Do the Darned 24-Hour Recall

My Hero's Journey during the 24-Hour Dietary Recall

This week has been a lil cray cray (crazy) for more reasons than one, so I thought I’d share a reflective piece to showcase some ~creativity~. Also, because I don’t have time for research.

Let’s talk about my first experience with the 24-hour dietary recall.

um… what is a “24-hour dietary recall”?

Sorry, I lied. I did some research.

A 24-hr dietary recall is a research tool used to measure someone’s beverage and food intake in the past 24 hours. Why should we care? Here are a few reasons:

• People have terrible memories. Do you remember what you ate for lunch 2 days ago? I don’t. Do you remember how often you’ve eaten cheese in the past 5 months? Uh, no. The “24-hours,” albeit somewhat arbitrary, provides a clear window of time that people can focus their attention and memory recall, thus enhancing the accuracy of food measurement.

• To capture consumption patterns to chart an individual or population’s nutrient intake. If assessed at multiple time points, we can identify patterns in dietary changes (or not) and connect them to health outcomes.

• To personalize recommendations to address possible areas for dietary improvement and, thus, health.

the interface

Researchers utilize the loftily-named “National Data System for Research (NDSR)” for dietary recall. The software was developed at the Nutrition Coordinating Center in the University of Minnesota. It is also used to collect and analyze food records, menus, and recipes.

Trained interviewers ask a series of questions, prompted by the NDSR, to participants, while selecting the suggested food options to record responses. Once completed, the program immediately spits out the total food servings and nutrient breakdown and compares it to the national dietary guidelines. Then everyone is free to nerd out about the results🤓

Let’s be honest. A 24-hour dietary recall probably doesn’t make you leap for joy. Listing out the foods that you ate yesterday? Boring.

So I thought.

And yet after finishing my first recall a few months ago, I found that the experience was a combination of chaos, vulnerability, enlightenment, and motivation all wrapped into one.

Who would have thought the NDSR would trigger a character arc (see: Joseph Campbell’s Hero’s Journey)?

the call to adventure

I completed this NDSR exercise for a class assignment. All I knew going in was that I had to bring my laptop; I couldn’t even have told you what “NDSR” stood for. A senior research dietitian presented the four-step process:

1. Make a quick list -> rough outline of meals and foods consumed

2. Review quick list -> double check that everything was reported

3. Collect meal, food, and amount detail -> specify preparation methods and quantity

4. Review intake -> double check that everything was reported

The process of asking and double-checking is called a “multiple-pass approach.” It’s a method of asking, are you sure you’ve told us everything? Are you? ARE YOU?

Once the lady lulled us into a comfortable trance, she spoke the chilling words “NOW DO IT.” And with that, a wave of anxiety rolled through the class.

the road of trials

First, no one could log into the platform. It required an obscure ID that we received randomly in the summer and now needed 4 months later.

Second, no one could open the virtual desktop. Turns out there was a firewall, so we had to log in using an obscure WiFi network.

Third, upon completion, I couldn’t figure out how to save the data. The professor joined, we exited the site, I thought I lost our data, internal turmoil, my partner confused, and… oh thank goodness the data saved!

the temptation

Upon seeing my results, I had a flurry of thoughts: I could have eaten more fruits and vegetables. I clearly love rice. Also, whoa, I ate 3x the amount of recommended sodium??

Though tempting to see the results as a “report card,” I also found that they made my food specific, objective, and tangible; a helpful measure of my dietary reality (as long as I stayed honest!).

In placing the foods within a larger 24-hour context, I realized that eating the KitKat was fine! And comparing my actual intake to the nutrition guidelines was kind of fun. I could see the areas where I struggled, which highlighted the importance of extending grace towards myself and to my future patients.

It also prompted me to think about how I could take action afterwards. Specifically, maybe changing my soy sauce use to reduce sodium (cries in Chinese) or to eat an apple when I get home. To me, these little changes seem worthwhile so I can increase my chances of living to play with my grandchildren :)

the ultimate reward

For me, the biggest value-add of the 24-hour recall was the fact that I got to sit down and think about the who, what, where, when, why, and how of my eating habits.

While I don’t expect to go through the recall often (not gonna lie, it felt so long), the NDSR created an opportunity for serious reflection of what I often take for granted. It expanded my perspective from not just what I eat, but also how I prepare it, where I eat it, and more.

It also provided a moment to see my habits as they really are, lifting the veil that is the mental gymnastics and vagueness of saying “I eat healthy.”

On a larger scale, this process opened my eyes to my lack of reflection in other areas of life. How often do I take my walk to the bus for granted? How about when fold my laundry? Or when I lie on the floor of my apartment? When we stop to turn these experiences over in our minds, we can draw inspiration and change for the better, whether it is for our health, for our kids and community, or for our personal growth. These liminal moments add up to make the majority of our lives, and so they warrant our attention.

So, whether with diet, laundry, or driving to work, I’d encourage that we all sit down and do the darned 24-hour recall.

P.S. If you’re curious about my NDSR results, you can check them out by clicking below!

NDSR Results

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