1
|
Oliveira GAL, Barrio DOL, Araújo GS, Saldanha MP, Schincaglia RM, Gubert MB, Toral N. Validation of the illustrated questionnaire on food consumption for Brazilian schoolchildren (QUACEB) for 6- to 10-year-old children. Front Public Health 2023; 11:1051499. [PMID: 37808993 PMCID: PMC10559973 DOI: 10.3389/fpubh.2023.1051499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 08/24/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Evaluating the food consumption of school-aged children is crucial to monitor their dietary habits, promote targeted interventions, and contribute public policies that aimed healthy eating. In this context, our objective was to develop and validate the Illustrated Questionnaire on Food Consumption for Brazilian Schoolchildren (QUACEB) of 6 to 10 years old, which is a self-reported illustrated recall. Methods Validity was obtained in four stages as follows: selection of foods, validation of items, validation of illustrations, and pretest. Foods were selected by considering the data from the main surveys that have been conducted with the Brazilian population and schoolchildren in recent years, the degree of food processing, and the main foods from each of the country's five macroregions. The content of the items was validated by comparing the children's and their parent's responses. For this, the questionnaire was published in an online format, and 6- to 10-year-old elementary schoolchildren were recruited using the snowball technique. The first part of the questionnaire was answered by the parent after the child's lunch, and the second was completed by the child the following day. Thirty-two parent and child dyads participated. Sensitivity, specificity, area under the curve (AUC), and kappa (k) tests were performed. Results Of the 30 foods presented on the questionnaire, 15 were reported as consumed. High sensitivity (mean of 88.5%), high specificity (average of 92.0%), substantial agreement (k = 0.78), low disagreement (6.2%), and AUC of 0.90 were found. The illustrations were validated in a focus group with fourth-grade children from a school chosen for convenience. The food illustrations were designed for children, who were asked to name the food. Eighteen children participated and verified that the images were representative of the foods. In the pretest, three schools were chosen for convenience that announced the link to the online questionnaire in WhatsApp groups of parents with students from first to fifth grade. Fifteen children answered the questionnaire and 86.7% (n = 13) judged it excellent or good. Conclusion Thus, the food consumption questionnaire is valid for elementary schoolchildren of 6 to 10 years old and can be applied in research to assess the dietary patterns of children in Brazil.
Collapse
Affiliation(s)
- Giovanna Angela Leonel Oliveira
- Graduate Program in Human Nutrition, Faculty of Health Science, Center for Epidemiological Studies in Health and Nutrition (NESNUT), University of Brasilia, Brasilia, Brazil
| | - Daniela Oliveira Llorente Barrio
- Department of Nutrition, Faculty of Health Science, Center for Epidemiological Studies in Health and Nutrition (NESNUT), University of Brasilia, Brasilia, Brazil
| | - Giovanna Soutinho Araújo
- Graduate Program in Human Nutrition, Faculty of Health Science, Center for Epidemiological Studies in Health and Nutrition (NESNUT), University of Brasilia, Brasilia, Brazil
| | - Marina Pimentel Saldanha
- Department of Nutrition, Faculty of Health Science, Center for Epidemiological Studies in Health and Nutrition (NESNUT), University of Brasilia, Brasilia, Brazil
| | | | - Muriel Bauermann Gubert
- Graduate Program in Human Nutrition, Faculty of Health Science, Center for Epidemiological Studies in Health and Nutrition (NESNUT), University of Brasilia, Brasilia, Brazil
- Department of Nutrition, Faculty of Health Science, Center for Epidemiological Studies in Health and Nutrition (NESNUT), University of Brasilia, Brasilia, Brazil
| | - Natacha Toral
- Graduate Program in Human Nutrition, Faculty of Health Science, Center for Epidemiological Studies in Health and Nutrition (NESNUT), University of Brasilia, Brasilia, Brazil
- Department of Nutrition, Faculty of Health Science, Center for Epidemiological Studies in Health and Nutrition (NESNUT), University of Brasilia, Brasilia, Brazil
| |
Collapse
|
2
|
Sugianto R, Chan MJ, Wong SF, Shek LPC, Tan KH, Chong YS, Godfrey KM, Tai BC, Chong MFF. Evaluation of a Quantitative Food Frequency Questionnaire for 5-Year-Old Children in an Asian Population. J Acad Nutr Diet 2019; 120:437-444. [PMID: 31866358 DOI: 10.1016/j.jand.2019.09.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 09/26/2019] [Indexed: 01/27/2023]
Abstract
BACKGROUND Food frequency questionnaires (FFQs) are often used to assess dietary intakes due to their ability to assess intake over extended periods, their low respondent burden, and their cost-effectiveness. A quantitative FFQ that includes locally appropriate food items for 5-year-old children in a multiethnic Asian population was developed, but its validity has not previously been evaluated. OBJECTIVE To evaluate the relative validity of a newly developed FFQ as a dietary assessment tool for 5-year-old children in a multiethnic Asian population. DESIGN The 112 -food item FFQ was administered by trained interviewers to caregivers of children. Frequency of food items consumed in the previous month and portion size information were collected. The FFQs were evaluated against 3-day nonweighed diet records (DRs) completed by caregivers. PARTICIPANTS/SETTING The dietary data of 361 children aged 5 years from the Growing Up in Singapore Towards Healthy Outcomes mother-offspring cohort were collected in 2015-2016. MAIN OUTCOME MEASURES Nutrients of interest