Friday, September 9, 2011

Diet Records: A Note from the TEDDY Staff -- Part 1

On behalf of the TEDDY Staff, we want to thank everyone for all of the work you do to benefit this study. And we want to give you a special thank you for completing the 3-day Diet Records. Trust us, we understand that these can be tedious and labor-intensive. We know that they are always inconvenient, and often frustrating. And we want you to know that your work does not go unnoticed. We would like to take this opportunity to address some of the most common challenges involved in keeping the diet records.

I don’t know exactly how much my child ate!

First, we know that it is difficult to know for sure exactly how much a child eats. Many of us who work for TEDDY have children at home, too, so we see that not everything you give a child ends up in their mouth. We know that it is very difficult, for example, to estimate how much applesauce a child may have in their hair after a meal, and that you may not discover the ¼ cup of cheerios that mysteriously ended up in your child’s diaper until the next diaper change. All we can possibly ask from you as TEDDY parents is to give us your best estimate when it comes to the amount of food that your child ate. Of course, there will be some “human error” (as the scientific community puts it) involved with “self-reporting”, but this study is designed to accommodate that. Some of you may have no problem reconciling yourselves to this fact, but for the perfectionists out there, this may be a continued source of frustration. But please know that, from the standpoint of the study, estimates and “best guesses” are expected, and this will still provide us with the information that we need to reach important conclusions regarding the causes of diabetes.

What about daycare?

Second, we know that some of the meals that your child receives may be outside of your control. And not only that, you may not even have been present for some of the meals! By requesting two weekdays and one weekend day, we know that, for many of you, this requires getting information from daycares and schools. In fact, this is the idea. To get a really good picture of what your child eats, it makes sense to not only include the meals they get at home, but also the meals they eat away from home, especially if this is a regular part of their diet. A child’s diet is impacted greatly by who is offering them their meals, and a daycare may provide foods that are different than those you give your child at home. Some daycare providers do a wonderful job helping us with this portion of the study, and are even happy to be given the opportunity to participate in something they view as important. We have received feedback that giving a daycare provider some information about the study and what these diet records are helping to achieve may make them even more willing to help out. (How much information you share with your daycare provider is, of course, completely up to you.) Even the most enthusiastic daycare providers may need a little direction from you, at first, though. It is a good idea to tell them specifically what kinds of information we need. For example, tell them that we need to know how much of each food item your child ate, not just what was on the menu. They will feel less frustrated with the process if they know what is expected and can feel like they are doing a good job.

Other daycare providers, although they try to help, are unable to provide us with all of the details that we ask about. When reviewing your diet record, please know that we have to ask clarifying questions, but we expect that your knowledge of the meals that your child receives outside of your care will be limited. We never mind if you have to tell us, for example, that you don’t know how your child’s oatmeal was prepared because they ate that meal at daycare. We enter the diet records that you give us into a computer system that gives us very detailed information about the calories and nutrients a child receives throughout the day. Generally speaking, this computer system requires a great deal of detail regarding the type and preparation of foods in order to provide us with this kind of information, which is why we ask so many questions when we review the diet records. However, this computer system also has ways to accommodate some “unknowns”, meaning that meals eaten at daycare, even if you don’t know some of the specifics, can still provide us with very useful information. Foods eaten at a restaurant, or at a friend’s party, or any time when preparation details are not known, are entered in the same way.

The above post was written by a TEDDY staff member who is involved with the diet collection both locally and over all 6 TEDDY sites. Part 2 will be posted in a couple weeks.