Twenty-four-hour recall overestimates the dietary intake of malnourished children.

Food intake and morbidity are the two main proximal determinants of childhood malnutrition. Intake is usually assessed through the 24-h recall method. Few studies, however, have evaluated the accuracy of this method; in particular, it is not known whether accuracy varies according to the child's nutritional status. The intake of 50 children (< 2 y old), of whom 25 were underweight (weight-for-age more than 2 SD below the National Center for Health Statistics reference), as evaluated through weighing of all foods (gold standard) and through recall. The overall intakes of energy, fat and protein were significantly greater according to the recall method than by weighing. The trend towards overestimation was more marked for malnourished children than for well-nourished children. The possibility of such bias should be taken into account in future studies.