to the supervisor.turn in their form to the supervisor.

All techniques have All techniques have advantages and advantages and disadvantagesdisadvantages

To choose the right measurement To choose the right measurement you have to consider:you have to consider:

- - What is the your aim?What is the your aim?

- - What is your target What is your target group?group?

- What are your resources?- What are your resources?