Hernández-Cordero et al. BMC Public Health (2015) 15:1031 DOI 10.1186/s12889-015-2367-0 RESEARCH ARTICLE Open Access Comparing a 7-day diary vs. 24 h-recall for estimating fluid consumption in overweight and obese Mexican women Sonia Hernández-Cordero1*, Nancy López-Olmedo1, Sonia Rodríguez-Ramírez1, Simón Barquera-Cervera1, Juan Rivera-Dommarco1 and Barry Popkin2 Abstract Background: High intake of sugar-sweetened beverages (SSB) is linked to increased weight, energy intake, and diabetes. Even though the increasing interest on beverages and water intake, there are few dietary tools carefully validated. The purpose of this paper is to compare a fluid intake 7-day diary against a 24-h recall questionnaire to estimate the fluid consumption in overweight and obese women participating in a randomized controlled trial in Mexico. Methods: This cross-sectional study explored the correlation of reported fluid consumption between two methods: 3-day 24-hr recalls and 7-day diary beverage registry in overweight and obese Mexican women aged 18–45 y (n =190). Results: There was no difference on median estimated volume (mL/d), nor the median estimated energy (kcal/d) from total beverage consumption registered by the two dietary tools. The crude and rank correlation among the two dietary instruments was high for total fluid consumption in mL/d r =0.7,p < 0.001 (crude and rank correlation) and for fluid consumption measured as energy intake: r =0.7;p < 0.001 crude, and r =0.5;p < 0.001 rank correlation. By type of beverage, the more meaningful rank correlations were for fluid intake in: mL/d, water, alcohol beverages, and SSB; and in kcal/d, alcohol beverages and SSBs (rank correlation ≥ 0.6). Conclusions: Overall, the 7-day diary showed high and strong rank correlations with that reported in the 24-h recall, suggesting that the diary method is a valid dietary tool to evaluate total fluid, water and SSB intake in this population. Keywords: Fluid intake measurement, Validation, Sugar-sweetened beverages, Dietary intake Background fruit drinks) are linked to increased weight, energy intake, Caloric beverages, particularly sugar-sweetened beverages and diabetes [15–17]. Additional concern is raised about (SSB), represent an increasing component of our diet. consumption of other beverages such as fruit juices, alco- Mattes and many others have shown that there are differ- hol, and high-fat milk due to their contribution to energy ential effects of calories consumed as a liquid beverage intake and its association with obesity and chronic dis- and a food [1–7]. In Mexico, the United States, the United eases such as type 2 diabetes and dyslipidemia, among Kingdom, Europe, and elsewhere increasing concern has others [18–26]. Some countries have developed programs focused on several key components of caloric beverages, and policies to promote water intake and limit access to those high in refined sugars, high-fructose corn syrup, or SSB in schools and feeding programs, mainly through fruit juice concentrates [8–14]. Meta-analyses have pro- banning SSB within schools, and to restrict media related vided evidence that high intake of SSB (e.g., soft drinks, to SSB through regulation of the marketing of foods (especially to children). [27–29]. Mexico has experienced rapid increases in SSB and * Correspondence: [email protected] caloric intake from beverages in the last 20 years 1Center of Research in Nutrition and Health, National Institute of Public Health, Av. Universidad 655 Col. Sta. Maria Ahuacatitlán, Cuernavaca, Morelos [12–14]. Furthermore, the government created a beverage CP 62100, Mexico guidance panel [30] and recently moved to reduce caloric Full list of author information is available at the end of the article © 2015 Hernández-Cordero et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Hernández-Cordero et al. BMC Public Health (2015) 15:1031 Page 2 of 10 intake from beverages in all age groups by taxing SSB were collected at baseline and at 3, 6, and 9 months. In [31]. In the Mexican government recommendations addition, women were contacted every month to re- and those discussed by many other countries, water in- ceive information about healthy lifestyles. For women take has been viewed as an important, viable alternative in the intervention group, we provided between 2 and 3 l to these caloric beverages; however, there is limited in- of water per person a day for every 2 weeks. For more de- formation on water consumption patterns in the con- tail see Hernandez-Cordero et al. [43]. The original trial text of a total beverage intake pattern [11, 32–34]. was registered at clinicaltrials.gov (NCT01245010). There are no entirely objective measures