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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Roberto DMT, Pereira LJ, Vieira FGK, Di Pietro PF, de Assis MAA, Hinnig PDF. Association between Sleep Timing, Being Overweight and Meal and Snack Consumption in Children and Adolescents in Southern Brazil. Int J Environ Res Public Health 2023; 20:6791. [PMID: 37754650 PMCID: PMC10531239 DOI: 10.3390/ijerph20186791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/16/2023] [Accepted: 09/18/2023] [Indexed: 09/28/2023]
Abstract
Sleep timing is one of the dimensions of sleep that refers to the time of day when sleep occurs. It has been included in sleep-related research because of the potential associations between being overweight and the consumption of meals and snacks. This cross-sectional study aimed to investigate associations between sleep timing, meal and snack consumption and weight status in 1333 schoolchildren aged 7-14 years. The midpoint of sleep was used as a sleep timing measure obtained by the midpoint between bedtime and wake-up time, classified as Early, Intermediate, and Late. Schoolchildren in the Early group were less likely to be overweight (OR: 0.83, 95% CI 0.69; 0.99), and had higher odds of mid-morning snack consumption (OR: 1.95, 95% CI 1.56; 2.44) and lower probability to consume an evening snack (OR: 0.75, 95% CI 0.59; 0.94) compared with the Intermediate group. The Late group had lower odds of mid-morning snack consumption (OR: 0.67, 95% CI 0.55, 0.80) than the Intermediate group. The consumption of mid-morning and evening snacks was associated with the Early and Late midpoints of sleep. These results suggest that bedtime and wake-up time are relevant to consuming meals and snacks and may also be related to a greater probability of being overweight in children and adolescents.
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Affiliation(s)
| | | | | | | | | | - Patrícia de Fragas Hinnig
- Post-Graduation Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
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O'Kane N, Watson S, Kehoe L, O'Sullivan E, Muldoon A, Woodside J, Walton J, Nugent A. The patterns and position of snacking in children in aged 2-12 years: A scoping review. Appetite 2023:106974. [PMID: 37421978 DOI: 10.1016/j.appet.2023.106974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/12/2023] [Accepted: 07/05/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND Childhood obesity is associated with serious comorbidities during childhood and into adulthood. One potential risk factor for childhood obesity is consumption of unhealthy, energy-dense foods. This scoping review examines evidence on snacking in children aged 2-12years of age and presents the patterns and position of snacking in children's diets. METHODS A search of electronic databases (MEDLINE, Web of Science, PubMed, Embase) for articles published from March 2011 to November 2022 was conducted. Articles providing insight into the position of snacking (e.g., energy contribution), or patterns (e.g., location, timing), in children aged 2-12years were included. A quality assessment was conducted and data was synthesised according to data source (nationally representative or other). RESULTS Twenty-one articles were included, most (n = 13) reporting nationally representative data. The average number of daily snacks was 3, with 92.9-100.0% of children consuming snacks. Most were consumed in the afternoon (75.2-84.0%) and at home (46.5-67.3%). Snacks frequently consumed were 'fruits and vegetables', 'baked desserts', 'sweets, candy and confectionery', and 'dairy products'. Snacks contributed 231-565 kcal daily, up to a third of daily carbohydrate intake, a quarter of fat intake, and a fifth of protein intake. Snacks provided up to one third of vitamin C intake, one quarter of vitamin E, potassium and magnesium intake, and a fifth of calcium, folic acid, vitamins D and B12, iron and sodium intake. DISCUSSION This scoping review provides insight into patterns and position of snacking within children's diets. Snacking plays a significant role in children's diets with multiple snacking occasions occurring throughout a child's day, the overconsumption of which has the potential to increase risk of childhood obesity. Further research is required into the role of snacking, particularly specific foods playing a role in micronutrient intake, and clear guidance for snacking intake in children.
