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Murai U, Ishihara J, Takachi R, Kotemori A, Ishii Y, Nakamura K, Tanaka J, Iso H, Tsugane S, Sawada N. Validity of the Intake of Sugars, Amino Acids, and Fatty Acids Estimated Using a Self-administered Food Frequency Questionnaire in Middle-aged and Elderly Japanese: The Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT) Protocol Area. J Epidemiol 2024; 34:372-379. [PMID: 38191182 PMCID: PMC11230880 DOI: 10.2188/jea.je20230132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/24/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND The Japanese database of food composition was revised in 2020, during which both the number of food items and the number of food items measured for sugars, amino acids, and fatty acids were increased. We evaluated the validity of estimated intakes of sugars, amino acids and fatty acids using a long food frequency questionnaire (long-FFQ) among middle-aged and elderly Japanese. METHODS From 2012 to 2013, 240 men and women aged 40-74 years from five areas in the JPHC-NEXT protocol were asked to respond to the long-FFQ and provide a 12-day weighed food record (WFR) as reference. The long-FFQ, which included 172 food and beverage items and 11 seasonings, was compared with a 3-day WFR, completed during each distinct season, and validity was assessed using Spearman's correlation coefficients. RESULTS Percentage differences based on the long-FFQ with the 12-day WFR in men and women varied from -84.4% to 419.6%, and from -75.8% to 623.1% for sugars, -17.5% to 3.8% and -5.8% to 19.6% for amino acids, and -58.5% to 78.8% and -43.4% to 129.3% for fatty acids, respectively. Median values of correlation coefficients for the long-FFQ in men and women were 0.52 and 0.42 for sugars, 0.38 and 0.37 for amino acids, and 0.42 and 0.42 for fatty acids, respectively. CONCLUSION The long-FFQ provided reasonable validity in estimating the intakes of sugars, amino acids, and fatty acids in middle-aged and elderly Japanese. Although caution is warranted for some nutrients, these results may be used in future epidemiological studies.
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Affiliation(s)
- Utako Murai
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Department of Food and Life Science, School of Life and Environmental Science, Azabu University, Kanagawa, Japan
| | - Junko Ishihara
- Department of Food and Life Science, School of Life and Environmental Science, Azabu University, Kanagawa, Japan
| | - Ribeka Takachi
- Department of Food Science and Nutrition, Nara Women’s University Graduate School of Humanities and Sciences, Nara, Japan
| | - Ayaka Kotemori
- Department of Food and Life Science, School of Life and Environmental Science, Azabu University, Kanagawa, Japan
| | - Yuri Ishii
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Kazutoshi Nakamura
- Department of Community Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Junta Tanaka
- Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroyasu Iso
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Graduate School of Public Health, International University of Health and Welfare, Tokyo, Japan
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
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Söderström E, Sandborg J, Nilsson E, Henström M, Lemming EW, Lindroos AK, Rood J, Sipinen JP, Löf M. Validation of an web-based dietary assessment tool (RiksmatenFlex) against doubly labelled water and 24 h dietary recalls in pregnant women. Nutr J 2024; 23:85. [PMID: 39080751 PMCID: PMC11287942 DOI: 10.1186/s12937-024-00987-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 07/17/2024] [Indexed: 08/03/2024] Open
Abstract
INTRODUCTION Digital technologies have enabled new possibilities to assess dietary intake and have shown promise in terms of decreased participant burden, improved accuracy and lower costs. However, their potential and validity in pregnant populations are scarcely explored. OBJECTIVES This study aimed to (a) validate energy intakes obtained from a web-based dietary recall method developed for national surveys (RiksmatenFlex) against total energy expenditure (TEE) by means of the doubly labelled water (DLW) method, and (b) to compare intakes of macronutrients, key unhealthy and healthy foods as well as adherence to food-based dietary guidelines between RiksmatenFlex and repeated 24 h telephone dietary recalls in healthy Swedish pregnant women. METHODS This study was conducted as a nested validation within the HealthyMoms trial. Intakes of foods, macronutrients and energy were assessed during three days through RiksmatenFlex and 24 h telephone dietary recalls, and Swedish Healthy Eating Index (SHEI) scores were also calculated for both methods (n = 52). For 24 women, TEE was also assessed through the DLW method. Paired Samples T-tests and Wilcoxon Signed Ranks Tests were used to identify differences between means for foods, macronutrients, energy and SHEI scores. Pearson correlation coefficient or Spearman's rho were performed to identify relationships between variables. To compare energy intake (RiksmatenFlex) with TEE (DLW method) and 24 h telephone dietary recalls, Bland and Altman plots were constructed. RESULTS Average energy intake from RiksmatenFlex (10,015 [SD 2004] kJ) was not statistically different from TEE (10,252 [SD 1197] kJ) (p = 0.596) (mean difference: -237 kJ/24 h). Correspondingly, there were small mean differences between average intakes of key unhealthy and healthy foods and average SHEI scores between RiksmatenFlex and 24 h telephone dietary recalls. However, the Bland and Altman plots showed wide limits of agreement for all dietary variables (e.g., for energy intake using RiksmatenFlex versus TEE: ±4239 kJ/24 h). High correlations between the investigated dietary variables for the two dietary methods were observed (r = 0.751 to 0.931; all p < 0.001). CONCLUSION RiksmatenFlex captured average intakes of energy, unhealthy and healthy food groups and adherence to food-based dietary guidelines in a comparable way to 24 h telephone dietary recalls and the DLW method. Our results support the validity of RiksmatenFlex as a web-based dietary assessment method for future use in pregnancy for intervention studies and national dietary surveys.
