The assessment level of fluoride intake/exposure using “3-day dietary diary” & “2-day duplicate” methods

  • Narges Omid

    Student thesis: Doctoral Thesis


    Background: Studies of assessing dietary fluoride intake in children have employed different dietary methods mainly “2-day duplicate” and “3-day food diary” methods. However, none of these methods have been validated or standardised. Main aims: The main aims of the current study were to develop a better understanding of strengths and weaknesses of dietary assessment methods “2-day duplicate plate” and “3-day food diary” by comparing dietary fluoride intake estimated by each method and evaluate the validity of the two methods for estimating dietary fluoride intake in young children. Methods: Sixty one healthy 4-6 year old children living in fluoridated area of the north-east of England since birth were recruited via 10 primary schools. Dietary information was collected using “2-day duplicate plate” and “3-day food diary” methods. Two 24-h urine samples and two samples of post brushing expectorate (a mixture of saliva, toothpaste and water used to rinse after brushing) from each child. Completeness of 24-h urine samples was checked using urinary excretion of creatinine and urinary flow rate. Validity of the two dietary assessment methods was checked by measuring urinary excretion of nitrogen and potassium as independent validity checks. Total daily fluoride intake from diet and toothpaste ingestion and urinary fluoride excretion was determined for each child. Results: All participated children completed all aspects of the study. According to the validity criteria, dietary data of 58 (95%) children, when collected by the 3-day food diary, were considered valid. However, when the dietary data were collected by the 2-day duplicate plate method, the data for 46 (75%) children were viewed as valid. Mean total dietary fluoride intake was 0.533 mg/d by the 3-day food diary method and 0.583 mg/d by the 2-day duplicate plate method. No statistically significant difference in total dietary fluoride intake was observed between the two methods. The mean difference in estimated dietary fluoride intake by the two dietary assessment methods was -0.050 mg/d with 95% limits of agreement of -0.501 to + 0.401 mg/d. Conclusion: Either the 3-day food diary or the 2-day duplicate plate method can be used when investigating mean total daily dietary fluoride intake of a population. However the methods cannot be used interchangeably at the individual level.
    Date of Award26 Jun 2012
    Original languageEnglish
    Awarding Institution
    • Teesside University
    SupervisorVida Zohoori (Supervisor)

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