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

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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.
dietary intake assessment, food security, fruit and vegetable intake, 24-hour recall, skin carotenoid, feasibility and Māori health, Māori Master's Thesis