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Affiliation(s)
- Emmie Söderström
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
- Department of Medicine, Karolinska Institutet, Huddinge, Sweden.
| | | | - Ellinor Nilsson
- Department of Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Maria Henström
- Department of Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Eva Warensjö Lemming
- Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
- Department of Food science, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Anna Karin Lindroos
- Swedish Food Agency, Uppsala, Sweden
- Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jennifer Rood
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | | | - Marie Löf
- Department of Medicine, Karolinska Institutet, Huddinge, Sweden
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Wang M, Liang S, Jiang T. Comparison of case-based and lecture-based learning in dental fluorosis diagnostic ability with visual analog scale assessment. BMC MEDICAL EDUCATION 2024; 24:761. [PMID: 39010047 PMCID: PMC11247894 DOI: 10.1186/s12909-024-05695-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 06/23/2024] [Indexed: 07/17/2024]
Abstract
OBJECTIVE This study aimed to compare the impact of case-based learning (CBL) versus lecture-based learning (LBL) on dental students' clinical decision-making regarding DF severity using Visual Analog Scale (VAS) scoring. METHODS Eighty first-year graduate dental students were randomly assigned to either the CBL (n = 38) or LBL (n = 42) groups. Both groups received instruction on DF diagnosis, with CBL involving small group sessions analyzing real cases and LBL involving traditional lectures. Effectiveness was assessed by presenting 32 dental fluorosis cases with Thylstrup-Fejerskov Index (TSIF) scores ranging from 0 to 7 through slide presentations to both groups for VAS assessment. Five evaluators of each group randomly selected were asked to repeat the rating 2 weeks later. Statistical analysis included two-way ANOVA for group and gender differences, intra-class correlation coefficient (ICC) for reliability, and Spearman correlation coefficients for validity. RESULTS Variations in VAS scores were observed between CBL and LBL groups, with no significant gender impact. Excellent inter- and intra-evaluator agreement was found for VAS scoring in both groups, indicating its reliability. Validation against established indices (such as DI and TSIF) demonstrated strong correlations, with CBL students exhibiting higher correlations. CONCLUSIONS CBL enhances students' clinical decision-making and proficiency in DF diagnosis, as evidenced by more consistent and accurate VAS scoring compared to LBL. These findings highlight the importance of innovative educational strategies in dental curricula, with implications for improving training quality and clinical outcomes. TRIAL REGISTRATION The study was registered at the Clinical Research Center, Hospital of Stomatology, Wuhan University (Registration code: HGGC-036).
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Affiliation(s)
- Man Wang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
- Department of Prosthodontics, Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
| | - Shanshan Liang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China.
- Department of Prosthodontics, Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China.
| | - Tao Jiang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China.
- Department of Prosthodontics, Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China.
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Zhang Y, Gu D, Luo M, Liu S, Peng H, Jia Y. Relative validity of an intelligent ordering system to estimate dietary intake among university students from a medical school in Shanghai, China. Int J Behav Nutr Phys Act 2024; 21:70. [PMID: 38965619 PMCID: PMC11225410 DOI: 10.1186/s12966-024-01619-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 06/14/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Dietary assessment methods have limitations in capturing real-time eating behaviour accurately. Equipped with automated dietary-data-collection capabilities, the "intelligent ordering system" (IOS) has potential applicability in obtaining long-term consecutive, relatively detailed on-campus dietary records among university students with little resource consumption. We investigated (1) the relative validity of IOS-derived nutrient/food intakes compared to those from the 7-day food diary (7DFD); (2) whether including a supplemental food frequency questionnaire (SFFQ) improves IOS accuracy; and (3) sex differences in IOS dietary intake estimation. METHODS Medical students (n = 221; age = 22.2 ± 2.4 years; 38.5% male and 61.5% female) completed the 7DFD and SFFQ. During the consecutive 7-day survey period, students weighed and photographed each meal before and after consumption. Then, students reviewed their 3-month diet and completed the SFFQ, which includes eight underprovided school-canteen food items (e.g., dairy, fruits, nuts). Meanwhile, 9385 IOS dietary data entries were collected. We used Spearman coefficients and linear regression models to estimate the associations among the different dietary intake assessment methods. Individual- and group-level agreement was assessed using the Wilcoxon signed-rank test, cross-classification, and Bland‒Altman analysis. RESULTS IOS mean daily energy, protein, fat, and carbohydrate intake estimations were significantly lower (-15-20%) than those of the 7DFD. The correlation coefficients varied from 0.52 (for added sugar) to 0.88 (for soybeans and nuts), with fruits (0.37) and dairy products (0.29) showing weaker correlations. Sixty-two (milk and dairy products) to 97% (soybeans and nuts) of participants were classified into the same or adjacent dietary intake distribution quartile using both methods. The energy and macronutrient intake differences between the IOS + SFFQ and 7DFD groups decreased substantially. The separate fruit intake measurements from each assessment method did not significantly differ from each other (p > 0.05). IOS and IOS + SFFQ regression models generally yielded higher R2 values for males than for females. CONCLUSION Despite estimation differences, the IOS can be reliable for medical student dietary habit assessment. The SFFQ is useful for measuring consumption of foods that are typically unavailable in school cafeterias, improving the overall dietary evaluation accuracy. The IOS assessment was more accurate for males than for females.