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Affiliation(s)
- Niamh O'Kane
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Ireland; Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Ireland.
| | - Sinead Watson
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Ireland
| | - Laura Kehoe
- Department of Biological Sciences, Munster Technological University, Cork, Ireland; School of Food & Nutritional Sciences, University College Cork, Cork, Ireland
| | - Emma O'Sullivan
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
| | - Aine Muldoon
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
| | - Jayne Woodside
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Ireland; Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Ireland
| | - Janette Walton
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
| | - Anne Nugent
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Ireland; Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Ireland
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Maraschim J, Honicky M, Moreno YMF, Hinnig PDF, Cardoso SM, Back IDC, Vieira FGK. Consumption and Breakfast Patterns in Children and Adolescents with Congenital Heart Disease. Int J Environ Res Public Health 2023; 20:5146. [PMID: 36982054 PMCID: PMC10048830 DOI: 10.3390/ijerph20065146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
Little is known about skipping breakfast and breakfast patterns (BP) and their evaluation according to sociodemographic, clinical, lifestyle, cardiometabolic and nutritional data in children and adolescents with congenital heart disease (CHD). This cross-sectional study with 232 children and adolescents with CHD identified the prevalence and patterns of the breakfast, described these according to sociodemographic, clinical and lifestyle characteristics, and assessed their association with cardiometabolic and nutritional markers. Breakfast patterns were identified by principal components, and bivariate and linear regression analysis were applied. Breakfast consumption was observed in 73% of participants. Four BP were identified: pattern 1 "milk, ultra-processed bread, and chocolate milk", pattern 2 "margarine and processed bread", pattern 3 "cold meats/sausages, cheeses and butter/cream" and pattern 4 "fruits/fruit juices, breakfast cereals, yogurts, and homemade cakes/pies and sweet snacks". Family history for obesity and acyanotic CHD were associated with breakfast skipping. Younger participants and greater maternal education were associated with greater adherence to pattern 1 and pattern 4. Older participants and longer post-operative time showed greater adherence to pattern 3. No association between skipping breakfast or BP and cardiometabolic and nutritional markers was observed. Nonetheless, the findings reinforce the need for nutritional guidance for healthy breakfast, aiming to reduce the consumption of ultra-processed foods and to prioritize fresh and minimally processed foods.
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Affiliation(s)
- Joanna Maraschim
- Post-Graduation Program in Nutrition, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Michele Honicky
- Post-Graduation Program in Nutrition, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Yara Maria Franco Moreno
- Post-Graduation Program in Nutrition, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Patricia de Fragas Hinnig
- Post-Graduation Program in Nutrition, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Silvia Meyer Cardoso
- University Hospital Polydoro Ernanni de São Tiago, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Isabela de Carlos Back
- Postgraduate Program in Public Health, Health Sciences Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
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Pereira LJ, Lopes CP, Martins ML, de Fragas Hinnig P, Di Pietro PF, de Moura Araujo PH, de Andrade DF, De Assis MAA, Vieira FGK. How Brazilian Schoolchildren Identify, Classify, and Label Foods and Beverages-A Card Sorting Methodology. Int J Environ Res Public Health 2023; 20:1296. [PMID: 36674051 PMCID: PMC9859169 DOI: 10.3390/ijerph20021296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
This study examined how Brazilian schoolchildren identified, classified, and labeled foods and beverages. Semi-structured interviews were conducted with 133 schoolchildren aged 7 to 10 years old from a public school located in southern Brazil in 2015. A set of cards with pictures of 32 food and beverage items from the web-based Food Intake and Physical Activity of Schoolchildren tool (Web-CAAFE) were used. Participants identified each item, formed groups for them based on similarity, and assigned labels for those groups. Student's t-tests and analysis of variance (ANOVA) tests were used to verify the mean difference between the groups of items. K-means cluster analysis was applied to identify similar clusters. Schoolchildren made an average of 9.1 piles of foods and beverages that they thought were similar (±2.4) with 3.0 cards (±1.8) each. Five groups were identified: meats, snacks and pasta, sweets, milk and dairy products, and fruits and vegetables. The most frequently used nomenclature for labeling groups was taxonomic-professional (47.4%), followed by the specific food item name (16.4%), do not know/not sure (13.3%), and evaluative (health perception) (8.8%). The taxonomic-professional category could be applied to promote improvements in the identification process of food and beverage items by children in self-reported computerized dietary questionnaires.
