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van der Heijden Z, de Gooijer F, Camps G, Lucassen D, Feskens E, Lasschuijt M, Brouwer-Brolsma E. User Requirements in Developing a Novel Dietary Assessment Tool for Children: Mixed Methods Study. JMIR Form Res 2024; 8:e47850. [PMID: 38300689 PMCID: PMC10870213 DOI: 10.2196/47850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 11/10/2023] [Accepted: 12/08/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND The prevalence of childhood obesity and comorbidities is rising alarmingly, and diet is an important modifiable determinant. Numerous dietary interventions in children have been developed to reduce childhood obesity and overweight rates, but their long-term effects are unsatisfactory. Stakeholders call for more personalized approaches, which require detailed dietary intake data. In the case of primary school children, caregivers are key to providing such dietary information. However, as school-aged children are not under the full supervision of one specific caregiver anymore, data are likely to be biased. Recent technological advancements provide opportunities for the role of children themselves, which would serve the overall quality of the obtained dietary data. OBJECTIVE This study aims to conduct a child-centered exploratory sequential mixed methods study to identify user requirements for a dietary assessment tool for children aged 5 to 6 years. METHODS Formative, nonsystematic narrative literature research was undertaken to delineate initial user requirements and inform prototype ideation in an expert panel workshop (n=11). This yielded 3 prototype dietary assessment tools: FoodBear (tangible piggy bank), myBear (smartphone or tablet app), and FoodCam (physical camera). All 3 prototypes were tested for usability by means of a usability task (video analyses) and user experience (This or That method) among 14 Dutch children aged 5 to 6 years (n=8, 57% boys and n=6, 43% girls). RESULTS Most children were able to complete FoodBear's (11/14, 79%), myBear's (10/14, 71%), and FoodCam's (9/14, 64%) usability tasks, but all children required assistance (14/14, 100%) and most of the children encountered usability problems (13/14, 93%). Usability issues were related to food group categorization and recognition, frustrations owing to unsatisfactory functioning of (parts) of the prototypes, recall of food products, and the distinction between eating moments. No short-term differences in product preference between the 3 prototypes were observed, but autonomy, challenge, gaming elements, being tablet based, appearance, social elements, and time frame were identified as determinants of liking the product. CONCLUSIONS Our results suggest that children can play a complementary role in dietary data collection to enhance the data collected by their parents. Incorporation of a training program, auditory or visual prompts, reminders and feedback, a user-friendly and intuitive interaction design, child-friendly food groups or icons, and room for children's autonomy were identified as requirements for the future development of a novel and usable dietary assessment tool for children aged 5 to 6 years. Our findings can serve as valuable guidance for ongoing innovations in the field of children's dietary assessment and the provision of personalized dietary support.
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Affiliation(s)
- Zoë van der Heijden
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Femke de Gooijer
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Guido Camps
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Desiree Lucassen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Edith Feskens
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Marlou Lasschuijt
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Elske Brouwer-Brolsma
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
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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] [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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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. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND 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] [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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Using short-term dietary intake data to address research questions related to usual dietary intake among populations and subpopulations: Assumptions, statistical techniques, and considerations. J Acad Nutr Diet 2022; 122:1246-1262. [DOI: 10.1016/j.jand.2022.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 02/17/2022] [Accepted: 03/07/2022] [Indexed: 11/19/2022]
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HADMAȘ RM, MARTIN ȘA, MĂRGINEAN O. Children anthropometric development: an analysis over food consumption and energy requirements. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2021. [DOI: 10.23736/s0393-3660.19.04310-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Karpouzis F, Lindberg R, Walsh A, Shah S, Abbott G, Lai J, Berner A, Ball K. Evaluating OzHarvest's primary-school Food Education and Sustainability Training (FEAST) program in 10-12-year-old children in Australia: protocol for a pragmatic cluster non-randomized controlled trial. BMC Public Health 2021; 21:967. [PMID: 34022839 PMCID: PMC8140478 DOI: 10.1186/s12889-021-10302-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 11/10/2022] Open
Abstract
Background The promotion of healthy eating is a public health priority. Poor dietary behaviours, including low fruit and vegetable (F&V) consumption are of particular concern among children. Novel nutrition promotion strategies are needed to improve F&V consumption. Sustainability education could be used to support nutrition education within the school context. The purpose of this paper is to report the protocol for impact and process evaluation of the school-based Food Education and Sustainability Training (FEAST) program, designed to educate children about sustainability, food waste and nutrition, using hands-on cooking activities. Methods A pragmatic, parallel, cluster non-randomized controlled trial with pre- and post-measures, will be implemented among 20 primary schools (10 intervention vs 10 wait-list-control) within NSW, Australia, involving children in Grades 5–6. FEAST is a curriculum-aligned program, delivered as a 1.5-h lesson/week, for a 10-week unit of inquiry, incorporating theory and cooking. FEAST was developed using theoretical frameworks which included Social Cognitive Theory and the Precede-Proceed Planning model. Primary outcomes include children’s self-reported F&V intakes (serves/day). Food literacy constructs such as: nutrition knowledge, food preparation and cooking skills, self-efficacy and behaviours, food waste knowledge and behaviours and food production knowledge, will be assessed as secondary outcomes. Process evaluation will assess program reach, adoption, implementation, maintenance, satisfaction and perceived benefits by teachers and students. An online survey (including quantitative and qualitative questions) was developed for administration at baseline (impact evaluation) and immediately post-intervention (impact and process evaluation). Intervention effects on quantitative study outcomes will be estimated with generalised linear mixed models, including random effects and will follow the intention-to-treat principles. Open-ended questions embedded within the surveys will be analysed qualitatively using content and thematic analyses. Discussion Results from this trial will provide valuable information on the value of adding environmental sustainability strategies to nutrition education in schools. Results will inform the design of future research and programs focused on primary-school children’s nutrition, sustainability-related behaviours and experiential school-based interventions. Trial registration Trial registered 14th December 2020 with the Australian and New Zealand Clinical Trials Registry (ACTRN12620001347954). Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10302-0.
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Affiliation(s)
- F Karpouzis
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia.
| | - R Lindberg
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - A Walsh
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - S Shah
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - G Abbott
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - J Lai
- eResearch, Deakin University, Melbourne, VIC, Australia.,Intersect Australia, Sydney, NSW, Australia
| | - A Berner
- OzHarvest, Sydney, NSW, Australia
| | - K Ball
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
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Kubik MY, Lee J, Fulkerson JA, Gurvich OV, Sirard JR. School-Based Secondary Obesity Prevention for Eight- to Twelve-Year-Olds: Results from the Students, Nurses, and Parents Seeking Healthy Options Together Randomized Trial. Child Obes 2021; 17:185-195. [PMID: 33601934 PMCID: PMC8418450 DOI: 10.1089/chi.2020.0321] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective: The primary aim of this randomized controlled trial, conducted in Minneapolis/St. Paul, Minnesota (2014-2019), was to evaluate the effects of a school-based, school nurse-delivered, secondary obesity prevention intervention to reduce excess weight gain among preadolescent children with obesity or at risk of developing obesity. Methods: Parent/child dyads (n = 132) were randomized to the 9-month Students, Nurses, and Parents Seeking Healthy Options Together (SNAPSHOT) intervention (32.5 contact hours) or newsletter-only control group. Eligible children were 8 to 12 years old, proficient in English, and with a BMI ≥75th percentile, calculated using height/weight reported by a parent, school nurse, or clinician. The primary outcome was child BMI for sex/age z-score (BMIz) at postintervention (12 months) and follow-up (24 months). Results: Among children, 63% were non-White, 51% were male, and 51% with obesity, including 21% with severe obesity. Among families, 59% received economic assistance and 30% reported food insecurity. The mean number of intervention contact hours received was 20 (range: 0-32.5). Among dyads (n = 54) receiving the intervention, parents were very satisfied/satisfied with SNAPSHOT and SNAPSHOT staff, 96% and 100%, respectively, and very likely/likely (97%) to recommend SNAPSHOT to others. Most (70%) children liked the kid group sessions "a lot." In an intent-to-treat analysis, there were no significant between-group differences in child BMIz at 12 [0.04; 95% confidence interval (CI) -0.07 to 0.16] or 24 months (0.06; 95% CI -0.08 to 0.20), with participant retention of 92% and 93%, respectively. Conclusions: The SNAPSHOT intervention was well received, but did not improve BMI in a mostly diverse, low-income preadolescent population. Approaches to intervention delivery that are feasible, maximize accessibility, and optimize clinician and school nurse collaboration warrant consideration. Clinical trial registration identifier NCT02029976.
