Adaptation of Locally Available Portion Sizes for Food Frequency Questionnaires in Nutritional Epidemiological Studies: How Much Difference does it Make?

Food frequency questionnaires developed and validated in Brazil: A scoping review protocol

A food frequency questionnaire (FFQ) is used to assess habitual food and nutrient intake. The choice of a FFQ should consider the study objectives, instrument particularities, target population, and geographic region. Over the past few years, FFQs have been constructed and validated in Brazil for children, adolescents, adults, athletes, and individuals with specific clinical conditions. The aim of this scoping review is to map the food frequency questionnaires developed and validated in Brazil. The Population-Concept-Context (PCC) framework was used for search strategy and defined as P-not applicable (open), C-food frequency questionnaire, and C-Brazil. FFQ validation studies performed with healthy or sick people will be included, regardless of clinical condition, age, sex, or region in the country. Studies with populations from other countries will be excluded. The review will be conducted in accordance with JBI (formerly known as Joanna Briggs Institute) methodology for scoping reviews. Search databases will include PubMed/MEDLINE, LILACS, Embase, Web of Science (ISI), Scopus, and Google Scholar. Data extraction will be performed by two independent reviewers and discrepancies resolved by a third reviewer. In order to improve the understanding and contextualization of the studies, a description of the results and presentation in tables and figures will be provided. Applications and implications for future research, practices, and policies will be discussed. Our protocol is registered through the Open Science Framework (doi 10.17605/OSF.IO/G5J3K).

Food frequency questionnaire assessing traditional food consumption in Dene/Métis communities, Northwest Territories, Canada

Food Frequency Questionnaires (FFQ) can be used to document food consumption and to estimate the intake of contaminants for Indigenous populations. The objective of this project was to refine and implement an FFQ to estimate the consumption of traditional locally harvested foods for Dene/Métis in the Northwest Territories, Canada. The strategy consisted of: 1) refining the FFQ through three focus groups and, 2) implementing the FFQ in Indigenous communities. Participants were asked to complete the FFQ using an iPad to document the types of traditional foods consumed over the past 12 months, as well as the consumption frequency, the portion size, and the preparation methods. Focus groups supported the refinement of the FFQ on the format, the list of foods, and the preparation methods listed in the questionnaire. The refined FFQ was then implemented with participants (n = 237). Findings indicated that the traditional foods most frequently consumed were moose, whitefish and lake trout. Participants who consumed fish and land animals reported, on average, a portion size for one serving of between 126 and 143 g, depending on age and sex. These findings increase knowledge of the current traditional food consumption of Dene/Métis communities and will support the assessment of contaminant exposure.

Trends in Nutrient Intakes of Indian Adults: Computerized Diet Analysis (CDiet) of Cross-sectional Surveys between 1998 and 2015

Background:

Time trends in nutrient intakes have been reported from household food consumption using food table values. However, accurate estimates of trends over the past decade in nutrient intakes using computerised nutrient analysis of Indian diets are lacking.

Objectives:

To examine changes in nutrient intakes of Indian adults by re-analysis of dietary food intakes between 1998 and 2015 with computerized diet analysis software, CDiet.

Methods:

Diets of men and women (20-60 years) from Western India in 1998-2000 (n=559), in 2007-2009 (n=638), and in 2013-2015 (n=1073) were assessed mostly using semi-quantitative food frequency questionnaire by interview method. Daily nutrient intakes were calculated with laboratory- based food composition database using computerised diet analysis software (CDiet). Physical activity was assessed through a structured questionnaire and classified as; sedentary, light, and moderate activity level (PAL). Trends in mean nutrient intakes were evaluated using generalised linear regression model.

Results:

Over the past 17 years, trend estimates of energy intakes adjusted for age and PAL showed a decline of 11 to 19.7% for men, whereas an insignificant increase of 1 to 3% in women. Higher reduction (23 to 45%) was seen in intakes of iron, riboflavin, thiamine, and folate than in other micronutrients. Men with sedentary activity increased by 16.8%, whereas women having light/moderate activity increased by 7.2%.

Conclusions:

A decreasing trend in nutrient intakes over the last 17 years and an increase in sedentary behavior suggested the need for change in lifestyle and increased consumption of nutrient-- dense foods by Indian adults.

Establishing a Demographic, Development and Environmental Geospatial Surveillance Platform in India: Planning and Implementation

BACKGROUND

Inadequate administrative health data, suboptimal public health infrastructure, rapid and unplanned urbanization, environmental degradation, and poor penetration of information technology make the tracking of health and well-being of populations and their social determinants in the developing countries challenging. Technology-integrated comprehensive surveillance platforms have the potential to overcome these gaps.