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Affiliation(s)
- Luciana Jeremias Pereira
- Post-Graduation Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Clarice Perucchi Lopes
- Post-Graduation Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Mayara Lopes Martins
- Doctoral School of Nutrition and Food Sciences, Institute of Nutrition, University of Debrecen, H-4002 Debrecen, Hungary
| | - Patrícia de Fragas Hinnig
- Post-Graduation Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Patricia Faria Di Pietro
- Post-Graduation Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Pedro Henrique de Moura Araujo
- Informatics and Statistics Department, Technological Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Dalton Francisco de Andrade
- Informatics and Statistics Department, Technological Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Maria Alice Altenburg De Assis
- Post-Graduation Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
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de Almeida Alves M, Molina MDCB, da Fonseca MJM, Lotufo PA, Benseñor IM, Marchioni DML. Different statistical methods identify similar population-specific dietary patterns: an analysis of Longitudinal Study of Adult Health (ELSA-Brasil). Br J Nutr 2022; 128:2249-57. [PMID: 35086581 DOI: 10.1017/S0007114522000253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In recent decades, different data-driven approaches have emerged to identify dietary patterns (DP) and little is discussed about how these methods are able to capture diet complexity within the same population. This study aimed to apply three statistical methods to identify the DP of the Longitudinal Study of Adult Health (ELSA-Brasil) population and evaluate the similarities and differences between them. Dietary data were assessed at baseline in the ELSA-Brasil study using a FFQ. DP were identified by applying three statistical methods: (1) factor analysis (FA), (2) treelet transform (TT) and (3) reduced rank regression (RRR). The characteristics of individuals classified in the last tertile of each DP were compared. Cross-classification and Pearson's correlation coefficients were assessed to evaluate the agreement between individuals' adherence to DP of the three methods. A similar convenience DP was identified for all three methods. FA and TT also identified a similar prudent DP and a DP highly loaded for the food groups rice and beans. Individuals classified in the third tertile of similar DP of each method presented similar socio-demographic and nutrient intake characteristics. Regarding the cross-classification, prudent DP from FA and TT presented a higher level of agreement (75 %), while convenience DP from TT and RRR presented the lowest agreement (44·8 %). The different statistical methods were able to capture the populations' DP in a similar way while highlighting the particularities of each method.
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Belchor ALL, de Assis MAA, Cezimbra VG, Pereira LJ, Roberto DMT, Giacomelli SDC, Vieira FGK, Di Pietro PF, Hinnig PDF. Is breakfast consumption among Brazilian schoolchildren associated with an ultra-processed food dietary pattern? NUTR BULL 2022; 47:488-500. [PMID: 36317890 DOI: 10.1111/nbu.12589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 10/02/2022] [Accepted: 10/10/2022] [Indexed: 11/29/2022]
Abstract
Omission of breakfast starts at school age and can be explained as a reflection of the independent behaviour acquired in this phase of life. Breakfast has been investigated for its association with healthier diet quality, but few studies have investigated this relationship in schoolchildren aged 7 to 13 years. The objective of this study was to assess breakfast consumption in schoolchildren aged 7 to 13 years and to examine associations with dietary patterns (DPs). It was a cross-sectional study carried out in 2017 with 1069 students in Florianopolis, southern Brazil. Previous-day food consumption, physical activity and screen activities were self-reported. Factor analysis was used to identify DPs. Associations between breakfast consumption and overall DPs were evaluated using multivariate linear regression. Breakfast consumption was reported by 85% of the children, with the highest proportion observed among students on the afternoon school shift. Five DPs were identified explaining 41% of the total variance in daily food consumption: Ultra-processed, Mixed, Traditional Brazilian Lunch, Healthy + Sweets and Traditional Brazilian Breakfast. Breakfast consumption was directly associated with a Traditional Brazilian Breakfast DP (β = 0.335; 95% CI = 0.227, 0.442), a Mixed DP (β = 0.241; 95% CI = 0.160, 0.323), and a Healthy + Sweets DP (β = 0.160; 95% CI = 0.061, 0.260), and inversely associated with an Ultra-processed DP (β = -0.116; 95% CI = -0.207, -0.026). Breakfast consumption was associated with overall DPs, suggesting the importance of eating this meal by schoolchildren. We emphasise the relevance of offering a healthy breakfast at public schools for students who do not take this meal at home, contributing to health promotion.