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Affiliation(s)
- Martha Y. Kubik
- School of Nursing, College of Health and Human Services, George Mason University, Fairfax, VA, USA
| | - Jiwoo Lee
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | | | - Olga V. Gurvich
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - John R. Sirard
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
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Skipping Breakfast and a Meal at School: Its Correlates in Adiposity Context. Report from the ABC of Healthy Eating Study of Polish Teenagers. Nutrients 2019; 11:nu11071563. [PMID: 31336699 PMCID: PMC6682891 DOI: 10.3390/nu11071563] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/01/2019] [Accepted: 07/09/2019] [Indexed: 12/11/2022] Open
Abstract
Little is known on skipping breakfast and a meal at school, especially considered together. The study identified nutrition knowledge-related, lifestyle (including diet quality, physical activity, and screen time) and socioeconomic correlates of skipping breakfast and a meal at school, considered together or alone and assessed the association of skipping these meals with adiposity markers in Polish teenagers. The sample consisted of 1566 fourth and fifth grade elementary school students (11–13 years). The study was designed as a cross-sectional study. Data related to the consumption of selected food items and meals, physical activity, screen time, sociodemographic factors, and nutrition knowledge (all self-reported) were collected (in 2015–2016) with a short form of a food frequency questionnaire. Respondents reported the usual consumption of breakfast (number of days/week) and a meal or any food eaten at school (number of school days/week) labelled as ‘a meal at school’. The measurements of body weight, height, and waist circumference were taken. BMI-for-age ≥25 kg/m2 was considered as a marker of overweight/obesity (general adiposity), while waist-to-height ratio ≥0.5 as a marker of central obesity (central adiposity). A multivariate logistic regression was applied to verify the association between variables. A total of 17.4% of teenagers frequently skipped breakfast (4–7 days/week), 12.9% frequently skipped a meal at school (3–5 school days/week), while 43.6% skipped both of these meals a few times a week. Predictors of skipping breakfast and/or a meal at school were female gender, age over 12 years, urban residence, lower family affluence, lower nutrition knowledge, higher screen time, and lower physical activity. In comparison to “never-skippers,” “frequent breakfast skippers” were more likely to be overweight/obese (odds ratio, OR 1.89; 95% confidence interval, 95%CI 1.38, 2.58) and centrally obese (OR 1.63; 95%CI 1.09, 2.44), while skippers a few times a week of both of these meals were more likely to be overweight/obese (OR 1.37; 95%CI 1.06, 1.78). Concluding, we estimated that a large percentage of Polish teenagers (approx. 44%) usually skipped both breakfast and a meal at school a few times a week. Similar predictors of skipping breakfast and predictors of skipping a meal at school were identified. Special attention should be paid to promoting shortening screen time and increasing physical activity and teenagers’ nutrition knowledge which are relatively easily modifiable correlates. The study shows that skipping both of these meals a few times a week was associated with general adiposity and also strengthens previous evidence showing the association of frequent skipping breakfast with general and central adiposity.
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Lobo AS, de Assis MAA, Leal DB, Borgatto AF, Vieira FK, Di Pietro PF, Kupek E. Empirically derived dietary patterns through latent profile analysis among Brazilian children and adolescents from Southern Brazil, 2013-2015. PLoS One 2019; 14:e0210425. [PMID: 30620755 PMCID: PMC6324812 DOI: 10.1371/journal.pone.0210425] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 12/21/2018] [Indexed: 12/25/2022] Open
Abstract
The aims of this study were to identify dietary patterns (DPs) of children and adolescents participating in three cross-sectional surveys (2013-2015) and to test their associations with sociodemographic variables, physical activity (PAS), screen-based sedentary activity (SA), and weight status. One-day data were obtained from 5,364 schoolchildren (7-12 years) from public schools of Florianopolis (South of Brazil), using the validated questionnaire Web-CAAFE (Food Intake and Physical Activity of Schoolchildren). DPs were derived from the frequency of daily consumption of 32 foods/beverages by latent profile analysis. Multinomial logistic regression analysis was used to estimate the association of the DPs with sociodemographic variables, physical activity, screen activity and weight status. 'Traditional', 'Monotonous', and 'Mixed' DPs were identified. The percentages of children and adolescents within these profiles were 41.3, 36.3, and 22.4%, respectively. Children and adolescents in the highest tertiles of both PAS and daily frequency of SA had a higher probability to present a 'Mixed' DP compared to peers with less PAS and SA. Children and adolescents who reported having a school meal were significantly more likely to present the 'Traditional'DP, while boys who did not report having a school meal had a higher probability to present the 'Monotonous' DP. The DPs were not associated with the year of survey, age, family income, or weight status.
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Affiliation(s)
- Adriana Soares Lobo
- Postgraduate Program in Nutrition, Center for Health Sciences, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Maria Alice Altenburg de Assis
- Postgraduate Program in Nutrition, Center for Health Sciences, Federal University of Santa Catarina, Florianópolis, SC, Brazil
- Postgraduate Program in Physical Education, Sports Center, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Danielle Biazzi Leal
- Postgraduate Program in Nutrition, Center for Health Sciences, Federal University of Santa Catarina, Florianópolis, SC, Brazil
- Postgraduate Program in Physical Education, Sports Center, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Adriano Ferreti Borgatto
- Postgraduate Program in Physical Education, Sports Center, Federal University of Santa Catarina, Florianópolis, SC, Brazil
- Department of Informatics and Statistics, Technological Center, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Francilene Kunradi Vieira
- Postgraduate Program in Nutrition, Center for Health Sciences, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Patricia Faria Di Pietro
- Postgraduate Program in Nutrition, Center for Health Sciences, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Emil Kupek
- Department of Public Health, Center for Health Sciences, Federal University of Santa Catarina, Florianópolis, SC, Brazil
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Wadolowska L, Hamulka J, Kowalkowska J, Kostecka M, Wadolowska K, Biezanowska-Kopec R, Czarniecka-Skubina E, Kozirok W, Piotrowska A. Prudent-Active and Fast-Food-Sedentary Dietary-Lifestyle Patterns: The Association with Adiposity, Nutrition Knowledge and Sociodemographic Factors in Polish Teenagers-The ABC of Healthy Eating Project. Nutrients 2018; 10:E1988. [PMID: 30558296 PMCID: PMC6315952 DOI: 10.3390/nu10121988] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/11/2018] [Accepted: 12/13/2018] [Indexed: 12/16/2022] Open
Abstract
A holistic approach to understanding the relationship between diet, lifestyle and obesity is a better approach than studying single factors. This study presents the clustering of dietary and lifestyle behaviours to determine the association of these dietary-lifestyle patterns (DLPs) with adiposity, nutrition knowledge, gender and sociodemographic factors in teenagers. The research was designed as a cross-sectional study with convenience sampling. The sample consisted of 1549 Polish students aged 11⁻13 years. DLPs were identified with cluster analysis. Logistic regression modelling with adjustment for confounders was applied. Three dietary-lifestyle patterns were identified: Prudent-Active (29.3% of the sample), Fast-food-Sedentary (13.8%) and notPrudent-notFast-food-lowActive (56.9%). Adherence to Prudent-Active pattern (reference: notPrudent-notFast-food-lowActive) was 29% or 49% lower in 12-year-old or 13-year-old teenagers than in 11-year-old teenagers, respectively, and higher by 57% or 2.4 times in the middle or the upper tertile than the bottom tertile of the nutrition knowledge score. To the contrary, adherence to Fast-food-Sedentary (reference: notPrudent-notFast-food-lowActive) was lower by 41% or 58% in the middle or the upper tertile than the bottom tertile of the nutrition knowledge score, respectively. In Prudent-Active, the chance of central obesity (waist-to-height ratio ≥0.5) was lower by 47% and overweight/obesity was lower by 38% or 33% (depending on which standard was used: International Obesity Task Force, 2012: BMI (body mass index)-for-age ≥ 25 kg/m² or Polish standards, 2010: BMI-for-age ≥ 85th percentile) when compared with the notPrudent-notFast-food-lowActive pattern. In Fast-food-Sedentary, the chance of central obesity was 2.22 times higher than the Prudent-Active pattern. The study identified a set of characteristics that decreased the risk of general and central adiposity in teenagers, which includes health-promoting behaviours related to food, meal consumption and lifestyle. Avoiding high-energy dense foods is insufficient to prevent obesity, if physical activity and the consumption frequency of health-promoting foods are low and breakfast and a school meal are frequently skipped. The results highlight the importance of the nutrition knowledge of teenagers in shaping their health-promoting dietary habits and active lifestyle to decrease adiposity risk and negative aspects of lower family affluence which promotes unhealthy behaviours, both related to diet and lifestyle.