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Affiliation(s)
- Yimeng Zhang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, 130 Dongan Road, Shanghai, 200032, People's Republic of China
| | - Dantong Gu
- Institute of Otolaryngology, Clinical Research Center, Eye and ENT Hospital, Fudan University, Shanghai, 200031, People's Republic of China
| | - Mengyun Luo
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Shaojie Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, 130 Dongan Road, Shanghai, 200032, People's Republic of China
- Department of Nutrition, the First Affiliated Hospital of Xiamen University, Xiamen, 361003, China
| | - Hong Peng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, 130 Dongan Road, Shanghai, 200032, People's Republic of China
| | - Yingnan Jia
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, 130 Dongan Road, Shanghai, 200032, People's Republic of China.
- Health Communication Institute, Fudan University, Shanghai, 200032, China.
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Drapeau V, Laramée C, Lafreniere J, Trottier C, Brochu C, Robitaille J, Lamarche B, Lemieux S. Assessing the relative validity of a web-based self-administered 24-hour dietary recall in a Canadian adolescent's population. Nutr J 2024; 23:66. [PMID: 38907225 PMCID: PMC11191218 DOI: 10.1186/s12937-024-00954-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 04/28/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Healthy eating habits at a young age are crucial to support growth and development and good general health. In this context, monitoring youth dietary intakes adequately with valid tools is important to develop efficient interventions and identify groups that are more at risk of inadequate intakes. This study aimed to assess the relative validity of the self-administered web-based 24-h dietary recall (R24W) for evaluating energy and nutrient intakes among active adolescents. METHODS Participants were invited to complete one interviewer-administered 24-h dietary dietary recall and the R24W on up to three occasions within one month. A total of 272 French-speaking active adolescents aged 12 to 17 years from the province of Québec were invited to complete three R24W and one interview-administered 24-h recall. Student's t-test and correlations were conducted on sex-adjusted data. Percent differences, cross-classification (percentage of agreement), weighted Kappa and Bland-Altman plots were calculated. RESULTS Mean (SD) energy intake from the R24W was 8.8% higher than from the interview-administered 24-h dietary recall (2558 kcal ± 1128 vs. 2444 kcal ± 998, p < 0.05). Significant differences in mean nutrient intake between the R24W and the interview-administered 24-h dietary recall ranged from 6.5% for % E from fat (p < 0.05) to 25.2% for saturated fat (p < 0.001), i.e., higher values with R24W. Sex-adjusted correlations were significant for all nutrients except for % E from proteins and thiamin (range: 0.24 to 0.52, p < 0.01). Cross-classification demonstrated that 36.6% of the participants were classified in the same fourth with both methods, 39.6% in the adjacent fourth, and 5.7% misclassified. Bland-Atman plots revealed proportional bias between the two methods for 7/25 nutrients. Completing at least two recalls with the R24W increased the precision of intake estimates. CONCLUSION These data suggest that the R24W presents an acceptable relative validity compared to a standard interview-administered 24-h recall for estimating energy and most nutrients in a cohort of French-speaking adolescents from the province of Québec.
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Affiliation(s)
- Vicky Drapeau
- Department of Kinesiology, Faculty of Medicine, Université Laval Québec, 2300, rue de la Terrasse, G1V 0A6, Québec, Canada.
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, G1V 0A6, Québec, Canada.