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Affiliation(s)
- Ana Luisa Lages Belchor
- Department of Public Health, Center of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - Vanessa Guimarães Cezimbra
- Department of Public Health, Center of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Luciana Jeremias Pereira
- Department of Nutrition, Center of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - Simone de Castro Giacomelli
- Department of Nutrition, Center of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - Patrícia Faria Di Pietro
- Department of Nutrition, Center of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Patrícia de Fragas Hinnig
- Department of Nutrition, Center of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
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Roberto DMT, Kupek E, Assis MAA, Lobo AS, Belchor ALL, Spanholi MW, Cezimbra VG, Oliveira MT, Pereira LJ, Vieira FGK, Hinnig PDF. Most meal and snack patterns are stable over a 3‐year period in schoolchildren in southern Brazil. NUTR BULL 2022; 47:79-92. [DOI: 10.1111/nbu.12541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Emil Kupek
- Department of Public Health Center for Health Sciences Federal University of Santa Catarina Florianópolis Brazil
| | | | - Adriana Soares Lobo
- Center for Health Sciences Federal University of Santa Catarina Florianópolis Brazil
| | - Ana Luisa Lages Belchor
- Department of Public Health Center for Health Sciences Federal University of Santa Catarina Florianópolis Brazil
| | | | - Vanessa Guimarães Cezimbra
- Department of Public Health Center for Health Sciences Federal University of Santa Catarina Florianópolis Brazil
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Giacomelli SC, de Assis MAA, de Andrade DF, Schmitt J, Hinnig PF, Borgatto AF, Engel R, Vieira FGK, Fiates GMR, Di Pietro PF. Development of a Food-Based Diet Quality Scale for Brazilian Schoolchildren Using Item Response Theory. Nutrients 2021; 13:3175. [PMID: 34579052 DOI: 10.3390/nu13093175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/05/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022] Open
Abstract
Item response theory (IRT) is a psychometric method that provides probabilistic model-based measurements. Its use is relatively recent in the assessment of food consumption, especially through dietary assessment tools. This study aims (1) to develop a food-based diet quality scale for Brazilian schoolchildren using IRT, and (2) to apply the scale to a representative sample of schoolchildren from a Southern Brazilian city. The scale was developed with daily consumption frequency of foods from 835 students who completed the Food Intake and Physical Activity of Schoolchildren questionnaire. Questionnaire foods were grouped into 10 items according to their nutritional similarities and were evaluated by full-information factor analysis that indicated a dominant factor explaining 28% of the variance. Psychometric item analysis was performed using Samejima’s model. The scale covered all levels of diet quality, from “very poor” (scores < 95) to “very good” (scores ≥ 130). Children who had higher diet quality scores consumed beans, meat, fish, eggs, fruits, vegetables, dairy products, and water more frequently, while reducing the consumption of ultraprocessed sugary foods, ultraprocessed savoury snacks and sausages, and sugary drinks. Of 6323 children, an average of less than 10% consumed the highest diet quality scores (good or very good diet quality) and about 60% of children consumed low diet quality scores. The scale can be applied to other schoolchildren with the same measure precision.
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