included energy, macronutrients, fiber, cholesterol, vitamin A, beta carotene, calcium, and iron, calculated from the FFQs and DRs. STATISTICAL ANALYSES PERFORMED Nutrient intakes according to FFQs in relation to DRs were assessed using Pearson's correlation, Lin's concordance, Bland-Altman plots, quintile joint classification, and Cohen's κ statistics. RESULTS The highest energy-adjusted correlation (Pearson's r=0.71) and concordance (Lin's concordance=0.69) were observed for calcium. Fiber, saturated fat, polyunsaturated fatty acids (PUFA), cholesterol, and iron also showed correlation coefficients and concordance of at least 0.40. Bland-Altman plots suggested no substantial bias across ranges of intakes for the nutrients with correlations and concordance of 0.40 or above. Quintiles joint classification showed substantial agreement for calcium (κ=0.66), and moderate agreement for iron, fiber, saturated fat, polyunsaturated fat, and beta carotene (κ=0.59, 0.54, 0.49, 0.44, 0.43, respectively). CONCLUSIONS The newly developed FFQ is in reasonable agreement with DR for estimating intakes of calcium, fiber, saturated fat, PUFA, cholesterol, and iron. In addition, the FFQ is able to classify children according to quintiles of nutrient intakes, with moderate to substantial quintile agreements between FFQ and DR for calcium, iron, fiber, saturated fat, PUFA, and beta carotene. To assess the remaining nutrients, DR method is recommended instead of the FFQ.
Collapse
|
3
|
Reproducibility and Validity of a Short Food Frequency Questionnaire for Dietary Assessment in Children Aged 7⁻9 Years in Spain. Nutrients 2019; 11:nu11040933. [PMID: 31027207 PMCID: PMC6521299 DOI: 10.3390/nu11040933] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 04/17/2019] [Accepted: 04/23/2019] [Indexed: 12/17/2022] Open
Abstract
The purpose of this study was to examine if the short semi-quantitative food frequency questionnaire (FFQ) is a reliable and valid tool to assess the diet of Spanish children aged 7-9 years. We collected data from 156 children of the birth cohort INMA (Infancia y Medio Ambiente (Environment and Childhood)). Children's parents or care-givers completed a 46-item FFQ on two occasions over a 9-12-month period about the children's diet. To explore the reproducibility of the FFQ, the nutrient and food group intake collected from the both FFQs were compared, while validity was examined by contrasting the nutrient values from the FFQs and the average of three 24-hour dietary recalls (24hDRs) taken in this period, and also with the concentration of several vitamins in the blood (carotenoids, vitamin D and α-tocopherol). Pearson and de-attenuated correlation coefficients were calculated. The average correlation coefficients for nutrient intake's reproducibility was 0.41, ranging from 0.25 (calcium) to 0.65 (β-carotene), and for food group intake was 0.45, ranging from 0.18 (cereals) to 0.68 (sweetened beverages). Correlation coefficients slightly improved when we compared energy-adjusted intakes. The average correlation coefficients for validity against 24hDRs was 0.34 for energy-adjusted intakes, and 0.39 when de-attenuation coefficients were used. The validity coefficients against the blood concentrations of vitamins were 0.38 for β-cryptoxanthin, 0.26 for lycopene, 0,23 for α-carotene and 0.15 for β-carotene, all of them statistically significant (p < 0.05). This study suggests that our brief FFQ is a suitable tool for the dietary assessment of a wide range of nutrients and food groups in children 7-9 years, despite the low to moderate reproducibility and validity observed for some nutrients.
Collapse
|
4
|
Horiuchi Y, Kusama K, Sar K, Yoshiike N. Development and validation of a food frequency questionnaire (FFQ) for assessing dietary macronutrients and calcium intake in Cambodian school-aged children. Nutr J 2019; 18:11. [PMID: 30791913 PMCID: PMC6385409 DOI: 10.1186/s12937-019-0437-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 02/15/2019] [Indexed: 11/10/2022] Open
Abstract
Background The nutritional status of school-aged children in Cambodia remains largely unknown. No tools for large-scale assessment of daily nutrient intake exist for this population, making development of appropriate intervention strategies difficult. Thus, we aimed to devise and validate a food frequency questionnaire (FFQ) that is suitable for and dedicated to assessing the dietary intake of macronutrients and calcium in school-aged children in Cambodia. Methods We developed an FFQ based on data from a single 24-h recall survey of 2020 children. The final list, which was developed as specified in the Block method and stepwise multiple regression analysis, comprised of 56 food items covering intake of energy, macronutrients, and calcium. We assessed the validity of the FFQ by comparison with a duplicated 24-h recall survey before and after de-attenuation. We also tested the reproducibility by comparing the first and second FFQs (FFQ1 and FFQ2) administered at an interval of approximately 6 weeks. Results The 56 food items in the FFQ accounted for 73.3% of the dietary calcium intake of Cambodian children and explained most of the inter-individual variation (cumulative R2: 0.96). The intake estimated by the FFQ was lower than the average intake across the two 24-h recall surveys. Spearman’s correlation coefficients for comparison between FFQ1 and FFQ2 ranged from 0.29 for fat to 0.47 for calcium. After de-attenuation of data, Pearson’s correlation coefficients ranged from 0.38 for fat to 0.71 for energy. Cross-classification analysis indicated that the average percentage of the subjects classified in the same or adjacent quartiles was 78.0%. Conclusions The FFQ is potentially a reliable scale for measuring nutrient intake in this population.