- Quebec Heart and Lung Institute Research Center, Université Laval, G1V 4G5, Québec, Canada.
| | - Catherine Laramée
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, G1V 0A6, Québec, Canada
| | | | - Christiane Trottier
- Department of Kinesiology, Faculty of Medicine, Université Laval Québec, 2300, rue de la Terrasse, G1V 0A6, Québec, Canada
| | - Charlotte Brochu
- Department of Kinesiology, Faculty of Medicine, Université Laval Québec, 2300, rue de la Terrasse, G1V 0A6, Québec, Canada
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, G1V 0A6, Québec, Canada
- Quebec Heart and Lung Institute Research Center, Université Laval, G1V 4G5, Québec, Canada
| | - Julie Robitaille
- School of Nutrition, Laval University, Québec, G1V 0A6, Canada
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, G1V 0A6, Québec, Canada
| | - Benoît Lamarche
- School of Nutrition, Laval University, Québec, G1V 0A6, Canada
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, G1V 0A6, Québec, Canada
| | - Simone Lemieux
- School of Nutrition, Laval University, Québec, G1V 0A6, Canada
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, G1V 0A6, Québec, Canada
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Eleraky L, Stuetz W, Rybak C, Frank J, Biesalski HK, Mbwana H, Kinabo J, Lambert C. Potentials and limitations of a food group-based algorithm to assess dietary nutrient intake of women in rural areas in Tanzania. Int J Food Sci Nutr 2024; 75:436-444. [PMID: 38639183 DOI: 10.1080/09637486.2024.2335523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 03/21/2024] [Indexed: 04/20/2024]
Abstract
The aim of this study was to evaluate the accuracy of nutrient intake assessment with the food group-based algorithm "Calculator of Inadequate Micronutrient Intake" (CIMI) in comparison to the established nutrition software NutriSurvey. Using Food Frequency Questionnaires and 24-h dietary recalls of 1010 women from two rural districts in Tanzania, 23 relevant typical Tanzanian food groups were identified and subsequently the dietary protocols assessed via CIMI algorithm were compared by bivariate correlations and Bland-Altman analysis with the results of the NutriSurvey software (reference) and were set in relation to blood biomarkers of 666 participants. CIMI and NutriSurvey calculations regarding macro- and micronutrient intakes were similar. The Bland-Altman analyses and correlation coefficients of energy (0.931), protein (0.898), iron (0.775) and zinc (0.838) confirm the agreement of both calculations. The food group based CIMI algorithm is a practical tool to identify the inadequacy of macro- and micronutrient intake at population level.
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Affiliation(s)
- Laila Eleraky
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany
| | - Wolfgang Stuetz
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany
| | - Constance Rybak
- Leibniz Centre for Agricultural Landscape Research (ZALF) e. V, Müncheberg, Germany
- Devision Urban Plant Ecophysiology, Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Jan Frank
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany
| | | | - Hadijah Mbwana
- Department of Food Science Technology, Nutrition and Consumer Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Joyce Kinabo
- Department of Food Science Technology, Nutrition and Consumer Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Christine Lambert
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany
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Gili RV, Leeson S, Carlino B, Contreras-Guillén IA, Xutuc D, Martins MCT, Díaz MDP, Segovia-Siapco G, Oliveira da Silva Pacheco S, Pacheco FJ. Validity and Reproducibility of an Electronic Food Frequency Questionnaire in Argentinian Adults. Nutrients 2024; 16:1564. [PMID: 38892498 PMCID: PMC11174462 DOI: 10.3390/nu16111564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/14/2024] [Accepted: 05/14/2024] [Indexed: 06/21/2024] Open
Abstract
This study aimed to validate a semiquantitative electronic food frequency questionnaire (eFFQ) in estimating the intake of a comprehensive list of nutrients and bioactive compounds among adults from six regions of Argentina using multiple 24 h dietary recall (24HR) as a reference. A total of 163 adults completed two administrations of the eFFQ and four 24HRs. The paired t-test/Wilcoxon signed-rank test, Spearman/Pearson correlations, cross-classification, weighted kappa statistics, and Bland-Altman plots were employed to determine relative validity. To determine reproducibility, intraclass correlations (ICC), cross-classification, and weighted kappa statistics were calculated. For relative validity, crude correlations ranged from 0.15 to 0.57; energy adjustment and de-attenuation slightly improved most of these correlations. In cross-classification analysis, agreements within one quintile adjacent to exact agreement (EA ± 1) ranged from 52.2% to ~74%; extreme misclassifications were < 7%. For reproducibility, the crude ICC ranged from 0.29 to 0.85, showing moderate to good correlations for most nutrients. Cross-classification analysis showed agreement levels for the EA ± 1 quintile of 70.6% to 87.7%. Weighted kappa values ranged from 0.21 to 0.62. The results show that this eFFQ is relatively valid in ranking adults according to their nutrient intake and has an acceptable reproducibility, yet it slightly overestimates the intake of most nutrients.
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Affiliation(s)
- Rocio Victoria Gili
- Interdisciplinary Center for Research in Health and Behavioral Sciences, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín 3103, Argentina; (S.L.); (B.C.); (I.A.C.-G.); (D.X.)
- School of Nutrition, Faculty of Medical Sciences, Universidad Nacional de Córdoba, Córdoba 5016, Argentina;
| | - Sara Leeson
- Interdisciplinary Center for Research in Health and Behavioral Sciences, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín 3103, Argentina; (S.L.); (B.C.); (I.A.C.-G.); (D.X.)
| | - Belén Carlino
- Interdisciplinary Center for Research in Health and Behavioral Sciences, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín 3103, Argentina; (S.L.); (B.C.); (I.A.C.-G.); (D.X.)
