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    Reliability of a Modified 24 h Dietary Recall and Veggie Meter to Assess Fruit and Vegetable Intake in New Zealand Children
    (MDPI (Basel, Switzerland), 2025-10-20) Patel VV; Perera TSH; Rush E; McArley S; Wham C; Rowlands DS; Witkowska AM
    Adequate intake of fruits and vegetables (F + V) supports healthy growth and development in children, yet many New Zealand children do not meet national dietary recommendations, and methods to evaluate intake require good reliability. Objectives: To establish the validity and reliability of a modified 24 h multiple pass recall (MPR) for evaluating F + V and carotenoid intakes in children aged 9–13 years. The reliability of the Veggie Meter® (VM®), a non-invasive reflection spectrometer to estimate skin carotenoid scores and derive blood carotenoid concentrations, was also examined. Methods: Thirty-two children (20 boys, 12 girls) completed three 24 h MPRs and parent-assisted weighed food diaries (WFDs) on randomised weekdays and weekends. Skin carotenoid scores were assessed using the VM®. The validity of the MPR was evaluated against WFDs using log-transformed Pearson correlations and mean x-axis bias. The reliability was assessed by the coefficient of variation (CV) and Pearson correlations. Results: Participants did not meet recommended F + V intakes (5–5.5 servings/day): MPR (mean fruit 1.3 servings/day; vegetables 2.0), WFD (fruit 1.3; vegetables 1.9). The MPR was a valid tool to estimate fruit and vegetable daily servings (combined-day Pearson coefficients > 0.71) with only trivial–small standardized mean bias-offset vs. WFD; however, the reliability was poor for the MPR-estimated carotenoid intake (CV 126%) and F + V intake. In contrast, the VM® was reliable (Pearson correlation 0.97–0.99) with low measurement error (CV 4.0–5.2%). Conclusions: The modified 24 h MPR was valid but unreliable for estimating F + V and carotenoid intake. The VM® demonstrated high reliability as a biomarker of skin carotenoid status in children.
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    The feasibility, validity and reliability of a modified 24-hour multiple pass dietary recall to assess fruit and vegetable intake in New Zealand children : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand
    (Massey University, 2025) Patel, Varshika Vrinda
    Background Adequate intake of fruits and vegetables (F/V) is crucial for children’s growth, development, and health. Despite this, many New Zealand children do not meet recommended F/V intake levels. The validity and reliability of a modified 24-hour multiple pass recall (MPR) and alternative tools such as the Veggie Meter® (VM®) for measuring skin-carotenoid scores (SCS) as a biomarker of F/V intake in children remain unexplored. Aims To establish the feasibility, validity and reliability of the modified 24-hour MPR for the evaluation of carotenoid and fruit and vegetable intake against weighed food diaries in 9 to 13–year–old school children living in Auckland. To estimate the reliability of the VM® as a tool to measure chronic skin carotenoid levels. Methods Thirty-two children (20 boys, 12 girls) participated in this study. Over a one-to-three week period, F/V intake was assessed using a modified 24-hour MPR (child-reported, weighed food diaries (parent-reported), and SCS measured by the VM®. Validity was evaluated by comparing the modified 24-hour MPR to weighed food diaries as the criterion. Reliability of the modified 24-hour MPR F/V servings were determined from raw arithmetic difference, while reliability of the modified 24-hour MPR carotenoid intake (μg/d) was expressed as a ratio. Inter-day reliability of the modified 24-hour MPR and the VM® SCS reliability were estimated using various metrics. Results Children did not meet recommended F/V intake levels based on both the modified 24-hour MPR (1.31 fruit serves; 2.00 vegetable serves) and weighed food diaries (1.26 fruit serves; 1.87 vegetable serves). Boys had higher F/V and carotenoid intakes, while girls had slightly higher SCS. The modified 24-hour MPR demonstrated significant bias and poor reliability for estimating F/V and carotenoid intake. In contrast, the VM® showed good reliability with low variability and excellent intraclass correlation coefficient (ICC). Conclusions The modified 24-hour MPR was valid but unreliable for measuring F/V intake in New Zealand children. The VM® was found to provide a reliable measure of carotenoid intake over a chronic time.
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    The feasibility of using an adapted 24-hour recall method versus skin carotenoids status to assess fruit and vegetable intake in low-income Māori households : a thesis presented for the partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand
    (Massey University, 2022) Young, Dana
    Background: High fruit and vegetables (F/V) intake have been repeatedly shown to decrease risk of developing obesity and non-communicable diseases. Māori people living in deprived areas are often experiencing some degree of food insecurity, which exposes this population to a greater nutritional risk due to lower F/V intake. There is currently no validated instrument to measure F/V intake in low-income Māori households. Finding a feasible dietary assessment tool will be helpful to determine nutritional status and consumption patterns; to assess the association between F/V and diseases; and to guide evaluation for food policies and programs in eliminating barriers to healthy eating. Aim: To assess the feasibility of an adapted 24-hour (24-h) recalls versus skin carotenoids status to assess F/V intake in low-income Māori households participating in a F/V intervention. Methods: This feasibility study was conducted in 12 Māori households living in Palmerston North, New Zealand. Intake of F/V were measured by a 24-h recall and skin carotenoid via Veggie Meter © (VM) on four randomised days during baseline, followed by a washout period of five weeks. The intervention study commenced with participants receiving a weekly free box of F/V (enough to feed the entire household according to guidelines). The same measurements were repeated. Feasibility of both instruments were analysed by Pearson and Spearman correlation. Significance was set as p <0.05. Results: There was no significant difference in the mean total F/V servings across the study. Median servings and intake of fruit were significantly different between baseline and endpoint (p = 0.05). Only one (8%) participant met the MoH daily recommendations of 5 servings of vegetables and 2 servings of fruits at baseline, and four participants (50%) at endpoint. Spearman’s rho correlation showed no association between VM scores and self-reported F/V intake (p = 0.50). A significant correlation was found between those with a ≥250 VM score and intake of yellow-vitamin-A F/V and F/V at baseline (p = 0.04) and intervention (p = 0.03). Conclusion: The developed multiple-pass 24-h recall was a feasible tool to assess F/V intake in low-income Māori income. To improve quality of data collection, more training and support for the research assistants is needed. Measuring skin carotenoids as a method to measure vitamin A F/V is feasible, but may not be the best to objectively measure F/V.