Collapse
Affiliation(s)
- Yoko Horiuchi
- Graduate School of Health Sciences, Aomori University of Health and Welfare, 58-1 Mase, Hamadate, Aomori City, Aomori, 030-8505, Japan.
| | - Kaoru Kusama
- Department of Food and Health Sciences, Faculty of Health and Human Development, The University of Nagano, 8-49-7 Miwa, Nagano City, Nagano, 380-8525, Japan
| | - Kanha Sar
- Strengthening Public Health Laboratory, Workforce Development, and Health Systems Research Capacity of the Cambodian National Institute of Public Health, Lot #80, St. Samdach Penn Nouth Blvd (289), Boeung Kok 2 commnue, Toul Kork district, Phnom Penh, 12152, Cambodia
| | - Nobuo Yoshiike
- Graduate School of Health Sciences, Aomori University of Health and Welfare, 58-1 Mase, Hamadate, Aomori City, Aomori, 030-8505, Japan
| |
Collapse
|
5
|
Relative Validity and Reproducibility of a Food Frequency Questionnaire to Assess Nutrients and Food Groups of Relevance to the Gut Microbiota in Young Children. Nutrients 2018; 10:nu10111627. [PMID: 30400145 PMCID: PMC6266661 DOI: 10.3390/nu10111627] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 10/19/2018] [Accepted: 10/22/2018] [Indexed: 01/28/2023] Open
Abstract
Dietary fiber is an important nutrient for the gut microbiota, with different fiber fractions having different effects. The aim of this study was to determine the relative validity and reproducibility of a food frequency questionnaire (EAT5 FFQ) for measuring intake of fiber, and low and high fiber foods, in studies examining diet and gut microbiota in young children. One hundred parents of 5-year old children completed the 123-item EAT5 FFQ on two occasions four weeks apart. A 3-day weighed diet record (WDR) was completed on non-consecutive days between FFQ appointments. Mean correlations between the (randomly chosen) FFQ and WDR were acceptable for nutrient and food group intakes (r = 0.34 and r = 0.41 respectively). Gross misclassification was below chance (12.5%) for quartiles of nutrient (mean 5.7%) and food group (mean 5.1%) intake. ‘Absolute values for surrogate categories’ suggested the FFQ clearly differentiated between highest and lowest quartiles for all nutrients and food groups tested. Mean correlations between repeat administrations of the FFQ suggested very good reproducibility for nutrients (r = 0.83) and food groups (r = 0.80). The EAT5 FFQ appears to be an appropriate tool for investigating the intake of nutrients and food groups of relevance to the gut microbiota, and is the first FFQ validated to measure total, soluble and insoluble non-starch polysaccharide intakes in young children.
Collapse
|
6
|
Dos Santos Rocha A, de Cássia Ribeiro-Silva R, Nunes de Oliveira Costa G, Alexandrina Figueiredo C, Cunha Rodrigues L, Maria Alvim Matos S, Leovigildo Fiaccone R, Oliveira PR, Alves-Santos NH, Blanton RE, Lima Barreto M. Food Consumption as a Modifier of the Association between LEPR Gene Variants and Excess Body Weight in Children and Adolescents: A Study of the SCAALA Cohort. Nutrients 2018; 10:E1117. [PMID: 30126176 PMCID: PMC6116060 DOI: 10.3390/nu10081117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/04/2018] [Accepted: 08/08/2018] [Indexed: 01/13/2023] Open
Abstract
No studies showing that food consumption is a modifier of the association of variants of the leptin receptor gene (LEPR) with body weight have involved a Brazilian population. The aim of this study was to evaluate the modifying effect of dietary intake on the association between the LEPR gene and excess weight. In this study, 1211 children and adolescents aged 4⁻11 years were assessed. Participants were genotyped for 112 single-nucleotide variants of the LEPR gene. Anthropometric measurements were performed, and dietary data were obtained. Logistic regressions were used to study the associations of interest. Of the participants, 13.4% were overweight/obese. The risk allele (G) of the rs1137100 variant was associated with excess weight in individuals with fat consumption below the median (odds ratio OR = 1.92; 95% confidence interval CI = 1.18⁻3.14), with daily frequency of consumption of drink/artificial juice (OR = 2.15; 95% CI = 1.26⁻3.68) and refined cereals (OR = 2.17; 95% CI = 1.31⁻3.62) above the median. The risk allele (G) of variant rs1177681 was also associated with excess weight (OR = 2.74; 95% CI = 1.65⁻4.57) in subjects with a daily frequency of refined cereal consumption above the median. The association between LEPR and excess weight can be modulated by the type and distribution of dietary fatty acids, sugary drinks, and refined cereals.
