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Protocol - ASA24

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Description:

The 24-hour recall process consists of an initial quick list, where the respondent reports all the foods and beverages consumed during the day by eating occasion. This is followed by detailed probing questions about food preparation, additions to food, and amount consumed. Respondents are then queried about forgotten foods; these represent food in categories commonly omitted in 24-hour recall reporting. The 24-hour recall ends with a final review, where any other item not already reported can be added. Throughout the program, respondents can add, delete, copy, modify, or change foods reported on their recalls. Intake of dietary supplements for the past 24 hours can also be queried. Based on the 2014 version of the Automated Self-administered 24-hour Dietary Recall (ASA24-2014), completion of the 24-hour recall takes an average of 22 minutes for foods and beverages only or 29 minutes if supplements are included. No data are yet available on the most recent version, ASA24-2016, but based on improvements in the new version, shorter times for recalls including supplements are expected.

Protocol:

The National Cancer Institute (NCI) has developed a Self-Administered Automated 24-hour Dietary Recall (ASA24) for use in large-scale nutrition research studies. The format and design of the ASA24 are modeled on the interviewer-administered Automated Multiple Pass Method (AMPM) 24-hour Recall developed by the U.S. Department of Agriculture (USDA). For ASA24-2016, this method was further adapted to add an option for researchers to collect food records. Both recalls and records require multilevel food probes to accurately assess food types and amounts. This tool consists of a Respondent Website (English and Spanish), where data are collected, and a Researcher Website to manage study logistics and obtain analyses.

The ASA24 software is programmed with a food database that includes all foods and beverages available from USDA’s Food and Nutrient Database for Dietary Studies (FNDDS) and Food Pyramid Equivalents (FPED) databases, and all dietary supplements available in the National Health and Nutrition Examination Survey (NHANES) Dietary Supplement Database (DSD). In addition, the software includes pictures of foods in multiple portion sizes to help respondents estimate portion size. This ASA24 system incorporates a branching database that allows questions and possible responses to be displayed on the screen for respondent selection. The steps in the interview process include a Meal-based Quick List, Meal Gap Review, Detail Pass, Forgotten Foods, Final Review, Last Chance, and Usual Intake Question. Researchers also have an option to include reminders to report dietary supplements.

The Respondent Website:

  • Provides visual cues to instruct participants and enhance use in low-literacy populations (with options to turn off help tips);
  • Asks respondents to report eating occasion and time of consumption;
  • Includes optional modules to query where meals were eaten, whether meals were eaten alone or with others, television and computer use during meals, and source where foods/beverages were obtained;
  • Flows as per modified USDA Automated Multiple-Pass Method (AMPM) 24-hour recall for both recalls and records;
  • Allows respondents to report foods and drinks by searching from a list of food and drink terms derived from the National Health and Nutrition Examination Survey (NHANES). Search results can be filtered by food group;
  • Asks detailed questions about food preparation, portion size, and additions so that food codes from USDA’s Food and Nutrient Database for Dietary Studies (FNDDS), USDA’s Food Pyramid Equivalents Database (FPED), and the NHANES Dietary Supplement Database (DSDB) can be assigned;
  • Uses images to assist respondents in reporting portion size;
  • Allows the respondent to add or modify food and drink choices at multiple points during the interview;
  • Includes an option to report dietary supplement intake in-line with foods based on supplements reported in the NHANES;
  • Includes a Canadian and children’s version with an Australian version to be released in 2016;
  • Is available in English and Spanish (U.S. versions); and
  • Is accessible by individuals with speech and hearing impairments.

The Researcher Website allows researchers, clinicians, and teachers to register a study, set study parameters, manage study logistics, and obtain dietary analyses. The Researcher Website:

For recalls and records:

  • Allows researchers to add their own opening and closing text scripts and study logo for use on the Respondent Website;
  • Enables researchers to monitor study progress and to obtain a variety of reports, including statistics for complete, incomplete, and upcoming recalls or records for each participant; and
  • By late 2016, will allow researchers to provide tailored Respondent Reports of food and nutrient intakes to Respondents.