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Affiliation(s)
- Lidia Wadolowska
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Pl. Cieszynski 1, 10-718 Olsztyn, Poland.
| | - Jadwiga Hamulka
- Department of Human Nutrition, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Science (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland.
| | - Joanna Kowalkowska
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Pl. Cieszynski 1, 10-718 Olsztyn, Poland.
| | - Malgorzata Kostecka
- Department of Chemistry, Faculty of Food Science and Biotechnology, University of Life Sciences, 15 Akademicka Street, 20-950 Lublin, Poland.
| | - Katarzyna Wadolowska
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Pl. Cieszynski 1, 10-718 Olsztyn, Poland.
| | - Renata Biezanowska-Kopec
- Department of Human Nutrition, Faculty of Food Technology, University of Agriculture in Krakow, 122 Balicka Street, 30-149 Krakow, Poland.
| | - Ewa Czarniecka-Skubina
- Department of Food Gastronomy and Food Hygiene, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Science (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland.
| | - Witold Kozirok
- Department of Commodity and Quality Management, Faculty of Entrepreneurship and Quality Science, Gdynia Maritime University, 81-87 Morska Street, 81-225 Gdynia, Poland.
| | - Anna Piotrowska
- Department of Functional Food, Ecological Food and Commodities, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Science (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland.
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11
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Kubik MY, Fulkerson JA, Sirard JR, Garwick A, Temple J, Gurvich O, Lee J, Dudovitz B. School-based secondary prevention of overweight and obesity among 8- to 12-year old children: Design and sample characteristics of the SNAPSHOT trial. Contemp Clin Trials 2018; 75:9-18. [PMID: 30342255 PMCID: PMC6249099 DOI: 10.1016/j.cct.2018.10.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 10/05/2018] [Accepted: 10/16/2018] [Indexed: 01/17/2023]
Abstract
Rising levels of severe obesity among children, worsening disparities by race and ethnicity and reluctance of primary care clinicians' to provide obesity management to children are compelling reasons to consider alternatives to primary care management of childhood obesity. The Students Nurses and Parents Seeking Healthy Options Together (SNAPSHOT) trial will test the efficacy of an elementary school-based, school nurse-led, healthy weight management program to reduce excess weight gain among children, 8- to 12-years old with a body mass index (BMI) ≥75th percentile, by increasing healthy dietary practices and physical activity and decreasing sedentary behaviors. SNAPSHOT has enrolled and randomized 132 child/parent dyads to either the: (1) 9-month SNAPSHOT intervention that includes four home visits, 14 kid groups held during out-of-school time and five parent groups or (2) a newsletter program consisting of monthly mailings and family-focused healthy lifestyle information. Outcomes are assessed at baseline, 12-months (post intervention) and 24-months (follow-up) post randomization. The primary outcome is child age- and gender-adjusted BMI z-score. Secondary outcomes include child dietary intake assessed with 24-h dietary recall interviews and accelerometer-measured activity levels. The SNAPSHOT intervention is a model of secondary obesity prevention for children that addresses the urgent need for theory-informed, evidence-based and safe weight management programs, delivered by skilled health professionals in accessible settings. This report describes development of the SNAPSHOT trial, including recruitment and randomization procedures, assessments, intervention and implementation plans, and baseline characteristics of the study sample.
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Affiliation(s)
- Martha Y Kubik
- Temple University, College of Public Health, Department of Nursing, 3307 North Broad Street, Philadelphia, PA 19103, United States.
| | - Jayne A Fulkerson
- Temple University, College of Public Health, Department of Nursing, 3307 North Broad Street, Philadelphia, PA 19103, United States
| | - John R Sirard
- Temple University, College of Public Health, Department of Nursing, 3307 North Broad Street, Philadelphia, PA 19103, United States
| | - Ann Garwick
- Temple University, College of Public Health, Department of Nursing, 3307 North Broad Street, Philadelphia, PA 19103, United States
| | - Judy Temple
- Temple University, College of Public Health, Department of Nursing, 3307 North Broad Street, Philadelphia, PA 19103, United States
| | - Olga Gurvich
- Temple University, College of Public Health, Department of Nursing, 3307 North Broad Street, Philadelphia, PA 19103, United States
| | - Jiwoo Lee
- Temple University, College of Public Health, Department of Nursing, 3307 North Broad Street, Philadelphia, PA 19103, United States
| | - Bonnie Dudovitz
- Temple University, College of Public Health, Department of Nursing, 3307 North Broad Street, Philadelphia, PA 19103, United States
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12
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Effect of an Education Program on Nutrition Knowledge, Attitudes toward Nutrition, Diet Quality, Lifestyle, and Body Composition in Polish Teenagers. The ABC of Healthy Eating Project: Design, Protocol, and Methodology. Nutrients 2018; 10:nu10101439. [PMID: 30720795 PMCID: PMC6213798 DOI: 10.3390/nu10101439] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 09/17/2018] [Accepted: 09/28/2018] [Indexed: 12/18/2022] Open
Abstract
To increase teenagers’ nutrition knowledge is an important target and has the potential to improve their dietary habits and lifestyle while reducing incidences of obesity-related non-communicable diseases throughout the whole lifespan. This study protocol presents the general approach and details of an assessment of nutritional knowledge, attitudes toward nutrition, diet quality, lifestyle and body composition that have been used to comprehensively evaluate the cross-behavioral patterns covering dietary and lifestyle behaviors in Polish teenagers. The study was designed in two paths as: a cross-sectional study (covering 1569 students) and an education-based intervention study (464 students) with a 9-month follow-up. We describe a short form of the food frequency questionnaire (SF-FFQ4PolishChildren) used to collect data and details of diet-related and lifestyle-related education program, which was developed and implemented by academic researchers involved in the study. We also describe details of the data development and statistical analysis, including multidimensional methods of clustering variables to identify cross-behavioral patterns covering diet and lifestyle. The results of the study will provide evidence-based support for preventive health care to promote normal growth and development of young population and reduce the risk of diet-related diseases in adulthood, by early shaping of adequate dietary and lifestyle behaviors. In the future, well-tailored education programs addressed to teenagers can be created as an important public health action, based on our results.
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13
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Reyes-García V, Gallois S, Díaz-Reviriego I, Fernández-Llamazares Á, Napitupulu L. Dietary Patterns of Children on Three Indigenous Societies. J ETHNOBIOL 2018. [DOI: 10.2993/0278-0771-38.2.244] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Victoria Reyes-García
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona, 08193 Bellatera, Barcelona, Spain
| | | | | | - Álvaro Fernández-Llamazares
- Global Change and Conservation (GCC), Helsinki Institute of Sustainability Science (HELSUS), Faculty of Biological and Environmental Sciences, University of Helsinki, Finland
| | - Lucentezza Napitupulu
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona, 08193 Bellatera, Barcelona, Spain
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14
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Evans EW, Bond DS, Pierre DF, Howie WC, Wing RR, Jelalian E. Promoting health and activity in the summer trial: Implementation and outcomes of a pilot study. Prev Med Rep 2018; 10:87-92. [PMID: 29868357 PMCID: PMC5984214 DOI: 10.1016/j.pmedr.2018.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/24/2018] [Accepted: 02/11/2018] [Indexed: 11/19/2022] Open
Abstract
The objectives of this study were to implement, test adherence to and examine the preliminary effectiveness of a summertime weight-gain prevention intervention in youth from a low-income, Rhode Island community. In 2016, 51 children, ages 6-12 years, participated in a daily, summertime intervention, which offered a minimum of two hours of physical activity programming and free lunch through the USDA's Summer Food Service Program (SFSP). Thirty children from the same community with similar SFSP access served as a comparison group. Height and weight were measured before and at the end of summer to assess change in body mass index z-score (BMIz). Diet and physical activity were assessed midsummer. Multivariate mixed models were used to test group differences in change in BMIz over the summer and weight-related behaviors midsummer. Repeated measures ANOVA was used to examine the relationships of intervention participation with change in BMIz and weight-related behaviors in intervention participants. On average, intervention participants attended 65.6% of program sessions. They lost 0.04 BMIz units, while those in the comparison group gained 0.03 BMIz units (p = 0.07). Midsummer, intervention participants spent 4.6% less time sedentary on weekdays as compared to comparison participants (p = 0.03). Among intervention participants, attendance was significantly associated with change in BMIz (p = 0.01), spending 41 more minutes in moderate to vigorous physical activity (MVPA) (p = 0.004) and 8.5% less time sedentary (p < 0.001). Implementing a summertime obesity prevention intervention in a low-income community is feasible. Despite moderate adherence, preliminary findings suggest that participation in the intervention was associated with reductions in BMIz. CLINICAL TRIALS REGISTRATION ClinicalTrials.govNCT03118635.