of an individ- For the current analysis, we estimated the correl- ual’s food or drink consumption except in the controlled ation of reported beverage consumption among three conditions of a metabolic unit. Any self-reported measure- repeated 24-h recalls and one 7-day diary beverage ment of intake will be biased in some way by the measure- registry, both collected at 3 months of the interven- ment process itself. There are two main approaches to tion. Three-month measurements, instead of those at individual assessment: prospective and retrospective, each baseline, were used for this analysis given that the 7-day with their advantages and disadvantages [35]. diary was not applied at baseline. We selected those Even though the increasing interest on beverages and women with data collected with the two instruments in water intake, there are few dietary tools carefully vali- thesameweek(n = 190) (Fig. 1). dated for U.S. adolescents [36] and adults [37–40]. To The original study was conducted according to the date no specific dietary instrument for simple collection guidelines laid down in the Declaration of Helsinki, of the full array of fluid has been carefully validated for and all procedures were approved by the IRB of National Mexicans. For epidemiological studies, retrospective Institute of Public Health, Mexico (INSP). Written methods are usually applied. A standard 24-h recall or informed consent was obtained from all subjects. food frequency questionnaire is the most used; both focus on obtaining data on foods and beverages con- Dietary tools and procedures taining calories and macro- and micro-nutrients. [41]. 3-day 24-h recall (24-h recall) For intervention and epidemiological studies, the use of The 24-h recall was administered as an in-person inter- a standard 24-h recall is more common, and the 24-h view consisting in a complete audit of what foods and urine collection could be used as a marker of fluid in- fluids the participant consumed during the previous take [42], but collecting 24-h urine is not practical and 24 h. The interviewer noted the amount consumed, in- therefore not always used in large epidemiological studies. cluding portion sizes, preparation methods, and recipes The purpose of this paper is to compare a prospective for each type of food and fluid reported. Specific extra method: a fluid intake 7-day diary against a retrospective probes for all fluids (beverages and water) were used in one: 24-h recall questionnaire for 3 days to estimate the addition to measurement cups to have a better estima- fluid consumption in overweight and obese Mexican tion of fluid intake. women participating in a clinical trial to reduce SSBs and The methods to recollect dietary data are described increase water consumption. elsewhere [43]. Briefly, three 24-h dietary recalls were administered at 3 months after the original intervention Methods had begun. Highly trained interviewers applied three re- Subjects calls of three randomly selected nonconsecutive days dur- Women participating in a randomized clinical trial with ing one week (two weekdays and one weekend). The first the primary objective to investigate whether replace- interview took place at the INSP (study headquarters). For ment of SSBs with water could reduce plasma triglycer- the last two, the interviewer visited the participants home ide concentrations and other cardiometabolic factors to collect the information in the place where food was over 9 months in overweight and obese young Mexican prepared and obtained the portion sizes as accurately as women. Women were overweight or obese (body mass possible. Each interview lasted approximately 60 min. index [BMI] range ≥25 kg/m2 and <39 kg/m2), aged 18–45 y, and otherwise healthy. Eligible participants re- 7-day diary ported consuming at least 250 kcal per day (kcal/d) of This is a self-administrated instrument designed spe- caloric beverages (e.g., includes soft drinks, juices-100 % cifically to capture all fluid consumption events. The juices and fruit drinks-sport drinks, sweetened tea or participants were asked to register all water and beverage coffee, and alcoholic beverages) measured through a consumed during one complete week. The diary included 24-h recall applied three randomly selected nonconsec- the different meal times (at waking up/before breakfast, utive days during one week (two weekdays and one during breakfast, during morning/before main meal, dur- weekend). As part of the original study, anthropometry, ing main meal, during afternoon/before dinner, during diet, physical activity, blood pressure, and fasting blood dinner, and before going to bed), a space to specify the Hernández-Cordero et al.