Collapse
Affiliation(s)
- Aline Dos Santos Rocha
- Departamento Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Av. Araújo Pinho, 32, Canela, CEP: 40.110-150, Salvador, BA Brasil.
| | - Rita de Cássia Ribeiro-Silva
- Departamento Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Av. Araújo Pinho, 32, Canela, CEP: 40.110-150, Salvador, BA Brasil.
| | - Gustavo Nunes de Oliveira Costa
- Instituto Gonçalo Moniz (IGM), Fundação Osvaldo Cruz-FIOCRUZ-Bahia, Av. Waldemar Falcão, 121, Candeal-Salvador/BA, CEP: 40296-710, Salvador, BA, Brasil.
- UNIFACS-Universidade Salvador, Laureate International Universities, Rua Doutor José Peroba, 251, Edf. Civil Empresarial, Sobreloja, STIEP, CEP: 41770-235, Salvador, BA, Brasil.
| | - Camila Alexandrina Figueiredo
- Departamento de Ciências da Biorregulação, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Av. Reitor Miguel Calmon. s/n, Vale do Canela, CEP: 40110-100, Salvador, BA, Brasil.
| | - Laura Cunha Rodrigues
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London, WC1E 7HT UK.
| | - Sheila Maria Alvim Matos
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Rua Basílio da Gama, s/n, Canela, CEP:40.110-040, Salvador, BA, Brasil.
| | - Rosemeire Leovigildo Fiaccone
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Rua Basílio da Gama, s/n, Canela, CEP:40.110-040, Salvador, BA, Brasil.
- Instituto de Matemática, Universidade Federal da Bahia-Av. Adhemar de Barros, s/n-Ondina, CEP: 40.170-110, Salvador, BA, Brasil.
- Cidacs-Centro de Integração de Dados e Conhecimentos para Saúde, Instituo Gonçalo Muniz, Fundação Owaldo Cruz, Ministério da Saúde, Parque Tecnológico da Bahia, Rua Mundo, 121, Trobogy, CEP: 41745-715, Salvador, BA, Brasil.
| | - Pablo Rafael Oliveira
- Instituto Gonçalo Moniz (IGM), Fundação Osvaldo Cruz-FIOCRUZ-Bahia, Av. Waldemar Falcão, 121, Candeal-Salvador/BA, CEP: 40296-710, Salvador, BA, Brasil.
- Cidacs-Centro de Integração de Dados e Conhecimentos para Saúde, Instituo Gonçalo Muniz, Fundação Owaldo Cruz, Ministério da Saúde, Parque Tecnológico da Bahia, Rua Mundo, 121, Trobogy, CEP: 41745-715, Salvador, BA, Brasil.
| | - Nadya Helena Alves-Santos
- Observatório de Epidemiologia Nutricional, Departamento de Nutrição Aplicada e Social, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro-UERJ. CEP: 21941-590, Rio de Janeiro, RJ, Brasil.
| | - Ronald E Blanton
- Center for Global Health & Diseases, Biomedical Research Building (BRB), Room 425, Case Western Reserve University, 2109 Adelbert Rd, Cleveland, OH 44106, USA.
| | - Maurício Lima Barreto
- Instituto Gonçalo Moniz (IGM), Fundação Osvaldo Cruz-FIOCRUZ-Bahia, Av. Waldemar Falcão, 121, Candeal-Salvador/BA, CEP: 40296-710, Salvador, BA, Brasil.
- Cidacs-Centro de Integração de Dados e Conhecimentos para Saúde, Instituo Gonçalo Muniz, Fundação Owaldo Cruz, Ministério da Saúde, Parque Tecnológico da Bahia, Rua Mundo, 121, Trobogy, CEP: 41745-715, Salvador, BA, Brasil.
