A working guide for Urban Food Listing Food listing for processed packaged and vendor-prepared foods in urban centers for use in 24-hour dietary recall surveys February 2021 RESEA AL RC IC H D I E N S M T A I T Y U N T E E K KEMRI A working guide for Urban Food Listing Food listing for processed packaged and vendor-prepared foods in urban centers for use in 24-hour dietary recall surveys February 2021 A working guide for Urban Food Listing Preface As the importance of national level information and the Centre for Public Health Research at the on dietary intakes in low- and middle-income Kenya Medical Research Institute (KEMRI-CPHR). countries is increasingly recognized; reliable It is based on: (i) the experiences of GAIN and methods, tools and guides to support the other researchers in food and recipe listing compilation of quality food and nutrient intake activities in preparation for dietary surveys in data are needed. In general, guidance on how rural or urban areas; (ii) the experience of Intake to adequately prepare for a dietary survey in developing guidance, and providing direct prior to embarking on data collection is scarce. technical support, for large-scale dietary intake However, particular gaps in available methods lie surveys in low- and middle-income countries; in the identification of the types of foods likely and (iii) our initial experience in developing and to be reported as consumed in a survey, and field testing a protocol in Nairobi, Kenya, as part what details are needed to adequately identify of the preparatory activities for a future national and link those foods to food composition data. Kenyan dietary survey to be headed by KEMRI. While these are important but more manageable The series of tasks and data collection tools tasks in rural areas, for urban areas, there are comprising the urban food listing activity, that particular challenges in the listing of foods and are presented here have been refined based on dishes consumed. This is due to the increasing our lessons learned from this experience and availability and popularity of processed packaged are considered to represent a starting point for foods, as well as prepared foods purchased in further improvement. ready-to-eat form from a variety of food vendors. A series of diverse but complementary tasks In the urban marketplace, there is a potentially were used in the field-tested protocol. These very large number and variety of processed included: packaged foods available for purchase and a desk review of existing data to inform consumption with limited information on i. on the types of processed packaged nutritional content obtainable from package and vendor-prepared foods available for labels. Likewise, there is a potentially large consumption or known to be consumed in number and variety of vendor prepared foods the survey population; available in urban areas for which survey respondents who consume them could not ii. Expert consultation as part of the process to provide quantitative information on their develop a listing of food types likely to be contents. Therefore, modified approaches are reported as consumed in a future survey; needed to identify processed packaged and Facilitated Group Discussions (FGDs) with vendor-prepared foods that are likely to be iii. members of the survey target group(s) to consumed in a survey population. While such acquire more details and the likelihood of methods are still needed in rural areas, it is the consumption scores for processed packaged larger number and variety of these foods likely to and vendor-prepared foods consumed, and be consumed in urban areas that requires a more their variations; systematic approach to adequately capture them without overburdening the dietary survey team iv. a review of existing food composition and or assigning such foods to inappropriate food standard recipe data that may be used to composition data due to inadequate information calculate energy and nutrient intakes from about them. these foods; and This guide for conducting an urban food listing v. a market survey to collect additional details activity was developed jointly by the Global on the types or variations of commonly Alliance for Improved Nutrition (GAIN), Intake consumed processed packaged and vendor- (Center for Dietary Assessment at FHI Solutions), prepared foods to better identify them. 3 A working guide for Urban Food Listing These tasks culminated in a final list of processed across teams of enumerators. This results in a foods likely to be reported as consumed in a greater likelihood that dietary intake records future dietary survey in Kenya, together with a are incomplete because appropriate food source of available food composition or standard composition data cannot be identified. However, recipe information (i.e., data on the standard this preparatory work needs to be balanced ingredients and amounts for prepared foods with the availability of time and resources for purchased from vendors), or a flag for future the survey as a whole and ensure that it does collection of primary or secondary data to fill not produce an