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Key Words
- BMI, Body Mass Index
- BMIz, Body Mass Index z-score
- Childhood obesity
- Diet
- GEMS, Girls health Enrichment Multisite Studies
- Low-income
- MVPA, Moderate to Vigorous Physical Activity
- NDSR, Nutrition Data Systems for Research
- PHAST, Promoting Health and Activity in the Summer Trial
- Physical activity
- SDH, Structured Day Hypothesis
- SFSP, Summer Food Service Program
- SPARK AS, Sports, Play, and Active Recreation for Kids - After School
- Summer
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Affiliation(s)
- E. Whitney Evans
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St, Providence, RI 02903, United States
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, RI, United States
| | - Dale S. Bond
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St, Providence, RI 02903, United States
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, RI, United States
| | - Denise F. Pierre
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St, Providence, RI 02903, United States
| | - Whitney C. Howie
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St, Providence, RI 02903, United States
| | - Rena R. Wing
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St, Providence, RI 02903, United States
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, RI, United States
| | - Elissa Jelalian
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St, Providence, RI 02903, United States
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, RI, United States
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15
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Abstract
INTRODUCTION Little is known about how to design serious videogames for children. The purpose of this article is to describe how behavior change techniques promoting self-regulation were incorporated into a serious videogame to help children consume more fruits and vegetables (FVs) and the extent to which these techniques were used by players. A secondary goal is to contribute to the body of scientific knowledge regarding how to design effective serious videogames for children. MATERIALS AND METHODS This research examines the gameplay data from an effective 10-episode online serious videogame promoting FV consumption to preadolescent children in the United States (roughly 9-11-year-olds). RESULTS Children participated in the self-regulation components. Modifications to reduce potential cognitive overload and inform future game design were identified. CONCLUSION This research provided suggestive evidence that behavior change techniques promoting self-regulation can be successfully integrated into a serious videogame for children without detracting from game appeal. It also emphasizes the importance of formative research to the design of an appealing game where children understand and can successfully perform the behavior change procedures.
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Affiliation(s)
- Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine , Houston, Texas
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16
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Tugault-Lafleur CN, Black JL, Barr SI. A Systematic Review of Methods to Assess Children's Diets in the School Context. Adv Nutr 2017; 8:63-79. [PMID: 28096128 PMCID: PMC5227974 DOI: 10.3945/an.116.013144] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
To evaluate the impact of school-based nutrition interventions, accurate and reliable methods are needed to assess what children eat at school. The primary objective of this study was to systematically review methodological evidence on the relative accuracy and reliability of dietary assessment methods used in the school context. The secondary objective was to assess the frequency of methods and analytical approaches used in studies reporting in-school dietary outcomes. Three health databases were searched for full-text English-language studies. Twenty-two methodological studies were reviewed. For school meal recalls, the majority of studies (n = 8 of 12) reported poor accuracy when accuracy was measured by using frequencies of misreported foods. However, when energy report rates were used as a measure of accuracy, studies suggested that children were able to accurately report energy intake as a group. Results regarding the accuracy of food-frequency questionnaires (FFQs) and food records (FRs) were promising but limited to a single study each. Meal observations offered consistently good interrater reliability across all studies reviewed (n = 11). Studies reporting in-school dietary outcomes (n = 47) used a broad range of methods, but the most frequently used methods included weighed FRs (n = 12), school meal recalls (n = 10), meal observations by trained raters (n = 8), and estimated FRs (n = 7). The range of dietary components was greater among studies relying on school meal recalls and FRs than among studies using FFQs. Overall, few studies have measured the accuracy of dietary assessment methods in the school context. Understanding the methodological characteristics associated with dietary instruments is vital for improving the quality of the evidence used to inform and evaluate the impact of school-based nutrition policies and programs.
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Affiliation(s)
- Claire N Tugault-Lafleur
- Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer L Black
- Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, Vancouver, British Columbia, Canada
| | - Susan I Barr
- Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, Vancouver, British Columbia, Canada
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17
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Krehbiel CF, DuPaul GJ, Hoffman JA. A Validation Study of the Automated Self-Administered 24-Hour Dietary Recall for Children, 2014 Version, at School Lunch. J Acad Nutr Diet 2016; 117:715-724. [PMID: 28017317 DOI: 10.1016/j.jand.2016.10.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 10/25/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Obtaining valid and reliable estimates of usual dietary intake at a reasonable cost is a challenge in school-based nutrition research. The Automated Self-Administered 24-Hour Dietary Recall for Children, 2014 version (ASA24 Kids-2014), a self-administered, computerized 24-hour dietary recall, offers improved feasibility over traditional interviewer-administered 24-hour recalls. OBJECTIVE This mixed-methods study examined ASA24 Kids-2014's validity for measuring dietary intake from National School Lunch Program lunches. PARTICIPANTS/SETTING After 24% attrition, 96 middle-school students from three urban schools in eastern Pennsylvania participated in the study. A subsample of 27 participants completed qualitative interviews. Data were collected in the spring of 2014. MAIN OUTCOME MEASURES Self-reported ASA24 Kids-2014 data were compared to direct observations of school lunch, which served as the criterion measure. Dependent variables included eight meal components selected from the National School Lunch Program guidelines (fruit, vegetables, grains, protein-rich foods, dairy, oils, solid fats, and added sugars). A supplemental interview collected qualitative data regarding students' perceptions of content and substantive validity. STATISTICAL ANALYSES The Wilcoxon signed rank test and Spearman's ρ examined criterion-related validity; qualitative content analysis examined content and substantive validity. RESULTS Participants inaccurately recalled food items eaten at lunch, as 58% of foods were reported in error. However, among foods recalled correctly, no statistically significant differences emerged for estimates of portions consumed for six meal components (fruit, vegetables, grains, protein-rich foods, oils, and added sugars). In addition, statistically significant positive correlations emerged between ASA24 Kids-2014 and direct observation for all estimates. Qualitative data identified students' interest and motivation, comprehension, memory, and English-language fluency as relevant sources of error. CONCLUSIONS Middle school students have difficulty recalling food items eaten at school lunch; however, they are somewhat successful at estimating intake of accurately recalled foods using ASA24 Kids-2014. Like many self-administered computerized recalls, it remains limited by substantial error. Findings have implications for the development of ASA24 Kids-2014 among diverse youth in urban school settings.
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18
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Fernandes Davies V, Kupek E, Faria Di Pietro P, Altenburg de Assis MA, Gk Vieira F, Perucchi C, Mafra R, Thompson D, Baranowski T. Qualitative Analysis of Cognitive Interviews With School Children: A Web-Based Food Intake Questionnaire. JMIR Public Health Surveill 2016; 2:e167. [PMID: 27895005 PMCID: PMC5153532 DOI: 10.2196/publichealth.5024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 08/02/2016] [Accepted: 09/03/2016] [Indexed: 11/24/2022] Open
Abstract
Background The use of computers to administer dietary assessment questionnaires has shown potential, particularly due to the variety of interactive features that can attract and sustain children’s attention. Cognitive interviews can help researchers to gain insights into how children understand and elaborate their response processes in this type of questionnaire. Objective To present the cognitive interview results of children who answered the WebCAAFE, a Web-based questionnaire, to obtain an in-depth understanding of children’s response processes. Methods Cognitive interviews were conducted with children (using a pretested interview script). Analyses were carried out using thematic analysis within a grounded theory framework of inductive coding. Results A total of 40 children participated in the study, and 4 themes were identified: (1) the meaning of words, (2) understanding instructions, (3) ways to resolve possible problems, and (4) suggestions for improving the questionnaire. Most children understood questions that assessed nutritional intake over the past 24 hours, although the structure of the questionnaire designed to facilitate recall of dietary intake was not always fully understood. Younger children (7 and 8 years old) had more difficulty relating the food images to mixed dishes and foods eaten with bread (eg, jam, cheese). Children were able to provide suggestions for improving future versions of the questionnaire. Conclusions More attention should be paid to children aged 8 years or below, as they had the greatest difficulty completing the WebCAAFE.