| |
Collapse
|
7
|
Veiga RV, Barbosa HJC, Bernardino HS, Freitas JM, Feitosa CA, Matos SMA, Alcântara-Neves NM, Barreto ML. Multiobjective grammar-based genetic programming applied to the study of asthma and allergy epidemiology. BMC Bioinformatics 2018; 19:245. [PMID: 29940834 PMCID: PMC6047363 DOI: 10.1186/s12859-018-2233-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 06/04/2018] [Indexed: 12/22/2022] Open
Abstract
Background Asthma and allergies prevalence increased in recent decades, being a serious global health problem. They are complex diseases with strong contextual influence, so that the use of advanced machine learning tools such as genetic programming could be important for the understanding the causal mechanisms explaining those conditions. Here, we applied a multiobjective grammar-based genetic programming (MGGP) to a dataset composed by 1047 subjects. The dataset contains information on the environmental, psychosocial, socioeconomics, nutritional and infectious factors collected from participating children. The objective of this work is to generate models that explain the occurrence of asthma, and two markers of allergy: presence of IgE antibody against common allergens, and skin prick test positivity for common allergens (SPT). Results The average of the accuracies of the models for asthma higher in MGGP than C4.5. IgE were higher in MGGP than in both, logistic regression and C4.5. MGGP had levels of accuracy similar to RF, but unlike RF, MGGP was able to generate models that were easy to interpret. Conclusions MGGP has shown that infections, psychosocial, nutritional, hygiene, and socioeconomic factors may be related in such an intricate way, that could be hardly detected using traditional regression based epidemiological techniques. The algorithm MGGP was implemented in c ++ and is available on repository: http://bitbucket.org/ciml-ufjf/ciml-lib. Electronic supplementary material The online version of this article (10.1186/s12859-018-2233-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Rafael V Veiga
- Center of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Muniz, Fundação Oswaldo Cruz, Salvador, Brazil. .,Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
| | - Helio J C Barbosa
- Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.,Laboraório Nacional de Computação Científica, Petrópolis, Rio de Janeiro, Brazil
| | - Heder S Bernardino
- Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - João M Freitas
- Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Caroline A Feitosa
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Savador, Bahia, Brazil
| | - Sheila M A Matos
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Savador, Bahia, Brazil
| | | | - Maurício L Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Muniz, Fundação Oswaldo Cruz, Salvador, Brazil.,Instituto de Saúde Coletiva, Universidade Federal da Bahia, Savador, Bahia, Brazil
| |
Collapse
|
8
|
Vioque J, Gimenez-Monzo D, Navarrete-Muñoz EM, Garcia-de-la-Hera M, Gonzalez-Palacios S, Rebagliato M, Ballester F, Murcia M, Iñiguez C, Granado F. Reproducibility and Validity of a Food Frequency Questionnaire Designed to Assess Diet in Children Aged 4-5 Years. PLoS One 2016; 11:e0167338. [PMID: 27898731 PMCID: PMC5127574 DOI: 10.1371/journal.pone.0167338] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 11/11/2016] [Indexed: 12/29/2022] Open
Abstract
Background The food frequency questionnaire (FFQ) is the most efficient and cost-effective method to investigate the relationship between usual diet and disease in epidemiologic studies. Although FFQs have been validated in many adult populations worldwide, the number of valid FFQ in preschool children is very scarce. The aim of this study was to evaluate the reproducibility and validity of a semi-quantitative FFQ designed for children aged 4 to 5 years. Materials and methods In this study, we have included 169 children aged 4–5 years from the INMA project in Valencia, a population-based prospective cohort study of mothers and children in Spain. The 105-items FFQ was administered twice to the parents or care-givers of children over a 9-month period. Reproducibility was explored by comparing intake of nutrients by the FFQs, while validity was examined by comparing the nutrient values from the FFQs with the average nutrient values of three 24 hour dietary recall (24hDR) taken in the period, and also, with the concentration in blood specimens for several vitamins (carotenoids, folate, vitamin B12, vitamin C and α-tocopherol). Pearson correlation coefficients and de-attenuated correlation coefficients were calculated and we also evaluated misclassification by quintile distribution. Results All correlation coefficients for reproducibility for nutrients and major food groups were statistically significant; the average correlation coefficients for daily intake were 0.43 for food groups and 0.41 for nutrients. The average correlation coefficients for validity for daily intakes against 24hDR was r = 0.30, and the average for de-attenuated correlation coefficients was r = 0.44. When evaluating validity against the blood concentration of vitamins, statistically significant correlations were observed for vitamin C (0.35), lycopene (0.31), β-Cryptoxantin (0.40), and vitamin E (0.29); the average of correlation coefficients was r = 0.21. Conclusion Despite some low to moderate correlations for reproducibility and validity, overall this study suggests that the FFQ may be a good method for assessing a wide range of food groups and nutrients intake in children aged 4–5 years.