OBJECTIVE

This paper provides methodological insights into establishing a geographic information system (GIS)-integrated, comprehensive surveillance platform in rural North India, a resource-constrained setting.

METHODS

The International Clinical Epidemiology Network Trust International established a comprehensive SOMAARTH Demographic, Development, and Environmental Surveillance Site (DDESS) in rural Palwal, a district in Haryana, North India. The surveillance platform evolved by adopting four major steps: (1) site preparation, (2) data construction, (3) data quality assurance, and (4) data update and maintenance system. Arc GIS 10.3 and QGIS 2.14 software were employed for geospatial data construction. Surveillance data architecture was built upon the geospatial land parcel datasets. Dedicated software (SOMAARTH-1) was developed for handling high volume of longitudinal datasets. The built infrastructure data pertaining to land use, water bodies, roads, railways, community trails, landmarks, water, sanitation and food environment, weather and air quality, and demographic characteristics were constructed in a relational manner.

RESULTS

The comprehensive surveillance platform encompassed a population of 0.2 million individuals residing in 51 villages over a land mass of 251.7 sq km having 32,662 households and 19,260 nonresidential features (cattle shed, shops, health, education, banking, religious institutions, etc). All land parcels were assigned georeferenced location identification numbers to enable space and time monitoring. Subdivision of villages into sectors helped identify socially homogenous community clusters (418/676, 61.8%, sectors). Water and hygiene parameters of the whole area were mapped on the GIS platform and quantified. Risk of physical exposure to harmful environment (poor water and sanitation indicators) was significantly associated with the caste of individual household (P=.001), and the path was mediated through the socioeconomic status and density of waste spots (liquid and solid) of the sector in which these households were located. Ground-truthing for ascertaining the land parcel level accuracies, community involvement in mapping exercise, and identification of small habitations not recorded in the administrative data were key learnings.

CONCLUSIONS

The SOMAARTH DDESS experience allowed us to document and explore dynamic relationships, associations, and pathways across multiple levels of the system (ie, individual, household, neighborhood, and village) through a geospatial interface. This could be used for characterization and monitoring of a wide range of proximal and distal determinants of health.

Portion Sizes from 24-Hour Dietary Recalls Differed by Sex among Those Who Selected the Same Portion Size Category on a Food Frequency Questionnaire

BACKGROUND

Accounting for sex differences in food portions may improve dietary measurement; however, this factor has not been well examined.

OBJECTIVE

The aim of this study was to examine sex differences in reported food portions from 24-hour dietary recalls (24HDRs) among those who selected the same portion size category on a quantitative food frequency questionnaire (QFFQ).

DESIGN

This study was conducted with a cross-sectional design.

PARTICIPANTS/SETTING

Participants (n=319) were members of the Hawaii-Los Angeles Multiethnic Cohort who completed three 24HDRs and a QFFQ in a calibration study conducted in 2010 and 2011.

MAIN OUTCOME MEASURES

Portions of individual foods reported from 24HDRs served as the outcome measures.

STATISTICAL ANALYSES PERFORMED

Mean food portions from 24HDRs were compared between men and women who reported the same portion size on the QFFQ, after adjustment for race/ethnicity using a linear regression model. Actual amount and the assigned amount of the selected portion size in the QFFQ were compared using one-sample t test for men and women separately.

RESULTS

Of 163 food items with portion size options listed in the QFFQ, 32 were reported in 24HDRs by ≥20 men and ≥20 women who selected the same portion size in the QFFQ. Although they chose the same portion size on the QFFQ, mean intake amounts from 24HDRs were significantly higher for men than for women for "beef/lamb/veal," "white rice," "brown/wild rice," "lettuce/tossed salad," "eggs cooked/raw," "whole wheat/rye bread," "buns/rolls," and "mayonnaise in sandwiches." For men, mean portions of 14 items from the 24HDRs were significantly different from the assigned amounts for QFFQ items (seven higher and seven lower), whereas for women, mean portions of 14 items were significantly lower from the assigned amounts (with five significantly higher).

CONCLUSIONS

These sex differences in reported 24HDR food portions-even among participants who selected the same portion size on the QFFQ-suggest that the use of methods that account for differences in the portions consumed by men and women when QFFQs are quantified may provide more accurate absolute dietary intakes.