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Affiliation(s)
| | - Emil Kupek
- Public HealthSanta Catarina Federal UniversityFlorianopolisBrazil
| | | | | | | | - Clarice Perucchi
- Nutrition DepartmentSanta Catarina Federal UniversityFlorianopolisBrazil
| | - Rafaella Mafra
- Nutrition DepartmentSanta Catarina Federal UniversityFlorianopolisBrazil
| | - Debbe Thompson
- Department of PediatricsBaylor College of MedicineHouston, TXUnited States
| | - Thomas Baranowski
- Department of PediatricsBaylor College of MedicineHouston, TXUnited States
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19
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Thompson D, Ferry RJ, Cullen KW, Liu Y. Improvement in Fruit and Vegetable Consumption Associated with More Favorable Energy Density and Nutrient and Food Group Intake, but not Kilocalories. J Acad Nutr Diet 2016; 116:1443-1449. [PMID: 27316780 PMCID: PMC5003727 DOI: 10.1016/j.jand.2016.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 05/02/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Children generally do not consume adequate amounts of fruits and vegetables (F/V). Eating more F/V can improve energy density and overall diet quality. OBJECTIVE Our aim was to investigate whether improvements in F/V consumption were associated with improvements in energy density, total calories, and dietary components related to F/V. DESIGN We performed secondary analyses of dietary data from a successful four-group randomized controlled trial promoting F/V. Data were collected at baseline, immediately after gameplay, and 3 months post intervention. PARTICIPANTS/SETTING Preadolescent child-parent dyads (n=400) were recruited. Eligibility criteria were 4th- or 5th-grade child (approximately 9 to 11 years old) with Internet access and a parent willing to participate in the intervention. Complete dietary data were collected on 387 of the 400 child participants. The videogame was available online on a secure, password-protected website. MAIN OUTCOME MEASURES Dietary intake was assessed with three unannounced dietary recalls collected at each data-collection period via telephone by trained staff using Nutrition Data System for Research software. Energy density and F/V, nutrient, and food consumption were calculated. STATISTICAL ANALYSIS PERFORMED A 4×3 (group by time) repeated measures analysis of covariance with mixed-effect linear models was used. Covariates included child's sex, race/ethnicity, and total energy intake as well as parent's age and household education. Energy was excluded as a covariate in the energy density and energy models. RESULTS Significant changes occurred in energy density. A significant interaction (group by time) was observed (F6, 515=2.40; P<0.05) in energy density from food only, while a significant time effect was observed for energy density from all foods and beverages (F2, 388=13.75; P<0.0001). Desirable changes were also observed in F/V-related dietary components. CONCLUSIONS Increasing F/V consumption improved energy density and diet quality considerably in preadolescent children.
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20
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The use of multiple imputation method for the validation of 24-h food recalls by part-time observation of dietary intake in school. Br J Nutr 2016; 116:904-12. [PMID: 27452779 DOI: 10.1017/s0007114516002737] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
External validation of food recall over 24 h in schoolchildren is often restricted to eating events in schools and is based on direct observation as the reference method. The aim of this study was to estimate the dietary intake out of school, and consequently the bias in such research design based on only part-time validated food recall, using multiple imputation (MI) conditioned on the information on child age, sex, BMI, family income, parental education and the school attended. The previous-day, web-based questionnaire WebCAAFE, structured as six meals/snacks and thirty-two foods/beverage, was answered by a sample of 7-11-year-old Brazilian schoolchildren (n 602) from five public schools. Food/beverage intake recalled by children was compared with the records provided by trained observers during school meals. Sensitivity analysis was performed with artificial data emulating those recalled by children on WebCAAFE in order to evaluate the impact of both differential and non-differential bias. Estimated bias was within ±30 % interval for 84·4 % of the thirty-two foods/beverages evaluated in WebCAAFE, and half of the latter reached statistical significance (P<0·05). Rarely (<3 %) consumed dietary items were often under-reported (fish/seafood, vegetable soup, cheese bread, French fries), whereas some of those most frequently reported (meat, bread/biscuits, fruits) showed large overestimation. Compared with the analysis restricted to fully validated data, MI reduced differential bias in sensitivity analysis but the bias still remained large in most cases. MI provided a suitable statistical framework for part-time validation design of dietary intake over six daily eating events.
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Šumonja S, Jevtić M. Accuracy of reported food intake in a sample of 7-10 year-old children in Serbia. Public Health 2016; 138:63-8. [PMID: 27087636 DOI: 10.1016/j.puhe.2016.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 08/04/2015] [Accepted: 03/15/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Children's ability to recall and report dietary intake is affected by age and cognitive skills. Dietary intake reporting accuracy in children is associated with age, weight status, cognitive, behavioural, social factors and dietary assessment techniques. This study analysed accuracy of 7-10 year-old children's reported food intake for one day. STUDY DESIGN Validation study. METHODS Sample included 94 children aged 7-10 years (median = 9 years) from two elementary schools in a local community in Serbia. 'My meals for one day' questionnaire was a combination of 24-h recall and food recognition form. It included recalls for five meals: breakfast at home; snack at home; lunch at home; snack at school and dinner at home. Parental reports were used as reference information about children's food intake for meals obtained at home and observation was used to gain reference information for school meal. Observed and reported amounts were used to calculate omission rate, intrusion rate, corresponding, over-reported and unreported amounts of energy, correspondence rate and inflation ratio. RESULTS Overall omission rate (37.5%) was higher than overall intrusion rate (36.7%). The same food item (bread) has been the most often correctly reported and omitted food item for breakfast, lunch and dinner. Snack at school had the greatest mean correspondence rate (79.6%) and snack at home the highest mean inflation ratio (90.7%). CONCLUSION Most errors in children's recalls were incorrectly reported amounts and not the food items. The questionnaire should be improved to facilitate accurate reports of the amounts.
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Affiliation(s)
- S Šumonja
- University of Novi Sad, Faculty of Education, Department of Natural Sciences, Serbia.
| | - M Jevtić
- University of Novi Sad, Faculty of Medicine, Department of Hygiene, Serbia
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22
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Validity of WebCAAFE questionnaire for assessment of schoolchildren's dietary compliance with Brazilian Food Guidelines. Public Health Nutr 2016; 19:2347-56. [PMID: 27049894 DOI: 10.1017/s1368980016000732] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To estimate reporting bias of WebCAAFE, a web-based questionnaire for the assessment of food intake (recall of frequency of intake of thirty-two food items the day before) and physical activity in schoolchildren. DESIGN Cross-sectional study. Self-reported food intake on WebCAAFE was compared with direct observation of school meals in five public schools. Additional data included school grade, sex, BMI, socio-economic status and access to Internet at home. Poisson regression was used to calculate the reporting bias (WebCAAFE v. direct observation) and the sample size necessary to detect a statistically significant difference between WebCAAFE reports and at least 75 % compliance with the recommendations for a healthy diet. SETTING Intentional sample of five elementary public schools in Florianopolis, Brazil. SUBJECTS Schoolchildren (n 629) from 2nd to 5th grades. RESULTS Moderate bias magnitude was found for most food groups of interest. Frequency of consumption was not related to the bias. Sample sizes necessary to detect the compliance with dietary recommendations varied between four and seventy-four individuals for the different groups investigated. CONCLUSIONS After adjusting for moderate bias, WebCAAFE may be used as a food questionnaire for evaluation of schoolchildren's food compliance on a group level, even with a relatively small sample size.
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Accuracy of self-reported intake of signature foods in a school meal intervention study: comparison between control and intervention period. Br J Nutr 2015; 114:635-44. [PMID: 26189886 DOI: 10.1017/s0007114515002020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Bias in self-reported dietary intake is important when evaluating the effect of dietary interventions, particularly for intervention foods. However, few have investigated this in children, and none have investigated the reporting accuracy of fish intake in children using biomarkers. In a Danish school meal study, 8- to 11-year-old children (n 834) were served the New Nordic Diet (NND) for lunch. The present study examined the accuracy of self-reported intake of signature foods (berries, cabbage, root vegetables, legumes, herbs, potatoes, wild plants, mushrooms, nuts and fish) characterising the NND. Children, assisted by parents, self-reported their diet in a Web-based Dietary Assessment Software for Children during the intervention and control (packed lunch) periods. The reported fish intake by children was compared with their ranking according to fasting whole-blood EPA and DHA concentration and weight percentage using the Spearman correlations and cross-classification. Direct observation of school lunch intake (n 193) was used to score the accuracy of food-reporting as matches, intrusions, omissions and faults. The reporting of all lunch foods had higher percentage of matches compared with the reporting of signature foods in both periods, and the accuracy was higher during the control period compared with the intervention period. Both Spearman's rank correlations and linear mixed models demonstrated positive associations between EPA+DHA and reported fish intake. The direct observations showed that both reported and real intake of signature foods did increase during the intervention period. In conclusion, the self-reported data represented a true increase in the intake of signature foods and can be used to examine dietary intervention effects.