- School of Nutrition, Faculty of Medical Sciences, Universidad Nacional de Córdoba, Córdoba 5016, Argentina;
| | - Ismael Alejandro Contreras-Guillén
- Interdisciplinary Center for Research in Health and Behavioral Sciences, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín 3103, Argentina; (S.L.); (B.C.); (I.A.C.-G.); (D.X.)
- School of Agricultural Sciences, Food Sciences and Engineering, Universidad Nacional de Entre Ríos, Oro Verde 3100, Argentina
| | - Daniel Xutuc
- Interdisciplinary Center for Research in Health and Behavioral Sciences, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín 3103, Argentina; (S.L.); (B.C.); (I.A.C.-G.); (D.X.)
| | | | - María del Pilar Díaz
- School of Nutrition, Faculty of Medical Sciences, Universidad Nacional de Córdoba, Córdoba 5016, Argentina;
- Institute of Health Sciences Research (INICSA), School of Medical Sciences, Universidad Nacional de Córdoba, Córdoba 5016, Argentina
| | - Gina Segovia-Siapco
- School of Public Health, Loma Linda University, 24951 Circle Dr. Nichol Hall, Loma Linda, CA 92350-1718, USA
| | - Sandaly Oliveira da Silva Pacheco
- Interdisciplinary Center for Research in Health and Behavioral Sciences, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín 3103, Argentina; (S.L.); (B.C.); (I.A.C.-G.); (D.X.)
| | - Fabio Juliano Pacheco
- Interdisciplinary Center for Research in Health and Behavioral Sciences, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín 3103, Argentina; (S.L.); (B.C.); (I.A.C.-G.); (D.X.)
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Ni X, Qiao T, Wang R, Wang F, Liang Y, Wei S. Assessing the reproducibility and validity of a food frequency questionnaire for pregnant women from the Chinese Miao ethnic group. Front Nutr 2024; 11:1322225. [PMID: 38774260 PMCID: PMC11106495 DOI: 10.3389/fnut.2024.1322225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 04/15/2024] [Indexed: 05/24/2024] Open
Abstract
Background Currently, no food frequency questionnaire is available to be administered exclusively to ethnic minorities in China. This study aimed to evaluate the reproducibility and validity of a culturally tailored semi-quantitative food frequency questionnaire (FFQ) designed for pregnant women belonging to the Miao ethnic group in China. Methods A total of 74 questions in the FFQ were administered to collect dietary information from Miao women in China during their pregnancy. This study included 153 and 127 pregnant women, respectively, for testing the validity and reproducibility of the results. Baseline FFQ data (FFQ1) were collected initially, followed by the administration of a repeated FFQ 4-6 weeks later (FFQ2). Two 24-h recalls (24HR) were used as references to compare food groups and nutrient intake. Pearson/Spearman's coefficients were used to measure the validity and reproducibility of the FFQ. Quartile cross-classification, weighted kappa coefficients, and Bland-Altman plots were employed to assess the agreement. Results Most food groups and nutrient intake estimated by the FFQ were higher than those estimated by the 24HR. Food groups and nutrients' correlations for FFQ vs. 24HR after being energy-adjusted and de-attenuated, respectively, were 0.10 (vegetables) to 0.45 (grains/tubers) and 0.15 (iron) to 0.52 (riboflavin). Comparatively, correlation coefficients for FFQ1 vs. FFQ2 ranged from 0.41 (fruit) to 0.71 (vegetables) and from 0.45 (energy) to 0.64 (calcium). The percentage of pregnant women classified in the same or adjacent quartiles ranged from 64.08% (vegetables) to 95.29% (sour soup) and from 68.88% (vitamin E) to 78.81% (energy). Weighted kappa coefficients exceeded 0.2 for food groups and most nutrients, and Bland-Altman plots demonstrated acceptable agreement between the two tools. Conclusions This study provides novel information on the validation of FFQ. It demonstrates that the FFQ exhibits ideal reproducibility and acceptable validity in estimating and ranking the intake of food groups and most nutrients among pregnant women belonging to the Chinese Miao ethnic group.