Collapse
Affiliation(s)
- Jesus Vioque
- Unidad de Epidemiologia de la Nutrición. Universidad Miguel Hernández, Alicante, Spain. Institute for Health and Biomedical Research (ISABIAL—FISABIO Foundation), Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- * E-mail:
| | - Daniel Gimenez-Monzo
- Unidad de Epidemiologia de la Nutrición. Universidad Miguel Hernández, Alicante, Spain. Institute for Health and Biomedical Research (ISABIAL—FISABIO Foundation), Alicante, Spain
| | - Eva Maria Navarrete-Muñoz
- Unidad de Epidemiologia de la Nutrición. Universidad Miguel Hernández, Alicante, Spain. Institute for Health and Biomedical Research (ISABIAL—FISABIO Foundation), Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Manuela Garcia-de-la-Hera
- Unidad de Epidemiologia de la Nutrición. Universidad Miguel Hernández, Alicante, Spain. Institute for Health and Biomedical Research (ISABIAL—FISABIO Foundation), Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sandra Gonzalez-Palacios
- Unidad de Epidemiologia de la Nutrición. Universidad Miguel Hernández, Alicante, Spain. Institute for Health and Biomedical Research (ISABIAL—FISABIO Foundation), Alicante, Spain
| | - Marisa Rebagliato
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO/CSISP), Valencia, Spain
- Departamento de Medicina, Universitat Jaume I, Castellón de la Plana, Spain
| | - Ferran Ballester
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO/CSISP), Valencia, Spain
| | - Mario Murcia
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO/CSISP), Valencia, Spain
| | - Carmen Iñiguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO/CSISP), Valencia, Spain
| | - Fernando Granado
- Servicio Bioquímica Clínica, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | | |
Collapse
|
9
|
Yanagisawa A, Sudo N, Amitani Y, Caballero Y, Sekiyama M, Mukamugema C, Matsuoka T, Imanishi H, Sasaki T, Matsuda H. Development and Validation of a Data-Based Food Frequency Questionnaire for Adults in Eastern Rural Area of Rwanda. Nutr Metab Insights 2016; 9:31-42. [PMID: 27429558 PMCID: PMC4936789 DOI: 10.4137/nmi.s38374] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 05/01/2016] [Accepted: 05/05/2016] [Indexed: 12/31/2022] Open
Abstract
This study aimed to develop and evaluate the validity of a food frequency questionnaire (FFQ) for rural Rwandans. Since our FFQ was developed to assess malnutrition, it measured energy, protein, vitamin A, and iron intakes only. We collected 260 weighed food records (WFRs) from a total of 162 Rwandans. Based on the WFR data, we developed a tentative FFQ and examined the food list by percent contribution to energy and nutrient intakes. To assess the validity, nutrient intakes estimated from the FFQ were compared with those calculated from three-day WFRs by correlation coefficient and cross-classification for 17 adults. Cumulative contributions of the 18-item FFQ to the total intakes of energy and nutrients reached nearly 100%. Crude and energy-adjusted correlation coefficients ranged from -0.09 (vitamin A) to 0.58 (protein) and from -0.19 (vitamin A) to 0.68 (iron), respectively. About 50%-60% of the participants were classified into the same tertile. Our FFQ provided acceptable validity for energy and iron intakes and could rank Rwandan adults in eastern rural area correctly according to their energy and iron intakes.
Collapse
Affiliation(s)
- Ayumi Yanagisawa
- The Graduate School of Humanities and Sciences, Ochanomizu University, Bunkyo-ku, Tokyo, Japan
| | - Noriko Sudo
- Natural Science Division, Faculty of Core Research, Ochanomizu University, Bunkyo-ku, Tokyo, Japan
| | - Yukiko Amitani
- The Graduate School of Humanities and Sciences, Ochanomizu University, Bunkyo-ku, Tokyo, Japan
| | - Yuko Caballero
- The Graduate School of Humanities and Sciences, Ochanomizu University, Bunkyo-ku, Tokyo, Japan
| | - Makiko Sekiyama
- Graduate Program in Sustainability Science-Global Leadership Initiative (GPSS-GLI), Graduate School of Frontier Sciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | | | | | | | | | - Hirotaka Matsuda
- Graduate Program in Sustainability Science-Global Leadership Initiative (GPSS-GLI), Graduate School of Frontier Sciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| |
Collapse
|
10
|
Saeedi P, Skeaff SA, Wong JE, Skidmore PML. Reproducibility and Relative Validity of a Short Food Frequency Questionnaire in 9-10 Year-Old Children. Nutrients 2016; 8:nu8050271. [PMID: 27164137 PMCID: PMC4882684 DOI: 10.3390/nu8050271] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 04/02/2016] [Accepted: 05/03/2016] [Indexed: 02/06/2023] Open
Abstract
The aim of this study was to assess the reproducibility and validity of a non-quantitative 28-item food frequency questionnaire (FFQ). Children aged 9-10 years (n = 50) from three schools in Dunedin, New Zealand, completed the FFQ twice and a four-day estimated food diary (4DEFD) over a two-week period. Intraclass correlation coefficients (ICC) and Spearman's correlation coefficients (SCC) were used to determine reproducibility and validity of the FFQ, respectively. Weekly intakes were estimated for each food item and aggregated into 23 food items/groups. More than half of the food items/groups (52.2%) had an ICC ≥0.5. The median SCC between FFQ administrations was 0.66 (ranging from 0.40 for processed meat to 0.82 for sweets and non-dairy drinks). Cross-classification analysis between the first FFQ and 4DEFD for ranking participants into thirds showed that breakfast cereals had the highest agreement (54.0%) and pasta the lowest (34.0%). In validity analyses, 70% of food items/groups had a SCC ≥0.3. Results indicate that the FFQ is a useful tool for ranking children according to food items/groups intake. The low respondent burden and relative simplicity of the FFQ makes it suitable for use in large cohort studies of 9-10 year-old children in New Zealand.
