Cross-cultural adaptation and reproducibility of the EPIC-Norfolk food frequency questionnaire in young people living in Croatia

AIM

To translate and adapt the European Prospective Investigation of Cancer (EPIC)-Norfolk food frequency questionnaire (FFQ) for use in Croatia, and to assess the reliability and reproducibility of the Croatian version of the EPIC-Norfolk FFQ.

METHODS

Translation and cross-cultural adaptation were performed according to published recommendations. Reliability was assessed in 140 respondents (61 men; age range 8-40 years) divided into three groups: young adults, pregnant women, and children and adolescents. Reproducibility was assessed in the group of young adults (32/61 men), who completed the questionnaire on two occasions three months apart.

RESULTS

The EPIC-Norfolk FFQ showed good reliability (Cronbach alpha=0.874). Most nutrient intakes showed good reproducibility (intraclass correlation coefficient [ICC] between 0.7 and 0.9). Poor reproducibility was observed for alcohol (ICC=0.337), and moderate reproducibility was observed for beta-carotene (ICC=0.692) and total carbohydrates (ICC=0.698). Nutrient intakes measured by FFQ on two occasions did not significantly differ.

CONCLUSION

The Croatian version of the EPIC-Norfolk FFQ can be a useful tool for assessing dietary intakes in young people in Croatia and possibly in neighboring countries with similar languages and dietary habits.

Estimation of Salt Intake in Normotensive and Hypertensive Children: The Role of Body Weight

OBJECTIVE

The connection between increased dietary salt intake and arterial hypertension has been recognized for a long time, even in children. This study aimed to investigate salt consumption in normotensive and hypertensive children and evaluate their dietary habits.

MATERIALS AND METHODS

A total of fifty participants were included in this cross-sectional study: twenty-five normotensive children and 25 children of both sexes with essential arterial hypertension from 12-17 years old. Subjects' body mass index, waist-to-hip ratio, body composition and arterial blood pressure were measured, and their daily salt intake was calculated from 24-h urine samples. Using the food frequency questionnaire (FFQ), the data on the average daily total energy and food intakes were collected and analyzed using a suitable program.

RESULTS

Estimated daily salt intake was significantly higher in hypertensive compared to normotensive children, and this is positively associated with blood pressure and body mass index (BMI). Hypertensive children had significantly higher BMIs, which also positively correlated with blood pressure. Consistently, resting metabolic rate (kcal) is higher in hypertensive children compared to normotensive, and this is also associated with blood pressure. Reported energy intake is also enlarged in hypertensive compared to normotensive children and for both groups, levels are significantly higher than the recommended values.

CONCLUSIONS

Our study results confirm the relationship between daily salt consumption, blood pressure and body weight. Sodium consumption related to blood pressure and body weight among children. Cardiovascular disease prevention should start in early childhood by reducing salt intake and preventing overweight/obesity since these are two of the most important modifiable risk factors for hypertension.

Sodium-to-Potassium Ratio as an Indicator of Diet Quality in Healthy Pregnant Women

This study aimed to investigate diet quality in healthy pregnant women based on the Na-to-K ratio from 24 h urine sample and food frequency questionnaire (FFQ), to compare dietary micro- and macronutrient intake with current nutritional recommendations (RDA), and to investigate whether gestational weight gain (GWG) is associated with Na-to-K ratio and diet quality during pregnancy in general. Sixty-four healthy pregnant women between 37 and 40 weeks of gestation participated in the study. Participants' GWG, body composition, molar 24 h urine Na-to-K ratio, and FFQ data on average daily total energy, food groups, and micro-/macronutrient intake were obtained. A Na-to-K ratio of 2.68 (1.11-5.24) does not meet nutrition quality and is higher than the WHO recommendations due to excessive sodium and insufficient potassium intake. FFQ Na-to-K ratio was associated with a higher daily intake of soups, sauces, cereals, fats, and oils and a low intake of fruit and non-alcoholic beverages. A total of 49% of pregnant women exhibited excessive GWG, which was attributed to the increase in adipose tissue mass. GWG was not associated with total energy but may be the result of insufficient physical activity during pregnancy. Daily intake of vitamin D, vitamin E, folate, niacin, riboflavin, calcium, iron, and zinc was suboptimal compared to RDA.