title: Novel dietary intake assessment in populations with poor literacy.
abstract: OBJECTIVE
  Cultural and/or environmental barriers make the assessment of dietary intake in rural populations challenging. We aimed to assess the accuracy of a meal recall questionnaire, adapted for use with impoverished South Indian populations living in rural areas.
  
  
  METHODS
  Dietary data collected by recall versus weighed meals were compared. Data were obtained from 45 adults aged 19-85 years, living in rural Andhra Pradesh, who were recruited by convenience sampling. Weighed meal records (WMRs) were conducted in the household by a researcher aided by a trained field worker. The following day, field workers conducted a recall interview with the same participant. Eight life size photographs of portions of South Indian foods were created to aid each participant's recall and a database of nutrients was developed to calculate nutrient intake. Pearson correlations were used to assess the strength of associations between intake of energy and nutrients calculated from meal recalls versus WMRs. Least products regression was conducted to examine fixed and proportional bias. Bland-Altman plots were constructed to measure systematic or differential bias.
  
  
  RESULTS
  Significant correlations were observed between estimates for energy and nutrients obtained by the two methods (r2=0.19-0.67, p<0.001). No systematic bias was detected by Bland-Altman plots. Recall method underestimated the intake of protein and fat in a manner proportional to the level of intake.
  
  
  CONCLUSIONS
  Our culturally adapted meal recall questionnaire provides an accurate measure for assessment of the intake of energy, macronutrients and some micronutrients in rural Indian populations.
authors.affiliation: Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Australia. Email: asvini.subasinghe@gmail.com.
authors.forename: Asvini K
authors.initials: AK
authors.lastname: Subasinghe
authors.affiliation: Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Australia.|Florey Neuroscience Institutes, Heidelberg, Victoria, Australia.
authors.forename: Amanda G
authors.initials: AG
authors.lastname: Thrift
authors.affiliation: Department of Physiology, Monash University, Australia.
authors.forename: Roger G
authors.initials: RG
authors.lastname: Evans
authors.affiliation: Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Australia.
authors.forename: Simin
authors.initials: S
authors.lastname: Arabshahi
authors.affiliation: Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Australia.|Rishi Valley Rural Health Centre, Andhra Pradesh, India.
authors.forename: Oduru
authors.initials: O
authors.lastname: Suresh
authors.affiliation: Rishi Valley Rural Health Centre, Andhra Pradesh, India.
authors.forename: Kamakshi
authors.initials: K
authors.lastname: Kartik
authors.affiliation: Rishi Valley Rural Health Centre, Andhra Pradesh, India.
authors.forename: Kartik
authors.initials: K
authors.lastname: Kalyanram
authors.affiliation: Department of Nutrition and Dietetics, Monash University, Melbourne, Australia.
authors.forename: Karen Z
authors.initials: KZ
authors.lastname: Walker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D004032:Diet; D015930:Diet Records; D002149:Energy Intake; D005260:Female; D005502:Food; D006801:Humans; D007194:India; D000067010:Literacy; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D015596:Nutrition Assessment; D011203:Poverty; D011247:Pregnancy; D012424:Rural Population; D011795:Surveys and Questionnaires; D055815:Young Adult