The impact of recipe disaggregation in the dietary surveys: results from a national food consumption survey in Saint Kitts and Nevis

Background and objectives: When assessing dietary intakes, individuals may report the consumption of single foods and beverages but also complex dishes or recipes. Although seen as necessary, it is not always the case that recipe disaggregation is performed in dietary surveys, and currently, no standardised methodology is available. This can potentially impact the amounts of reported food items and food grouping, and ultimately influence the dietary indicator of interest. The aim of the investigation was to assess the impact of recipe disaggregation in the recent national dietary survey in Saint Kitts and Nevis and provide recommendations for future assessments. Methods: Data collected in the first National Food Consumption survey in Saint Kitts and Nevis (2020) was used. A total of 1004 individuals provided information on their food intake obtained using 24-hour dietary recalls (24HDR) and 440 recipes were reported. Recipes were reported in single ingredients at the stage of data collection (n=65) but in most cases, a standard recipe without disaggregation was provided by the respondent (n=375). A simple and pragmatic recipe methodology was developed whereby only those recipes reported more than once during the study or those consumed in large amounts (defined as >;=500 grams) would be disaggregated. The procedure of recipe disaggregation comprised nine steps, including identification of recipes, ingredients, quantities, conversion factors, presence of apparent fluid, among others. Results: 78 standard recipes were disaggregated (21% of recipes). These recipes contributed to 15.2 percent of the total energy intake of the population while the remaining non-disaggregated dishes (n=297) contributed to 12.5 percent. The proportion of consumers across the different food groups increased dramatically for some food groups after recipe disaggregation, with the most remarkable difference for fats (6.9% before and 44.5% after), pulses (18.6% before and 49.2% after), and vegetables (49.9% before and 76.6% after). Consequently, the reported intakes were also impacted across the food groups. Conclusions: Recipes are an important source of food group intakes and their disaggregation should be carefully considered in dietary assessments. The methodology used in this investigation will be further refined in order to provide guidance for future surveys.