For recalls only:

  • Allows researchers the option to have participants complete a recall in one sitting (with breaks of no more than 30 minutes) or over a longer specified time interval;
  • Allows researchers the option to collect recalls for the previous day from midnight to midnight or for the past 24-hours from time of login;
  • Produces individual-level nutrient estimates for each food and daily totals based on the USDA’s 2011-12 Food and Nutrient Database for Dietary Surveys (FNDDS), food group estimates based on USDA’s 2011-12 Food Pyramid Equivalents Database (FPED), and NHANES 2011-12 Dietary Supplement Database (DSD). Versions of ASA24 prior to ASA24-2016 use older versions of these databases. These data can be analyzed by researchers or used to provide reports to respondents.

For records only:

  • Allows researchers to collect consecutive or nonconsecutive-day records
  • Allows researchers to collect any number of record days

Additional information:

NCI is currently providing the ASA24 at no cost to researchers and clinicians. Costs that might be incurred by researchers are systems and labor costs associated with providing participant IDs, dates to complete, and other information to NCI as well as costs associated with contacting participants to complete the ASA24.

To formally evaluate the impact of the change in mode of administration from the interviewer-administered AMPM 24-hour recall to a self-administered web-based recall, two studies were conducted using ASA24-2011:

One large study of healthy individuals in a variety of geographic regions compared the nutrient, food group, and supplement intake estimates from respondents completing ASA24 to those completing a standardized AMPM interviewer-administered recall.

  • Findings indicate comparability between the ASA24 system and AMPM in reported intakes and response rates, and that respondents prefer ASA24 system over AMPM.
  • Another manuscript from this study assesses comparability of reported dietary supplement usage between AMPM and ASA24 system. Findings also indicate comparability. This manuscript is under review.
  • Findings regarding the impact of default coding of free text options in the ASA24 system found that, in large studies, default coding led to intake estimates similar to those when free text was edited to fix inconsistencies.

Thompson, F. E., Dixit-Joshi, S., Potischman, N., Dodd, K. W., Kirkpatrick, S. I., Kushi, L. H., Alexander, G. L., Coleman, L. A., Zimmerman, T. P., Sundaram, M. E., Clancy, H. A., Groesbeck, M., Douglass, D., George, S. M., Schap, T. E., & Subar, A. F. (2015). Comparison of interviewer-administered and automated self-administered 24-hour dietary recalls (ASA24) in three diverse integrated health systems. American Journal of Epidemiology, 181(12), 970-978.

Zimmerman, T. P., Potischman, N., Douglass, D., Dixit-Joshia, S., Kirkpatrick, S. I., Subar, A. F., McNutt, S., Coleman, L. A., Alexander, G. L., Kushi, L. H., & Thompson, F. E. (2015). The effect of editing open-ended text responses on nutrient and food group estimates from the Automated Self-Administered 24-Hour Dietary Recall (ASA24). Procedia Food Science, 4, 160-172.

In a second smaller study, investigators unobtrusively documented food intakes of respondents randomly assigned to one of two groups. One group completed a recall using the ASA24 system and the second group completed a standardized AMPM interviewer-administered recall. Analyses considered how each of these recalls performed relative to true intake.

  • The AMPM performed slightly better than the ASA24 system relative to true intake for matches (the proportion of items consumed that were reported), exclusions (foods consumed but not reported), and intrusions (food reported but not consumed). There was little evidence of differences between the AMPM and the ASA24 system in true and reported energy, nutrient, and food group intakes or portion sizes. Overall, the ASA24 system performed well and comparably to the AMPM.

Kirkpatrick, S. I., Douglass, D., Zimmerman, T. P., Thompson, F. E., Subar, A. F., Kahle, L. L., George, S. M., Dodd, K. W., & Potischman, N. (2014). The Automated Self-Administered 24-hour Recall (ASA24) performs well relative to a measure of true intakes and to an interviewer-administered 24-hour recall. American Journal of Clinical Nutrition, 100, 233-240.

Additional information about the ASA24, including sample analysis files and data dictionaries, can be found on researcher link of the National Cancer Institute, ASA24 website: http://epi.grants.cancer.gov/asa24/.

ASA24® is a registered trademark of the U.S. Department of Health and Human Services.