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Affiliation(s)
- Xiaorong Ni
- The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, China
| | - Tian Qiao
- Department of Clinical Nutrition, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Rong Wang
- The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, China
| | - Fang Wang
- The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, China
| | - Yi Liang
- The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, China
- Department of Clinical Nutrition, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Shaofeng Wei
- The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, China
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9
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Shatylo S, Solovyova G. Adaptation and validation of the EPIC-Norfolk food frequency questionnaire for assessing dietary intake in Ukrainian adults. BMJ Nutr Prev Health 2024; 7:160-165. [PMID: 38966104 PMCID: PMC11221282 DOI: 10.1136/bmjnph-2023-000703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 04/02/2024] [Indexed: 07/06/2024] Open
Abstract
Introduction Currently, there are no validated food frequency questionnaires (FFQs) for evaluating nutrient intake in Ukrainian adults. This study aimed to adapt and validate the European Prospective Investigation into Cancer Food Frequency Questionnaire (EPIC-Norfolk FFQ) for this population group. Methods Adults aged 18-54 years (n=90) living in different regions of Ukraine completed the new Ukrainian version of the EPIC-Norfolk FFQ and provided information about their 24-hour dietary recall. Raw and energy-adjusted data were analysed using Spearman's correlation coefficients, Wilcoxon signed-ranks test, cross-classification method, weighted kappa and Bland-Altman analysis. Results Correlations ranged from 0.0738 (retinol equivalents) to 0.458 (total energy and phosphorus) and were statistically significant for all nutrients except cholesterol and vitamin A (as retinol and retinol equivalents). The percentage of participants classified into the same and adjacent quartiles ranged from 61.11% (vitamin A as retinol equivalents) to 81.11% (vitamin D). Gross misclassification into the opposite quartile ranged from 3.33% (magnesium) to 10% (cholesterol, vitamin A as retinol and retinol equivalents). Using the weighted kappa, most nutrients had a fair agreement (ĸ=0.21-0.40). Energy adjustment did not affect the results for most nutrients. Bland-Altman plots confirmed overestimation of the absolute intake of most nutrients and appeared to underestimate total sugars intake by FFQ; nevertheless, there was good agreement between the two methods. Conclusion The new Ukrainian version of the FFQ demonstrated reasonable relative validity for ranking an individual's nutrient intake. The overestimation of the absolute intake of most nutrients is comparable to or even less than that in other FFQ validation studies. We cannot recommend the current Ukrainian version of the FFQ for the assessment of vitamin A (as retinol and retinol equivalents) consumption because of significant differences in results between the two methods.
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Affiliation(s)
- Sofiia Shatylo
- Department of Internal Medicine, Faculty of Dentistry, Bogomolets National Medical University, Kyiv, T. Shevchenko boulevard, 13, Ukraine
| | - Galyna Solovyova
- Department of Internal Medicine, Faculty of Dentistry, Bogomolets National Medical University, Kyiv, T. Shevchenko boulevard, 13, Ukraine
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10
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Faessen JPM, Feskens EJM, Brouwer-Brolsma EM. Development and short evaluation of the Dutch healthy diet index for pregnant women; DHD-P. Front Nutr 2024; 11:1386888. [PMID: 38737511 PMCID: PMC11082309 DOI: 10.3389/fnut.2024.1386888] [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: 02/16/2024] [Accepted: 04/12/2024] [Indexed: 05/14/2024] Open
Abstract
Introduction Diet quality indices provide a quick indicator of overall diet and are commonly used in research and surveillance. We developed a Dutch Healthy Diet for pregnant women (DHD-P) index, comprising 22 components aligned with the 2021 Dutch food-based dietary guidelines for pregnant women. Our evaluation focused on assessing its performance and sensitivity to change. Methods The DHD-P index was quantified by using a validated Food Frequency Questionnaire (FFQ) and two 24-h recalls at 12 and 24 weeks gestation completed by 24-to-41 year old pregnant women participating in the GLIMP-II study. Strength and direction of associations were evaluated based on de-attenuated correlation coefficients between FFQ and 24-h recall data at 24 weeks gestation (n = 47). Sensitivity to change was evaluated by comparing DHD-P index data assessed by both FFQ and recalls at 12 and 24 weeks gestation using paired t-tests or Wilcoxon Signed Rank Test (n = 27). Results De-attenuated correlation coefficients between FFQ and 24-recall data showed a good correlation for the total DHD-P score (rho = 0.57) and moderate to good correlations for component scores. FFQ as well as recall data showed comparable dietary intake at 12 and 24 weeks, suggesting minimal changes during pregnancy. Correlations over time were moderate-to-good for scores based on FFQ and low to moderate for scores based on 24hRs, indicating better reproducibility of scores based on FFQ data. Conclusion Considering the moderate to good correlations, the DHD-P index appears to be an appropriate index to assess diet quality among pregnant women, and could serve as a foundation to provide dietary feedback toward healthier food choices. Studies including dietary data for all relevant food groups and nutrients are needed to substantiate our findings and further explore the DHD-P sensitivity to change.
