Comparison of an Automated Exit Survey with a Multi‐Pass Meal Recall Interview in Assessing Nutrient Intake of Undergraduates at a University Dining Hall
Authors: Slavin Margaret , Hauver Alexandra , Brennan Katelyn , Durant Lois , Best Amy 
Published: November 2023

The nutritional intake of undergraduate students in on‐campus dining facilities is of great interest, to witness and potentially influence eating habits by young adults early in their autonomous lives. However, current methods to measure nutrient intake during a single eating occasion in all‐you‐care‐to‐eat dining halls are limited to those which intrude on the eating experience and may influence food choices (i.e., observation or photographic food records) or require a trained interviewer, with subsequent data entry into nutrient analysis software. We developed an exit survey method utilizing an automated survey platform and electronic tablet devices to calculate nutrient intake of a single eating occasion. The survey asks students to report which foods they consumed at a single visit to the dining hall by selecting foods from the pre‐populated list of menu items and identifying their portion sizes.

The objective of this study was to compare the results of the automated exit survey (AES) with an exit interview (EI), using a multi‐pass food recall interview technique. Students exiting a single dining hall during the lunch hours were recruited to participate by a single interviewer. Forty‐two (42) participants completed the survey and interview (for one eating occasion) in random order, according to a random numbers table. Mean age was 19.4 ± 1.3 years across 31 females and 11 males. All protocols were approved by the University Institutional Research Board. Nutrient intake for both methods was calculated using self‐reported portion sizes and a custom database containing food composition data specific to the foods and recipes served in the dining hall. Intake of calories, total fat, saturated fat, protein, total carbohydrates, sugar, fiber, and sodium were analyzed.

The difference between the means of the two methods was evaluated for each nutrient by a one‐factor, two‐way t‐test (P < 0.05). For all 8 nutrients, no fixed bias was detected, as the mean difference between the two methods was not significantly different from 0. The potential for proportional bias was analyzed by ordinary least squares regression of the difference versus the average of the two methods, and fiber was the only nutrient to exhibit a slight proportional bias with a slope significantly different from 0, at −0.60. Bland‐Altman qualitative visual analysis suggests that sizable variation exists in differences between methods on an individual basis, which also agrees with the high standard deviations observed for most nutrients. For example, the results of the two methods differed on average by 23 calories, but the standard deviation was 505 calories. In conclusion, the automated exit survey method performs similarly to a multi‐pass meal recall interview for calculating the average intake of the 8 studied nutrients, but the survey may not be an appropriate tool on the individual level. The survey may be useful for monitoring the impact of nutritional interventions in the dining hall on the average nutrient intake of students.

Support or Funding Information

This research was funded by George Mason University's Provost Multidisciplinary Research Initiative.