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Accepted manuscript

The validity of parent-report dietary assessment tools for estimating young children’s intake of macronutrients and micronutrients: A systematic review

Published online by Cambridge University Press:  15 May 2026

Roberta Gomez Diaz Barreiro
Affiliation:
Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO
Fadia Chehadeh
Affiliation:
Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO
Bryce Alderson
Affiliation:
Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO
Greg Barbosa
Affiliation:
Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO
John Carey
Affiliation:
Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO
Catherine C. Cohen
Affiliation:
Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO
Celeste P. Connell
Affiliation:
Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO
Christopher Hollander
Affiliation:
Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO
Kameron J. Moding
Affiliation:
Department of Human Development & Family Science, Purdue University, West Lafayette, Indiana
Christi Piper
Affiliation:
Strauss Health Sciences Library, University of Colorado Anschutz Medical Campus, Aurora, Colorado
Alexandra Stamatoiu
Affiliation:
Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO
Cindy I. Zavala
Affiliation:
Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO
Traci A. Bekelman*
Affiliation:
Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO
*
Corresponding author: Traci Bekelman 1890 N. Revere Court, Ste 1002 - F426, Aurora, CO 80045. Email: Traci.Bekelman@cuanschutz.edu. 303-724-0185
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Abstract

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Obtaining accurate estimates of children’s dietary intake is important because these estimates are used to characterize diet-disease relationships and inform nutrition interventions. This systematic review synthesized findings from validation studies of dietary assessment tools for children (aged 1-10 years), in which parents were proxy-reporters. Database searches (Ovid Medline, Embase, Web of Science, Cochrane) in January 2026 for validation studies of dietary assessment tools used for estimating daily intake of macronutrients and micronutrients yielded 4,545 citations. Articles were uploaded to Covidence for screening. Sixty-six articles met the inclusion criteria. Median sample size was 103. Eighty-six percent of studies (n=57) validated a food frequency questionnaire; the remainder validated dietary recalls (11%, n=8) or food diaries (2%, n=1). Many studies (67%, n=44) used another parent-proxy report tool as the reference method. For most nutrients, over a quarter of the 66 studies failed to find a significant correlation between the assessment tool and reference method. Among the 69% of analyses that did show a significant correlation, the median correlation for each nutrient ranged from 0.37 to 0.40 for macronutrients and 0.29 to 0.55 for micronutrients. Studies were limited by lack of generalizability, use of reference methods prone to error, and misalignment between the assessment tool and reference method. Overall, this review found no correlation or low-to-moderate correlations between dietary assessments and the reference method. The studies had significant methodological limitations. Future studies should validate parent-proxy report dietary assessments against objective measures, such as biomarkers. The development of novel assessment tools may also be warranted.

Information

Type
Review Article
Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of The Nutrition Society