title: Methodological approaches for dietary intake assessment in formula-fed infants.
abstract: OBJECTIVE
  The estimation of dietary intake remains a challenge in human nutritional studies. In infants, the use of food diaries (FDs) is a suitable method already validated; however, this method is not exempt from error. In formula-fed infants, dilution of powdered formulas may produce errors. Our aim was to develop and validate standard operating procedures (SOPs) for the assessment of dietary intake in formula-fed infants, attending potential sources of error.
  
  
  METHODS
  We analysed sources of error in a random subsample of 3-day FDs from 100 infants enrolled in the European Childhood Obesity Project. Calculations to estimate intakes were standardised and included in a software tool (SOPsystem). An evaluation of a simulated FD was performed by 9 trained nutritionists and 23 nutrition students (n=225 and n=575 bottle evaluations, respectively) to compare the results obtained when using or not the SOPsystem. Correct answers (%), coefficients of variation, and the time spent (minutes) to assess the simulated FD were analysed.
  
  
  RESULTS
  Overall, 60% of the FDs contained reports of incorrect volumes, and 37% reported incorrect formula dilutions. When the SOPsystem was used, correct answers in the simulated FD were more frequent (P<0.001) and the mean coefficient of variation and the time spent were lower (P<0.005 and P<0.01, respectively).
  
  
  CONCLUSIONS
  The development and implementation of SOPs with a software tool that identifies specific sources of error in record-keeping achieved a harmonised and improved process for assessing dietary intakes in formula-fed infants, minimising errors in calculations and reducing the work time invested.
authors: Paediatrics Unit, Universitat Rovira i Virgili, IISPV, Reus, Spain.
authors: Veronica
authors: V
authors: Luque
authors: Joaquin
authors: J
authors: Escribano
authors: Georgina
authors: G
authors: Mendez-Riera
authors: Sonia
authors: S
authors: Schiess
authors: Berthold
authors: B
authors: Koletzko
authors: Elvira
authors: E
authors: Verduci
authors: Anna
authors: A
authors: Stolarczyk
authors: Françoise
authors: F
authors: Martin
authors: Ricardo
authors: R
authors: Closa-Monasterolo
mesh_terms: D017028:Caregivers; D053198:Child Nutrition Sciences; D003430:Cross-Sectional Studies; D015930:Diet Records; D002149:Energy Intake; D005060:Europe; D005260:Female; D005511:Food Handling; D006801:Humans; D007223:Infant; D007225:Infant Food; D041943:Infant Formula; D008297:Male; D015596:Nutrition Assessment; D010290:Parents; D015203:Reproducibility of Results; D012984:Software; D013997:Time Factors