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Affiliation(s)
- Janine P. M. Faessen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
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11
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Bell L, Manson A, Zarnowiecki D, Tan SN, Byrne R, Taylor R, Zheng M, Wen LM, Golley R. Development and validation of a short dietary questionnaire for assessing obesity-related dietary behaviours in young children. MATERNAL & CHILD NUTRITION 2024; 20:e13613. [PMID: 38192050 PMCID: PMC10981485 DOI: 10.1111/mcn.13613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 11/07/2023] [Accepted: 11/29/2023] [Indexed: 01/10/2024]
Abstract
There are few short, validated tools to assess young children's obesity-related dietary behaviours, limiting the rapid screening of dietary behaviours in research and practice-based early obesity prevention. This study aimed to develop and assess the reliability and validity of a caregiver-reported short dietary questionnaire to rapidly assess obesity-related dietary behaviours in children aged 6 months to 5 years. The Early Prevention of Obesity in Childhood Dietary Questionnaire (EPOCH-DQ) was developed using a rigorous process to determine content and structural validity. Three age-appropriate versions were developed for (1) infants, aged 6-12 months, (2) toddlers, aged 1-2.9 years and (3) pre-schoolers, aged 3-5 years. The questionnaire (7-15 items) measures dietary behaviours, including diet risk from non-core food and beverage intake, diet quality from vegetable frequency, bread type and infant feeding practices. Test-retest reliability was assessed from repeated administrations 1 week apart (n = 126). Internal consistency, concurrent validity (against a comparison questionnaire, the InFANT Food Frequency Questionnaire), construct validity and interpretability were assessed (n = 209). Most scores were highly correlated and significantly associated (p < 0.05) for validity (rs: 0.45-0.89, percentage agreement 68%-100%) and reliability (intraclass correlation coefficient: 0.61-0.99) for diet risk, diet quality and feeding practice items. The EPOCH-DQ shows acceptable validity and reliability for screening of obesity-related behaviours of children under 5 years of age. The short length and, thus, low participant burden of the EPOCH-DQ allows for potential applications in various settings. Future testing of the EPOCH-DQ should evaluate culturally and socio-economically diverse populations and establish the predictive validity and sensitivity to detect change.
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Affiliation(s)
- Lucinda Bell
- Flinders University, College of Nursing and Health Sciences, Caring Futures InstituteAdelaideSouth AustraliaAustralia
| | - Alexandra Manson
- Flinders University, College of Nursing and Health Sciences, Caring Futures InstituteAdelaideSouth AustraliaAustralia
| | - Dorota Zarnowiecki
- Flinders University, College of Nursing and Health Sciences, Caring Futures InstituteAdelaideSouth AustraliaAustralia
| | - Shi Ning Tan
- Flinders University, College of Nursing and Health Sciences, Caring Futures InstituteAdelaideSouth AustraliaAustralia
| | - Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of HealthQueensland University of TechnologyKelvin GroveQueenslandAustralia
| | - Rachael Taylor
- Department of MedicineUniversity of OtagoDunedinNew Zealand
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition SciencesDeakin UniversityGeelongVictoriaAustralia
| | - Li Ming Wen
- Sydney School of Public Health, Faculty of Medicine and HealthSydneyNew South WalesAustralia
| | - Rebecca Golley
- Flinders University, College of Nursing and Health Sciences, Caring Futures InstituteAdelaideSouth AustraliaAustralia
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12
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Baart AM, Brouwer-Brolsma EM, de Jong HBT, de Vries JHM, Feskens EJM. Assessment of the Dutch Healthy Diet index 2015 in the Lifelines cohort study at baseline. Eur J Clin Nutr 2024; 78:217-227. [PMID: 38017142 PMCID: PMC10927538 DOI: 10.1038/s41430-023-01372-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Dietary indices are useful measures to investigate associations between dietary intake and disease development. The Dutch Healthy Diet index 2015 (DHD2015-index), a measure of diet quality, assesses adherence to the 2015 Dutch dietary guidelines. We assessed the DHD2015-index in the Lifelines cohort study, and compared calculations from basic and detailed dietary intake data. This article replaces the retracted article that was published on 16 May 2022 [1]. METHODS Dietary intake was assessed with a specially developed Food Frequency Questionnaire (FFQ) called Flower-FFQ, which consists of one main questionnaire (heart-FFQ), which asks for intakes of major food groups, and three complementary questionnaires (petal-FFQs), which ask for detailed information on food types within major food groups of the heart-FFQ. The DHD2015-index was assessed using data from the total Flower-FFQ (for 56,982 participants), and using data from the heart-FFQ only (for 129,030 participants). Agreement between the two indices was assessed with correlation and cross-classification. RESULTS The median (25th-75th percentile) DHD2015-index score was 75 (65-85) for men and 81 (70-91) for women based on the Flower-FFQ, and 68 (58-77) for men and 73 (63-82) for women based on the heart-FFQ. The Kendall's tau-b correlation coefficient between the two scores was 0.67 for men and 0.66 for women. Cross-classification into quartiles of the DHD2015-index showed that 59-60% of participants were classified in the same quartile, 36-37% in the adjacent, and 4% in the non-adjacent. CONCLUSION Dietary data from the Flower-FFQ provide the most optimal information to assess the DHD2015-index. However, the DHD2015-index from the heart-FFQ showed good agreement with the index from the Flower-FFQ of ranking participants according to diet quality, and can be used when the DHD2015 index from the Flower-FFQ is not available.