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Diep CS, Hingle M, Chen TA, Dadabhoy HR, Beltran A, Baranowski J, Subar AF, Baranowski T. The Automated Self-Administered 24-Hour Dietary Recall for Children, 2012 Version, for Youth Aged 9 to 11 Years: A Validation Study. J Acad Nutr Diet 2015; 115:1591-8. [PMID: 25887784 DOI: 10.1016/j.jand.2015.02.021] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 02/16/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Valid methods of diet assessment are important for nutrition research and practice, but can be difficult with children. OBJECTIVE To validate the 2012 version of the Automated Self-Administered 24-Hour Dietary Recall for Children (ASA24-Kids-2012), a self-administered web-based 24-hour dietary recall (24hDR) instrument, among children aged 9 to 11 years, in two sites. DESIGN Quasiexperimental. PARTICIPANTS/SETTING In one site, trained staff members observed and recorded foods and drinks consumed by children (n=38) during school lunch. The next day, the observed children completed both ASA24-Kids-2012 and an interviewer-administered 24hDR in a randomized order. Procedures in a second site (n=31) were similar, except observations occurred during dinner in a community location. STATISTICAL ANALYSES Foods were classified as matches (reported and consumed), intrusions (reported, but not consumed), or omissions (not reported, but consumed) for each participant. Rates of matches, intrusions, and omissions were calculated. Rates were compared between each recall method using repeated measures analysis of covariance. For matched foods, the authors determined correlation coefficients between observed and reported serving sizes. RESULTS Match, intrusion, and omission rates between ASA24-Kids-2012 and observed intakes in Site 1 were 37%, 27%, and 35%, respectively. Comparable rates for interviewer-administered 24hDRs were 57%, 20%, and 23%, respectively. In Site 2, match, intrusion, and omission rates between ASA24-Kids-2012 and observed intakes were 53%, 12%, and 36%, respectively, vs 76% matches, 9% intrusions, and 15% omissions for interviewer-administered 24hDRs. The relationship strength between reported and observed serving sizes for matched foods was 0.18 in Site 1 and 0.09 in Site 2 for ASA24-Kids-2012, and 0.46 in Site 1 and 0.11 in Site 2 for interviewer-administered 24hDRs. CONCLUSIONS ASA24-Kids-2012 was less accurate than interviewer-administered 24hDRs when compared with observed intakes, but both performed poorly. Additional research should assess the age at which children can complete recalls without the help of a parent or guardian, as well as elucidate under which circumstances recalls can reasonably be used among children.
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Carvalho M, Baranowski T, Foster E, Santos O, Cardoso B, Rito A, Pereira Miguel J. Validation of the Portuguese self-administered computerised 24-hour dietary recall among second-, third- and fourth-grade children. J Hum Nutr Diet 2014; 28:666-74. [DOI: 10.1111/jhn.12280] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M.A. Carvalho
- Institute of Preventive Medicine and Public Health; Faculty of Medicine; University of Lisbon; Lisboa Portugal
| | - T. Baranowski
- USDA/ARS Children's Nutrition Research Center; Baylor College of Medicine; Houston TX USA
| | - E. Foster
- Human Nutrition Research Centre; Institute of Health and Society; University of Newcastle; Newcastle upon Tyne UK
| | - O. Santos
- Institute of Preventive Medicine and Public Health; Faculty of Medicine; University of Lisbon; Lisboa Portugal
| | - B. Cardoso
- Center for Informatics and Information Technologies; Faculty of Sciences and Technology; New University of Lisbon; Lisboa Portugal
| | - A. Rito
- National Institute of Health Doutor Ricardo Jorge; Lisboa Portugal
| | - J. Pereira Miguel
- Institute of Preventive Medicine and Public Health; Faculty of Medicine; University of Lisbon; Lisboa Portugal
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Ollberding NJ, Couch SC, Woo JG, Kalkwarf HJ. Within- and between-individual variation in nutrient intake in children and adolescents. J Acad Nutr Diet 2014; 114:1749-58.e5. [PMID: 24819232 DOI: 10.1016/j.jand.2014.03.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 03/07/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Little is known regarding the number of 24-hour recalls required to rank-order children and adolescents on usual intake for diet-disease studies. OBJECTIVE To determine the within- to between-individual variance ratios and number of 24-hour recalls required to rank-order individuals on usual intake for select macro- and micronutrients in a large, multiracial/ethnic sample of children and adolescents. DESIGN Cross-sectional survey. PARTICIPANTS/SETTING Children and adolescents ages 6 to 17 years participating in the 2007-2008 and 2009-2010 National Health and Nutrition Examination Survey (NHANES). MAIN OUTCOME MEASURES Variance ratios for predefined sex, age (children age 6 to 11 years, adolescents age 12 to 17 years), and racial/ethnic groups (Mexican American/Hispanic, non-Hispanic black, and non-Hispanic white). STATISTICAL ANALYSIS Mixed-effects linear regression models were used to estimate within- and between-individual variance components for selected nutrients. The number of 24-hour recalls required to rank-order participants on usual intake (absolute values and energy-adjusted) was obtained from the nutrient variance ratios for various levels of accuracy. RESULTS Variance ratios were more than 1 for all nutrients examined. High values (variance ratio >3) were observed for protein, saturated and unsaturated fatty acids, cholesterol, and several micronutrients. Variance ratios for absolute nutrient intakes were similar for both sexes within age groups, but higher for children than for adolescents. A total of six to nine and three to six 24-hour recalls were typically sufficient to rank-order children and adolescents, respectively, on usual intake with an accuracy of r=0.8. Additional recalls were required to achieve the same accuracy for energy-adjusted nutrients. Variance ratios were similar for adolescents across racial/ethnic groups, but highly variable in children. CONCLUSIONS A total of six to nine 24-hour recalls may represent a reasonable trade-off between accuracy and participant burden for rank-ordering nutrient intakes in children and adolescents. Additional research is required to determine whether this may be reduced using statistical modeling-based approaches and the number of recalls children and adolescents will reliably complete.
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Bean MK, Jeffers AJ, Tully CB, Thornton LM, Mazzeo SE. Motivational interviewing with parents of overweight children: study design and methods for the NOURISH + MI study. Contemp Clin Trials 2014; 37:312-21. [PMID: 24530488 PMCID: PMC4025966 DOI: 10.1016/j.cct.2014.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 01/30/2014] [Accepted: 02/05/2014] [Indexed: 11/24/2022]
Abstract
There is an urgent need for innovative approaches to pediatric obesity treatment. There is also a demand for targeted strategies that reduce attrition and improve treatment adherence. Intervening exclusively with parents of overweight children is a novel approach with demonstrated efficacy in reducing child body mass index (BMI) percentile. Motivational interviewing (MI), a brief communication style for exploring and resolving ambivalence about behavior change, might enhance treatment engagement when implemented as part of obesity interventions. The aim of this report is to provide the rationale and methods for a novel study of MI with parents in the treatment of their children's overweight. We designed and are currently implementing NOURISH+MI, a randomized controlled trial examining the feasibility and efficacy of an adjunct values-based MI intervention, implemented within a culturally-tailored parent intervention for overweight children ages 5-11 years, NOURISH(+) (Nourishing Our Understanding of Role modeling to Improve Support and Health). Specifically, we are randomly assigning 60 parents to this adjunctive treatment, and investigating if adding two MI sessions prior to the NOURISH(+) group intervention will enhance treatment effects. We will be able to compare NOURISH+MI participants with those from the two NOURISH(+) treatment conditions (NOURISH(+) and control). We hypothesize that children whose parents participate in NOURISH+MI will demonstrate lower attrition and greater adherence with NOURISH(+), ultimately leading to greater treatment effects, compared with children whose parents are randomized to NOURISH(+) or a control group. Findings will contribute to the emerging literature examining the efficacy of MI within pediatric obesity interventions.
