Feasibility study to explore the practicality of using a 3-day food diary to collect information on nutritional intake of people using a food bank.

Background:
Food insecurity is increasing in the UK and the charities have responded by creating food banks distributing food to vulnerable populations(1). There is a strong positive correlation between food insecurity and poor health outcomes(2) but there is a paucity of research regarding the nutritional intake of people using food banks(3). This study aimed to explore the practicality of using a 3-day food diary to obtain nutritional intake data from this population.
Methods:
The study design was a cross-sectional observation. Participants were recruited opportunistically from adults attending one food bank in a town in the East of England over seven consecutive weeks. The researcher invited participants; she was familiar with the food bank’s procedures but was not known to them. The study was explained to participants in a private area of the food bank and those agreeing to take part gave written consent. Their age, gender and ethnicity were recorded and they were asked to record all food, drink and any supplements consumed over two weekdays and one weekend day in a food diary. Written instructions, including illustrations, were also provided. The diary was adapted from the 4-day National Diet and Nutrition Survey Food and Drink Diary(4). The participants were contacted after two days and in the following four weeks to prompt completion and return their diary via freepost envelope provided. Ethics approval was granted.
Results:
Fourteen people who were receiving food from the food bank were invited to take part. Two declined; two appeared not to understand its purpose; seven men and four women consented. Their self-identified ethnicity included one Asian, two Black, six White and two Other. Their ages ranged between 23-58 years. No completed diaries were received following reminders. Some participants spontaneously offered reasons why they could not complete the diaries although they were not obliged to do so (Table).
Table - Reasons given spontaneously for incompletion of food diary
Participant did not have time
Participant lost the original diary when they moved to a new house
Participant’s electricity had been cut off. They had no food in cupboard and expressed that they could not do anything at that time
Participant started a new job
Discussion:
Food diaries are often used to collect information for nutritional analysis. However, this method limited participation in the present novel study. Although enthusiastic at recruitment, participant feedback indicates that life circumstances contributed to withdrawal from the study. Other studies have reported that ‘hard to reach’ populations engaged with repeated 24-hour recalls, incentives and regular contact(5). Food frequency questionnaires may also provide useful information but they require validation for use in this population in the UK.
Conclusion:
This study found that a 3-day food diary was not a useful method for collecting nutritional intake data from people using a food bank.
References:
1 Dowler EA, O’Connor D (2012) Rights-based approaches to addressing food poverty and food insecurity in Ireland and UK. Soc. Sci. Med. 74:44-51.
2 Gregory CA et al (2017) Food insecurity, chronic disease, and health among working-age adults. Retrieved 8 July 2018 from: https://www.ers.usda.gov/publications/pub-details/?pubid=84466.
3 Simmet A, Depa J, Tinnemann P et al. (2017) The Dietary Quality of Food Pantry Users: A Systematic Review of Existing Literature.J Acad Nutr Diet. 117:563-576.
4 Medical Research Council Collaborative Centre for Human Nutrition Research (MRC-HNR) (2008) National diet and nutrition survey: food and drink diary. Retrieved 8 July 2018 from http://dapa-toolkit.mrc.ac.uk/pdf/Diet/Food%20Diaries/Food_diary_Adults_A5_v3_Q4.pdf
5 Buscemi J, Blumstein L, Kong A et al. (2015) Retaining traditionally hard to reach participants: Lessons learned from three childhood obesity studies. Contemp. Clin. Trials 42:98-104.