Collapse
Affiliation(s)
- Pouya Saeedi
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Sheila A Skeaff
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Jyh Eiin Wong
- School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia.
| | - Paula M L Skidmore
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| |
Collapse
|
11
|
Moghames P, Hammami N, Hwalla N, Yazbeck N, Shoaib H, Nasreddine L, Naja F. Validity and reliability of a food frequency questionnaire to estimate dietary intake among Lebanese children. Nutr J 2016; 15:4. [PMID: 26753989 PMCID: PMC4709981 DOI: 10.1186/s12937-015-0121-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 12/30/2015] [Indexed: 01/10/2023] Open
Abstract
Background Nutritional status during childhood is critical given its effect on growth and development as well as its association with disease risk later in life. The Middle East and North Africa (MENA) region is experiencing alarming rates of childhood malnutrition, both over- and under-nutrition. Hence, there is a need for valid tools to assess dietary intake for children in this region. To date, there are no validated dietary assessment tools for children in any country of the MENA region. The main objective of this study was to examine the validity and reliability of a Food Frequency Questionnaire (FFQ) for the assessment of dietary intake among Lebanese children. Methods Children, aged 5 to 10 years (n = 111), were recruited from public and private schools of Beirut, Lebanon. Mothers (proxies to report their children’s dietary intake) completed two FFQs, four weeks apart. Four 24-hour recalls (24-HRs) were collected weekly during the duration of the study. Spearman correlations and Bland-Altman plots were used to assess validity. Linear regression models were used to derive calibration factors for boys and girls. Reproducibility statistics included Intraclass Correlation Coefficient (ICC) and percent agreement. Results Correlation coefficients between dietary intake estimates derived from FFQ and 24-HRs were significant at p < 0.001 with the highest correlation observed for energy (0.54) and the lowest for monounsaturated fatty acids (0.26). The majority of data points in the Bland-Altman plots lied between the limits of agreement, closer to the middle horizontal line. After applying the calibration factors for boys and girls, the mean energy and nutrient intakes estimated by the FFQ were similar to those obtained by the mean 24-HRs. As for reproducibility, ICC ranged between 0.31 for trans-fatty acids and 0.73 for calcium intakes. Over 80 % of study participants were classified in the same or adjacent quartile of energy and nutrients intake. Conclusions Findings of this study showed that the developed FFQ is reliable and is also valid, when used with calibration factors. This FFQ is a useful tool in dietary assessment and evaluation of diet-disease relationship in this age group. Electronic supplementary material The online version of this article (doi:10.1186/s12937-015-0121-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Patricia Moghames
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Lebanon, 11-0236 Riad El Solh, 1107-2020, Beirut, Lebanon.
| | - Nour Hammami
- School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Lebanon, 11-0236 Riad El Solh, 1107-2020, Beirut, Lebanon.
| | - Nadine Yazbeck
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Lebanon, 11-0236 Riad El Solh, 1107-2020, Beirut, Lebanon.
| | - Hikma Shoaib
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Lebanon, 11-0236 Riad El Solh, 1107-2020, Beirut, Lebanon.
| | - Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Lebanon, 11-0236 Riad El Solh, 1107-2020, Beirut, Lebanon.
| | - Farah Naja
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Lebanon, 11-0236 Riad El Solh, 1107-2020, Beirut, Lebanon.
| |
Collapse
|
12
|
Lombard MJ, Steyn NP, Charlton KE, Senekal M. Application and interpretation of multiple statistical tests to evaluate validity of dietary intake assessment methods. Nutr J 2015; 14:40. [PMID: 25897837 PMCID: PMC4471918 DOI: 10.1186/s12937-015-0027-y] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 04/10/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Several statistical tests are currently applied to evaluate validity of dietary intake assessment methods. However, they provide information on different facets of validity. There is also no consensus on types and combinations of tests that should be applied to reflect acceptable validity for intakes. We aimed to 1) conduct a review to identify the tests and interpretation criteria used where dietary assessment methods was validated against a reference method and 2) illustrate the value of and challenges that arise in interpretation of outcomes of multiple statistical tests in assessment of validity using a test data set. METHODS An in-depth literature review was undertaken to identify the range of statistical tests used in the validation of quantitative food frequency questionnaires (QFFQs). Four databases were accessed to search for statistical methods and interpretation criteria used in papers focusing on relative validity. The identified tests and interpretation criteria were applied to a data set obtained using a QFFQ and four repeated 24-hour recalls from 47 adults (18-65 years) residing in rural Eastern Cape, South Africa. RESULTS 102 studies were screened and 60 were included. Six statistical tests were identified; five with one set of interpretation criteria and one with two sets of criteria, resulting in seven possible validity interpretation outcomes. Twenty-one different combinations of these tests were identified, with the majority including three or less tests. Coefficient of correlation was the most commonly used (as a single test or in combination with one or more tests). Results of our application and interpretation of multiple statistical tests to assess validity of energy, macronutrients and selected micronutrients estimates illustrate that for most of the nutrients considered, some outcomes support validity, while others do not. CONCLUSIONS One to three statistical tests may not be sufficient to provide comprehensive insights into various facets of validity. Results of our application and interpretation of multiple statistical tests support the value of such an approach in gaining comprehensive insights in different facets of validity. These insights should be considered in the formulation of conclusions regarding validity to answer a particular dietary intake related research question.