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Affiliation(s)
- Melanie K Bean
- Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, United States.
| | - Amy J Jeffers
- Department of Psychology, Virginia Commonwealth University, United States
| | - Carrie B Tully
- Department of Psychology, Virginia Commonwealth University, United States
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina, Chapel Hill, United States
| | - Suzanne E Mazzeo
- Department of Psychology, Virginia Commonwealth University, United States; Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, United States
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Abstract
Assessing dietary intake in people of any age is challenging but measuring the diet of infants and children can be particularly problematic. Young children may lack the cognitive skills, writing skills and food knowledge to record their own food intake. Multiple people may be responsible for the care of the child and to collect an accurate picture of intake it may be necessary to combine parental reports with observation in school or nursery. Where interviews are conducted with the child themselves questions may need to focus on aspects of the diet which children are likely to attend to. For example, children may not be familiar with food names or brands but may be able to describe their texture, colour and images on packaging. Adolescents are likely to be more aware of the foods they consume and have the cognitive and writing skills to record their own food intake but may lack the interest or motivation. Research has focused on reducing the burden of recording intake on the participant. Developments include food photographs for assessment of portion size which remove the need for weighing each food item, and, in recent years, computer-based methods have been developed for self-completion by young people with the aim of motivating them to participate in studies by making dietary reporting more engaging. The present paper discusses methods and challenges in assessing food intake in children followed by details of two such tools developed at Newcastle University, UK, the Young Person's Food Atlas and INTAKE24.
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Foster E, Hawkins A, Delve J, Adamson AJ. Reducing the cost of dietary assessment: self-completed recall and analysis of nutrition for use with children (SCRAN24). J Hum Nutr Diet 2013; 27 Suppl 1:26-35. [PMID: 23662627 DOI: 10.1111/jhn.12108] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Self-Completed Recall and Analysis of Nutrition (scran24) is a prototype computerised 24-h recall system for use with 11-16 year olds. It is based on the Multiple Pass 24-h Recall method and includes prompts and checks throughout the system for forgotten food items. METHODS AND RESULTS The development of scran24 was informed by an extensive literature review, a series of focus groups and usability testing. The first stage of the recall is a quick list where the user is asked to input all the foods and drinks they remember consuming the previous day. The quick list is structured into meals and snacks. Once the quick list is complete, additional information is collected on each food to determine food type and to obtain an estimate of portion size using digital images of food. Foods are located within the system using a free text search, which is linked to the information entered into the quick list. A time is assigned to each eating occasion using drag and drop onto a timeline. The system prompts the user if no foods or drinks have been consumed within a 3-h time frame, or if fewer than three drinks have been consumed throughout the day. The food composition code and weight (g) of all items selected are automatically allocated and stored. Nutritional information can be generated automatically via the scran24 companion Access database. CONCLUSIONS scran24 was very well received by young people and was relatively quick to complete. The accuracy and precision was close to that of similar computer-based systems currently used in dietary studies.
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Affiliation(s)
- E Foster
- Human Nutrition Research Centre, Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
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Higgins J, Hagman J, Pan Z, MacLean P. Increased physical activity not decreased energy intake is associated with inpatient medical treatment for anorexia nervosa in adolescent females. PLoS One 2013; 8:e61559. [PMID: 23637854 PMCID: PMC3630220 DOI: 10.1371/journal.pone.0061559] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 03/11/2013] [Indexed: 11/18/2022] Open
Abstract
There is a dearth of data regarding changes in dietary intake and physical activity over time that lead to inpatient medical treatment for anorexia nervosa (AN). Without such data, more effective nutritional therapies for patients cannot be devised. This study was undertaken to describe changes in diet and physical activity that precede inpatient medical hospitalization for AN in female adolescents. This data can be used to understand factors contributing to medical instability in AN, and may advance rodent models of AN to investigate novel weight restoration strategies. It was hypothesized that hospitalization for AN would be associated with progressive energy restriction and increased physical activity over time. 20 females, 11–19 years (14.3±1.8 years), with restricting type AN, completed retrospective, self-report questionnaires to assess dietary intake and physical activity over the 6 month period prior to inpatient admission (food frequency questionnaire, Pediatric physical activity recall) and 1 week prior (24 hour food recall, modifiable activity questionnaire). Physical activity increased acutely prior to inpatient admission without any change in energy or macronutrient intake. However, there were significant changes in reported micronutrient intake causing inadequate intake of Vitamin A, Vitamin D, and pantothenic acid at 1 week versus high, potentially harmful, intake of Vitamin A over 6 months prior to admission. Subject report of significantly increased physical activity, not decreased energy intake, were associated with medical hospitalization for AN. Physical activity and Vitamin A and D intake should be carefully monitored following initial AN diagnosis, as markers of disease progression as to potentially minimize the risk of medical instability.
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Affiliation(s)
- Janine Higgins
- School of Medicine, Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.
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Ledoux TA, Watson K, Barnett A, Nguyen NT, Baranowski JC, Baranowski T. Components of the diet associated with child adiposity: a cross-sectional study. J Am Coll Nutr 2012; 30:536-46. [PMID: 22331689 DOI: 10.1080/07315724.2011.10720000] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study sought to determine which components of youths' diets were related to adiposity while controlling for potential often-neglected confounders such as moderate to vigorous physical activity (MVPA) and dietary reporting error. Secondary goals of this study were to determine the extent to which MVPA confounded the associations between diet and adiposity and whether associations between diet and adiposity would differ depending on reporting error. METHODS An ethnically diverse urban sample of 342 children aged 9-10 years and 323 adolescents aged 17-18 years were recruited for this cross-sectional study. Body mass index (BMI) and waist circumference (WC) were measured in the school; dietary assessment included three 24-hour recalls via telephone in the evenings, and MVPA assessment included 5 days of accelerometry. Over (n = 68), under (n = 250), or plausible (n = 347) dietary intake reporters were identified with the Huang calculation method. Linear regression assessed the relationship between adiposity indicators (BMI z-score and WC) and components of the diet (energy intake, food groups, macronutrients) after controlling for reporting error, demographic variables, and MVPA. RESULTS When dietary reporting error and potential confounders such as MVPA and demographic variables were controlled, energy intake (EI), vegetables, refined grains, total fat, total protein, and total carbohydrate were positively related to BMI z-score and WC and artificially sweetened beverages to WC. MVPA was a significant confounder. For BMI z-score, but not WC, relationships and strength of these relationships differed depending on dietary reporting error group (plausible, underreporter, overreporter). CONCLUSIONS Among plausible reporters, as expected, EI, refined grains, and all macronutrients were positively related to adiposity; however, artificially sweetened beverages and vegetables, which are low-energy-dense foods, were also positively related to adiposity. Reporting error interfered with associations between diet and BMI z-score but not WC, suggesting WC is a more robust measure of adiposity in relation to diet.
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Affiliation(s)
- Tracey A Ledoux
- Children's Nutrition Research Center USDA/ARS, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
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Gwynn JD, Flood VM, D'Este CA, Attia JR, Turner N, Cochrane J, Louie JCY, Wiggers JH. Poor food and nutrient intake among Indigenous and non-Indigenous rural Australian children. BMC Pediatr 2012; 12:12. [PMID: 22304829 PMCID: PMC3308924 DOI: 10.1186/1471-2431-12-12] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Accepted: 02/04/2012] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The purpose of this study was to describe the food and nutrient intake of a population of rural Australian children particularly Indigenous children. Participants were aged 10 to 12 years, and living in areas of relative socio-economic disadvantage on the north coast of New South Wales. METHODS In this descriptive cross-sectional study 215 children with a mean age of 11.30 (SD 0.04) years (including 82 Indigenous children and 93 boys) completed three 24-hour food recalls (including 1 weekend day), over an average of two weeks in the Australian summer of late 2005. RESULTS A high proportion of children consumed less than the Australian Nutrient Reference Values for fibre (74-84% less than Adequate Intake (AI)), calcium (54-86% less than Estimated Average Requirement (EAR)), folate and magnesium (36% and 28% respectively less than EAR among girls), and the majority of children exceeded the upper limit for sodium (68-76% greater than Upper Limit (UL)). Energy-dense nutrient-poor (EDNP) food consumption contributed between 45% and 49% to energy. Hot chips, sugary drinks, high-fat processed meats, salty snacks and white bread were the highest contributors to key nutrients and sugary drinks were the greatest per capita contributor to daily food intake for all. Per capita intake differences were apparent by Indigenous status. Consumption of fruit and vegetables was low for all children. Indigenous boys had a higher intake of energy, macronutrients and sodium than non-Indigenous boys. CONCLUSIONS The nutrient intake and excessive EDNP food consumption levels of Australian rural children from disadvantaged areas are cause for concern regarding their future health and wellbeing, particularly for Indigenous boys. Targeted intervention strategies should address the high consumption of these foods.
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Affiliation(s)
- Josephine D Gwynn
- Faculty of Health, University of Newcastle, Callaghan, NSW, Australia.