Protocol Name from Source:

National Cancer Institute, Epidemiology and Genomics Research Program. (2016). Automated Self-administered 24-hour Dietary Recall (ASA24). Bethesda, MD: Author.

Availability:

Publicly available

Personnel and Training Required

None

Equipment Needs

Respondent Website:

  • Has been designed to be a lightweight application requiring minimum memory usage, local storage, and no long term storage;
  • Is a highly dynamic application that relies on a high speed, reliable internet connection to communicate with the host server; and
  • Is an HTML5 application and can run in any HTML5 capable browser used on a desktop, tablet, or smartphone. The latest versions of Google Chrome and Firefox (both freely available online), as well as Safari and Internet Explorer/Edge, are compatible.

Researcher Website:

  • High-speed internet connection;
  • Monitor size of at least 10" (greater than 13" is recommended); and
  • Flash Player 10.

Requirements
Requirement CategoryRequired
Major equipment Yes
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual Yes
Mode of Administration

Self-administered questionnaire

Life Stage:

Infant, Toddler, Child, Adolescent, Adult, Senior

Participants:

Ages 18 and older

Specific Instructions:

The Working Group recommends that at least two 24-hour recalls be administered more than a week apart: one on a weekday, and one on a weekend day.

Selection Rationale

A 24-hour dietary recall has been found to be more reliable than food frequency questionnaires and more versatile across a variety of populations. Food records are useful for modifying dietary behaviors in interventions.

Language

English, Spanish, soon to be in French Canadian for the Canadian adaptation of the Automated Self-administered 24-hour Recall (ASA24-Canada-2016)

Standards
StandardNameIDSource
Common Data Elements (CDE) Nutrition Automatic Self-Administered 24 hours Dietary Recall Questionnaire 6132556 CDE Browser
Derived Variables

None

Process and Review

The Expert Review Panel #1 (ERP1) reviewed the measures in the Anthropometrics, Diabetes, Physical Activity and Physical Fitness, and Nutrition and Dietary Supplements domains.

Guidance from ERP 2 includes:

• Updated protocol

• New Data Dictionary (see ASA24 website)

Back-compatible: there are changes to the Data Dictionary, previous version of the Data Dictionary is available at the ASA24 website

Source

Ingwersen, L., Raper, N., Anand, J., & Moshfegh, A. (2004). Validation study shows importance of probing for forgotten foods during a dietary recall [abstract]. Journal of the American Dietetic Association, 104(Suppl. 2), A-13.

National Cancer Institute. Epidemiology and Genomics Research Program Automated Self-administered 24-hour Recall (ASA24). http://epi.grants.cancer.gov/asa24/.

National Cancer Institute. Dietary Assessment Primer. http://dietassessmentprimer.cancer.gov/

Thompson, F., & Subar, A. F. (2013). Dietary assessment methodology. In A. Coulston, C. Boushey, & M. G. Ferruzzi (Eds.), Nutrition in the prevention and treatment of disease (3rd ed.; pp. 5-46). San Diego, CA: Academic Press.

General References

National Cancer Institute. Dietary Assessment Primer. http://dietassessmentprimer.cancer.gov/

Thompson, F., & Subar, A. F. (2013). Dietary assessment methodology. In A. Coulston, C. Boushey, & M. G. Ferruzzi (Eds.), Nutrition in the prevention and treatment of disease (3rd ed.; pp. 5-46). San Diego, CA: Academic Press.

Protocol ID:

51202

Variables:
Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
Research Domain Information
Measure Name:

Total Dietary Intake

Release Date:

July 8, 2016

Definition

A measure to assess the foods and beverages consumed throughout the previous day (from midnight to midnight), the previous 24 hours (starting at time of login), or in real time (for one or multiple days).

Purpose

The 24-hour recall has long been regarded as the optimal methodology for collecting total dietary intake because it provides the highest quality and least biased dietary data for a single day. This method allows collection of detailed intake and portion sizes. Because the data collection occurs after consumption, this method does not affect an individual’s food choices on a given day.

Food records collected in real time can be used to effect change in intakes in dietary interventions; because participants know they are being observed, they tend to be compliant while reporting intakes.

Keywords

Nutrition and dietary supplements, Automated Self-administered 24-hour Dietary Recall, ASA24, dietary recall, public use