Context: Overestimation or underestimation of portion size leads to measurement error during dietary assessment.Objective: To identify portion size estimation elements (PSEEs) and evaluate their relative efficacy in relation to dietary assessment, and assess the quality of studies validating PSEEs.Data Selection and Extraction: Electronic databases, internet sites, and cross-references of published records were searched, generating 16 801 initial records, from which 334 records were reviewed and 542 PSEEs were identified, comprising 5% 1-dimensional tools (eg, food guides), 46% 2-dimensional tools (eg, photographic atlases), and 49% 3-dimensional tools (eg, household utensils). Out of 334 studies, 21 validated a PSEE (compared PSEE to actual food amounts) and 13 compared PSEEs with other PSEEs.Conclusion: Quality assessment showed that only a few validation studies were of high quality. According to the findings of validation and comparison studies, food image–based PSEEs were more accurate than food models and household utensils. Key factors to consider when selecting a PSEE include efficiency of the PSEE and its applicability to targeted settings and populations.

Monitoring dietary intake of sugars in the population’s diet has great importance in evaluating the efficiency of national sugar reduction programmes. The study objective was to provide a comprehensive assessment of dietary sources of added and free sugars to assess adherence to public health recommendations in the UK population and to consider the impact of different sugar definitions on monitoring. The terms “added sugar” and “free sugar” are different sugar definitions which include different sugar components and may result in different sugar intakes depending on the definition. Dietary intake of added sugars, free sugars and seven individual sugar components (sugar from table sugar; other sugars; honey; fruit juice; fruit puree; dried fruit; and stewed fruit) of 2138 males and females (1.5–64 years) from the National Diet and Nutrition Survey (NDNS) 2014–2016, collected using a 4 day estimated food diary, were studied. Added and free sugar intake accounted for 7% to 13% of total energy intake respectively. Major sources of free sugar intake were “cereals and cereal products”, “non-alcoholic beverages”, and “sugars, preserves, confectionery”. Differences between added and free sugar intake were significantly large, and thus use of free sugar versus added sugar definitions need careful consideration for standardised monitoring of sugar intake in relation to public health.

The UK National Diet and Nutrition Survey rolling programme (NDNS RP) commenced in 2008 and moved in 2019 from a traditional paper food diary to a web-based 24 h recall, Intake24. This paper describes the approach to update and downsize the underlying UK Nutrient Databank (NDB) for efficient data management and integration into Intake24. Consumption data from the first 10 years (2008/2009 to 2017/2018) of NDNS RP informed decisions on whether foods from the extensive UK NDB were to be retained, excluded, revised or added to for creation of a rationalised NDB. Overall, 5933 food codes in the extensive NDB were reduced to 2481 food codes in the rationalised NDB. Impact on assessment of nutrient intakes was evaluated by re-coding NDNS 2017 data using the rationalised NDB. Small differences were observed between estimated intakes (Cohen’s d ≤ 0.1) for all nutrients and there was a good level of agreement (Cohen’s κ ≥ 0.6) between the extensive and rationalised NDBs. The evaluation provides confidence in dietary intake estimates for ongoing nutritional surveillance in the UK and strengthens the evidence of a good agreement between concise food databases and large food databases incorporated into web-based 24 h recalls for estimating nutrient intakes at the population level.

Uncertainty remains about the composition of contemporary plant-based diets and whether they provide recommended nutrient intakes. We established Feeding the Future (FEED), an up-to-date online cohort of UK adults following different plant-based diets and diets containing meat and fish. We recruited 6342 participants aged 18–99 [omnivores (1562), flexitarians (1349), pescatarians (568), vegetarians (1292), and vegans (1571)] between February 2022 and December 2023, and measured diet using a food frequency questionnaire and free text. We compared personal characteristics and dietary intakes between diet groups and assessed compliance with dietary guidelines. Most participants met UK dietary recommendations for fruit and vegetables, sodium, and protein, although protein intakes were lowest among vegetarians and vegans. Omnivores did not meet the fibre recommendation and only vegans met the saturated fat recommendation. All diet groups exceeded the free sugars recommendation. Higher proportions of vegetarians and vegans were below the estimated average requirements (EARs) for zinc, iodine, selenium, and, in vegans, vitamins A and B12, whereas calcium intakes were similar across the diet groups. People following plant-based diets showed good compliance with most dietary targets, and their risk for inadequate intakes of certain nutrients might be mitigated by improved dietary choices and/or food fortification.