excess of irrelevant information. gaps. One of the guiding principles for this work is to limit the final listing of foods to those likely to Adequate preparation for a dietary survey is be reported as consumed by a non-negligible critical to support the collection of good quality number of respondents (e.g., subjectively ≥5% data. Details that are required for all food types of the survey respondents), and omit those reported to be consumed in a survey by several unlikely to be reported or only reported by a respondents should be incorporated in the small number of respondents. methods and training for data collection, and for the conversion of amounts consumed to We hope that this guide will be useful for survey gram-weight equivalents and their energy and planners and managers to begin implementing nutrient contents. The more foods appearing in urban food listing activities. We also hope that a survey that were not considered in the data their additional experience in adapting and collection tools, methods and procedures for further field testing these methods, or testing the survey, or the training of survey staff, then alternative methods and tools, will allow for the more ad hoc decisions that will need to be advancement of these methods and ultimately made during survey data collection, all lead to the improvement of large-scale 24-hour dietary a lack of standardization of details collected recall surveys.1 1 Comments and feedback on the use of this guide may be sent to: [email protected] 4 A working guide for Urban Food Listing Acknowledgments The development of this guide was supported International; MSND Consultants International; with the technical input of Wendy Gonzalez New Kenya Cooperative Creameries (KCC) from the Global Alliance for Improved Nutrition Limited; Java House; Naivas Supermarkets; (GAIN) (Geneva, Switzerland) and Megan Carrefour Supermarkets; and Clean Shelf Deitchler from Intake - Center for Dietaray Supermarket. We are also grateful to the Ministry Assessment (Washington DC, USA). of Health (Fortification Programme), Kenya Bureau of Standards and the Kenya Association The research primarily used to inform this guide of Manufacturers for its support in providing was co-led by Christine Hotz (consultant, GAIN); access to national food registry information. Abdelrahman Lubowa (Senior Dietary Survey Advisor, Intake - Center for Dietary Assessment); We would finally like to thank the individuals and Zipporah Bukania (Deputy Director, KEMRI who served as key informants in the early and head of CPHR). Special thanks are extended stages of developing the urban food listing to Lorraine Ombogo and Lucy Magige for their activity for field testing: Cecilia Acuin (Institute commitment in coordinating this research. We of Human Nutrition and Food, University of would like to express our appreciation for the the Philippines, Philippines); Camila Corvalan dedication of the technical teams in executing (Institute of Nutrition and Technology of Foods the various tasks, including the review and [INTA], University of Chile, Chile); Sandra Patricia analysis of existing dietary data (Esther Kariuki, Crispim (Federal University of Parana, Brazil); Umi Richard Mutisya, Eva Kosgei and Lucy Magige) Fahmida (Southeast Asian Ministers of Education and the FGDs and market survey work (Tecla Organization Regional Center for Food and Mbithe, Hellen Okochil, Beryl Odipo, Beryln Nutrition [SEAMO RECFON], Indonesia); Maria Katiechi, Eva Kosgei Mary Njeri Muchiri and Laura Louzada (University of Sao Paulo, Brazil); Rogders Ochieng). We also thank the KEMRI- Alannah Moshfegh (Agricultural Research Service CPHR administrative support team. All members - US Department of Agriculture [ARS-USDA], of the research and technical teams contributed USA); Alissa Pries (Helen Keller International, significantly to the methods development and USA); Teresa Shamah-Levy (National Institute lessons learned. of Public Health, Mexico); and Nelia Steyn (University of Cape Town, South Africa). We would also like to acknowledge the input, support and cooperation of the County This work was partially funded by the Government of Nairobi; County Commissioner, Government of Canada, as part of the Business Nairobi County; and the valuable technical Platform for Nutrition Research hosted by support from representatives of the Ministry the Global Alliance for Improved Nutrition. of Health (Nutrition and Dietetics Unit); CPHR- Additional funding for the work was provided by KEMRI; Kenya National Bureau of Statistics; the Bill & Melinda Gates Foundation through a Kenya Bureau of Standards; University of grant to FHI Solutions to support Intake - Center Nairobi; Kenyatta University; Bioversity for Dietary Assessment. Global Alliance for Improved Nutrition [GAIN], Intake - Center for Dietary Assessment, Kenya Medical Research Institute-Centre for Public Health Research [KEMRI-CPHR]. A working guide for urban food listing. Geneva and Washington DC: GAIN and Intake - Center for Dietary Assessment; 2020. 5 A working guide for Urban Food Listing Table of contents Preface 3 Acknowledgments 5 1.