Collapse
Affiliation(s)
- Martani J Lombard
- Centre of Excellence for Nutrition (CEN), North-West University, Private Bag X6001, Nutrition, Box 594, Potchefstroom, 2520, South Africa.
| | - Nelia P Steyn
- Division of Human Nutrition, University of Cape Town, Cape Town, South Africa.
| | - Karen E Charlton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia.
| | - Marjanne Senekal
- Division of Human Nutrition, University of Cape Town, Cape Town, South Africa.
| |
Collapse
|
13
|
Geremia R, Cimadon HMS, de Souza WB, Pellanda LC. Childhood overweight and obesity in a region of Italian immigration in Southern Brazil: a cross-sectional study. Ital J Pediatr 2015; 41:28. [PMID: 25883083 PMCID: PMC4427939 DOI: 10.1186/s13052-015-0126-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 03/11/2015] [Indexed: 12/02/2022] Open
Abstract
Background The main modifiable risk factors for obesity are related to lifestyle and significantly influenced by the family, environment and culture. We aimed to estimate the prevalence of overweight/obesity and associated lifestyle factors in children from Bento Gonçalves, a southern Brazil city with strong Italian immigration influence. Italian traditional foods were locally adapted since the immigrants’ arrival in the XIX century, to include more fat and fewer vegetables, and physical activity levels have decreased. Methods Cross-sectional study of a population-based cluster sample with students aged 9–18 years. We assessed time spent in sedentary behaviors, hours of physical activity, food frequency and family history. All children underwent physical examination with anthropometric and blood pressure measurements. Overweight and obesity were classified according to WHO percentile curves. Results A total of 590 students were evaluated. Mean age was 12.45 ± 1.49 years. The prevalence of overweight and obesity was 16.3% and 8.3%, respectively. Boys were more frequently overweight and obese than girls (16.3% and 12.2% versus 16.2% and 5.5%, respectively). Vegetables and fruits were consumed less than 4 times per week in 49% and 36.8%, while soft drinks, fast food and sweets were consumed more than 4 times a week by 71%, 70.3% and 42.7%, respectively. The habit of omitting breakfast was associated with overweight (p = 0.007). The average screen time was 5.38 ± 2.88 hours/day. Overweight/obesity was present in 12.2% (n = 5), 24.8% (n = 122) and 36.8% (n = 14) children with low birth weight, normal birth weight and high birth weight respectively (p = 0.04). The prevalence of high blood pressure was higher in obese (30.6%) and overweight (21.2%) children, comparing to eutrophic children (6.8%; p < 0.001). Excess weight was more frequent among fathers (62.8%) than in mothers (46.3%), but excess weight in mothers was positively associated with excess weight in children (p 0.048). Conclusion The city showed high prevalence of overweight and obesity. These findings reinforce the importance of implementing prevention strategies aimed at children and their families, considering that health habits are shared and transmitted along generations.
Collapse
Affiliation(s)
- Renata Geremia
- Programa de Pós-Graduação em Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, Brazil.
| | - Hosana Maria Speranza Cimadon
- Programa de Pós-Graduação em Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, Brazil. .,Centro Universitário Feevale, Novo Hamburgo, Brazil. .,CNEC, Bento Gonçalves, Brazil.
| | - William Brasil de Souza
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), IC/FUC, Avenida Princesa Isabel, 370, Porto Alegre, RS, 90620-001, Brazil.
| | - Lucia Campos Pellanda
- Programa de Pós-Graduação em Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, Brazil. .,Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), IC/FUC, Avenida Princesa Isabel, 370, Porto Alegre, RS, 90620-001, Brazil.
| |
Collapse
|
14
|
Amaral RCD, Scabar LF, Slater B, Frazão P. Estimates of self-reported dietary behavior related to oral health among adolescents according to the type of food. J Appl Oral Sci 2014; 22:416-25. [PMID: 25466475 PMCID: PMC4245754 DOI: 10.1590/1678-775720130529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 06/08/2014] [Indexed: 11/21/2022] Open
Abstract
Objective To compare estimates of food behavior related to oral health obtained through a
self-report measure and 24 hour dietary recalls (R24h). Method We applied three R24h and one self-report measure in 87 adolescents. The estimates
for eleven food items were compared at individual and group levels. Results No significant differences in mean values were found for ice cream, vegetables and
biscuits without filling. For the remaining items, the values reported by the
adolescents were higher than the values estimated by R24h. The percentage of
adolescents who reported intake frequency of 1 or more times/ day was higher than
the value obtained through R24h for all food items except soft drinks. The highest
values of crude agreement between the instruments, individually, were found in the
biscuits without filling (75.9%) and ice cream (72.4%). Conclusion The results suggest that adolescents tend to report a degree of exposure to the
food items larger than what they actually experience in their daily lives.
Collapse
Affiliation(s)
- Regiane Cristina do Amaral
- Department of Social and Preventive Dentistry, School of Dentistry, State University of Campinas, Piracicaba, SP, Brazil
| | - Luiz Felipe Scabar
- Department of Public Health, School of Dentistry, University Paulista, São Paulo, SP, Brazil
| | - Betzabeth Slater
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Paulo Frazão
- Department of Public Health, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| |
Collapse
|