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Recommendations for a trans-European dietary assessment method in children between 4 and 14 years. Eur J Clin Nutr 2011; 65 Suppl 1:S58-64. [DOI: 10.1038/ejcn.2011.88] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Feasibility of 2 × 24-h dietary recalls combined with a food-recording booklet, using EPIC-Soft, among schoolchildren. Eur J Clin Nutr 2011; 65 Suppl 1:S65-76. [DOI: 10.1038/ejcn.2011.89] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Dunton GF, Liao Y, Intille SS, Spruijt-Metz D, Pentz M. Investigating children's physical activity and sedentary behavior using ecological momentary assessment with mobile phones. Obesity (Silver Spring) 2011; 19:1205-12. [PMID: 21164502 DOI: 10.1038/oby.2010.302] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The risk of obesity during childhood can be significantly reduced through increased physical activity and decreased sedentary behavior. Recent technological advances have created opportunities for the real-time measurement of these behaviors. Mobile phones are ubiquitous and easy to use, and thus have the capacity to collect data from large numbers of people. The present study tested the feasibility, acceptability, and validity of an electronic ecological momentary assessment (EMA) protocol using electronic surveys administered on the display screen of mobile phones to assess children's physical activity and sedentary behaviors. A total of 121 children (ages 9-13, 51% male, 38% at risk for overweight/overweight) participated in EMA monitoring from Friday afternoon to Monday evening during children's nonschool time, with 3-7 surveys/day. Items assessed current activity (e.g., watching TV/movies, playing video games, active play/sports/exercising). Children simultaneously wore an Actigraph GT2M accelerometer. EMA survey responses were time-matched to total step counts and minutes of moderate-to-vigorous physical activity (MVPA) occurring in the 30 min before each EMA survey prompt. No significant differences between answered and unanswered EMA surveys were found for total steps or MVPA. Step counts and the likelihood of 5+ min of MVPA were significantly higher during EMA-reported physical activity (active play/sports/exercising) vs. sedentary behaviors (reading/computer/homework, watching TV/movies, playing video games, riding in a car) (P < 0.001). Findings generally support the acceptability and validity of a 4-day EMA protocol using mobile phones to measure physical activity and sedentary behavior in children during leisure time.
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Affiliation(s)
- Genevieve F Dunton
- Department of Preventive Medicine, University of Southern California, Alhambra, California, USA.
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Dancause KN, Dehuff C, Soloway LE, Vilar M, Chan C, Wilson M, Tarivonda L, Regenvanu R, Kaneko A, Garruto RM, Lum JK. Behavioral changes associated with economic development in the South Pacific: Health transition in Vanuatu. Am J Hum Biol 2011; 23:366-76. [DOI: 10.1002/ajhb.21146] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Revised: 10/31/2010] [Accepted: 12/01/2010] [Indexed: 11/06/2022] Open
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The reliability and validity of a short FFQ among Australian Aboriginal and Torres Strait Islander and non-Indigenous rural children. Public Health Nutr 2010; 14:388-401. [PMID: 20633315 DOI: 10.1017/s1368980010001928] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine the reproducibility and validity of a short FFQ (SFFQ) for Australian rural children aged 10 to 12 years, particularly Aboriginal and Torres Strait Islander children. DESIGN In this cross-sectional study participants completed the SFFQ on two occasions and three 24 h recalls. Concurrent validity was established by comparing results of the first SFFQ against food recalls; reproducibility was established by comparing the two SFFQ. SETTING The north coast of New South Wales in the Australian summer of late 2005. SUBJECTS Two hundred and forty-one children (ninety-two Aboriginal and Torres Strait Islander children and 100 boys) completed two SFFQ and were included in the reproducibility study; of these, 205 participants with a mean age of 10·8 (sd 0·7) years took part in the validity study. RESULTS The SFFQ showed moderate to good reproducibility among all children with kappa coefficients for repeated measures between 0·41 and 0·80. Eighteen of twenty-three questions demonstrated good validity against the mean of the 24 h recalls, with statistically significant increasing trends (P ≤ 0·05) for mean daily weight and/or frequency as survey response categories increased. A similar number of short questions showed good validity for Aboriginal and Torres Strait Islander children as for their non-Indigenous counterparts. CONCLUSIONS Many short questions in this SFFQ are able to discriminate between different categories of food intake and provide information on relative intake within the given population. They can be used to monitor and/or evaluate population-wide health programmes, including those with rural Aboriginal and Torres Strait Islander children.
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General principles for the collection of national food consumption data in the view of a pan-European dietary survey. EFSA J 2009. [DOI: 10.2903/j.efsa.2009.1435] [Citation(s) in RCA: 196] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Baxter SD, Guinn CH, Royer JA, Hardin JW, Mackelprang AJ, Smith AF. Accuracy of children's school-breakfast reports and school-lunch reports (in 24-h dietary recalls) differs by retention interval. Eur J Clin Nutr 2009; 63:1394-403. [PMID: 19756033 PMCID: PMC2788046 DOI: 10.1038/ejcn.2009.107] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Revised: 07/15/2009] [Accepted: 07/20/2009] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Validation-study data were analyzed to investigate the effect of retention interval (time between the to-be-reported meal and interview) on accuracy of children's school-breakfast reports and school-lunch reports in 24-h recalls, and to compare accuracy of children's school-breakfast reports for two breakfast locations (classroom; cafeteria). SUBJECTS/METHODS Each of 374 fourth-grade children was interviewed to obtain a 24-h recall using one of six conditions from crossing two target periods (prior 24 h; previous day) with three interview times (morning; afternoon; evening). Each condition had 62 or 64 children (half boys). A recall's target period included one school breakfast and one school lunch, for which the child had been observed. Food-item variables (observed number; reported number; omission rate; intrusion rate) and energy variables (observed; reported; report rate; correspondence rate; inflation ratio) were calculated for each child for school breakfast and school lunch separately. RESULTS Accuracy for school-breakfast reports and school-lunch reports was inversely related to retention interval. Specifically, as indicated by smaller omission rates, smaller intrusion rates, larger correspondence rates and smaller inflation ratios, accuracy for school-breakfast reports was best for prior-24-h recalls in the morning, and accuracy for school-lunch reports was best for prior-24-h recalls in the afternoon. For neither school meal was a significant sex effect found for any variable. For school-breakfast reports, there was no significant school-breakfast location effect for any variable. CONCLUSIONS By shortening the retention interval, accuracy can be improved for school-breakfast reports and school-lunch reports in children's 24-h recalls.
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Affiliation(s)
- S D Baxter
- Institute for Families in Society, University of South Carolina, Columbia, SC 29208, USA.
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Assis MAAD, Benedet J, Kerpel R, Vasconcelos FDAGD, Di Pietro PF, Kupek E. Validação da terceira versão do Questionário Alimentar do Dia Anterior (QUADA-3) para escolares de 6 a 11 anos. CAD SAUDE PUBLICA 2009; 25:1816-26. [DOI: 10.1590/s0102-311x2009000800018] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2008] [Accepted: 05/04/2009] [Indexed: 11/21/2022] Open
Abstract
O estudo objetivou conferir validade à terceira versão do Questionário Alimentar do Dia Anterior (QUADA-3) para escolares. O QUADA-3 é um instrumento estruturado com seis refeições e 21 alimentos. Participaram 164 escolares de 6 a 11 anos de idade, de uma escola pública de período integral, em 2007. A validade foi testada pela comparação entre os itens alimentares selecionados no questionário e a observação direta de alimentos consumidos em três refeições escolares do dia anterior (lanche da manhã, almoço, lanche da tarde). Análise de regressão logística multivariada foi conduzida para avaliar a discordância entre as respostas do questionário e o registro das observações. Os resultados indicaram alta sensibilidade e especificidade para a maioria dos itens alimentares. Em média, os valores de sensibilidade e especificidade foram de 70,2% e de 96,2%, respectivamente, para os 12 itens alimentares nas três refeições combinadas. Os escolares de 6 a 8 anos, quando comparados aos de 9 a 11 anos, apresentam maiores taxas de discordância de respostas entre o QUADA-3 e as observações. Os resultados indicaram que o QUADA-3 pode gerar dados válidos para avaliar o consumo alimentar do dia anterior em nível de grupo de escolares.
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Affiliation(s)
| | | | | | | | | | - Emil Kupek
- Universidade Federal de Santa Catarina, Brasil
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Warren JM, Stephen AM. Dietary assessment at the end of life's spectrum. Eur J Clin Nutr 2009; 63 Suppl 1:S1-4. [DOI: 10.1038/ejcn.2008.58] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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