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Affiliation(s)
- A Mireille Baart
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, The Netherlands.
| | - Elske M Brouwer-Brolsma
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, The Netherlands
| | - Hanne B T de Jong
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, The Netherlands
| | - Jeanne H M de Vries
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, The Netherlands
| | - Edith J M Feskens
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, The Netherlands
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13
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O'Hara C, Gibney ER. Dietary Intake Assessment Using a Novel, Generic Meal-Based Recall and a 24-Hour Recall: Comparison Study. J Med Internet Res 2024; 26:e48817. [PMID: 38354039 PMCID: PMC10902769 DOI: 10.2196/48817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/19/2023] [Accepted: 11/29/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Dietary intake assessment is an integral part of addressing suboptimal dietary intakes. Existing food-based methods are time-consuming and burdensome for users to report the individual foods consumed at each meal. However, ease of use is the most important feature for individuals choosing a nutrition or diet app. Intakes of whole meals can be reported in a manner that is less burdensome than reporting individual foods. No study has developed a method of dietary intake assessment where individuals report their dietary intakes as whole meals rather than individual foods. OBJECTIVE This study aims to develop a novel, meal-based method of dietary intake assessment and test its ability to estimate nutrient intakes compared with that of a web-based, 24-hour recall (24HR). METHODS Participants completed a web-based, generic meal-based recall. This involved, for each meal type (breakfast, light meal, main meal, snack, and beverage), choosing from a selection of meal images those that most represented their intakes during the previous day. Meal images were based on generic meals from a previous study that were representative of the actual meal intakes in Ireland. Participants also completed a web-based 24HR. Both methods were completed on the same day, 3 hours apart. In a crossover design, participants were randomized in terms of which method they completed first. Then, 2 weeks after the first dietary assessments, participants repeated the process in the reverse order. Estimates of mean daily nutrient intakes and the categorization of individuals according to nutrient-based guidelines (eg, low, adequate, and high) were compared between the 2 methods. P values of less than .05 were considered statistically significant. RESULTS In total, 161 participants completed the study. For the 23 nutrient variables compared, the median percentage difference between the 2 methods was 7.6% (IQR 2.6%-13.2%), with P values ranging from <.001 to .97, and out of 23 variables, effect sizes for the differences were small for 19 (83%) variables, moderate for 2 (9%) variables, and large for 2 (9%) variables. Correlation coefficients were statistically significant (P<.05) for 18 (78%) of the 23 variables. Statistically significant correlations ranged from 0.16 to 0.45, with median correlation of 0.32 (IQR 0.25-0.40). When participants were classified according to nutrient-based guidelines, the proportion of individuals who were classified into the same category ranged from 52.8% (85/161) to 84.5% (136/161). CONCLUSIONS A generic meal-based method of dietary intake assessment provides estimates of nutrient intake comparable with those provided by a web-based 24HR but with varying levels of agreement among nutrients. Further studies are required to refine and improve the generic recall across a range of nutrients. Future studies will consider user experience including the potential feasibility of incorporating image recognition of whole meals into the generic recall.
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Affiliation(s)
- Cathal O'Hara
- University College Dublin Institute of Food and Health, Science Centre South, University College Dublin, Dublin, Ireland
- Insight Centre for Data Analytics, University College Dublin, Belfield, Dublin, Ireland
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, Ireland
| | - Eileen R Gibney
- University College Dublin Institute of Food and Health, Science Centre South, University College Dublin, Dublin, Ireland
- Insight Centre for Data Analytics, University College Dublin, Belfield, Dublin, Ireland
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, Ireland
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14
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Matsumoto M, Murakami K, Yuan X, Oono F, Adachi R, Tajima R, Okada E, Nakade M, Sasaki S, Takimoto H. A scoping review of dietary assessment questionnaires potentially suitable for assessing habitual dietary intake in the National Health and Nutrition Survey, Japan. J Nutr Sci 2024; 13:e8. [PMID: 38379590 PMCID: PMC10877143 DOI: 10.1017/jns.2024.1] [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: 05/26/2023] [Revised: 12/27/2023] [Accepted: 01/12/2024] [Indexed: 02/22/2024] Open
Abstract
This scoping review aimed to identify questionnaire-based dietary assessment methods for use in the National Health and Nutrition Survey (NHNS) in Japan. The search was conducted in three databases (PubMed, Web of Science, and Ichushi) to identify questionnaire such as food frequency questionnaire and dietary history questionnaire validated against dietary recalls or food records for the intakes of both food groups and nutrients among Japanese adults. Study quality was assessed based on previously developed criteria. We extracted the questionnaire characteristics and the design and results of the validation studies. We identified 11 questionnaires, with the number of food items ranging from 40 to 196, from 32 articles of good quality. In the validation studies, participants were aged 30-76 years and 90% of the articles used ≥3 d dietary records as reference. The number of nutrients and food groups with a group-level intake difference within 20% against the reference method ranged from 1 to 30 and 1 to 11, respectively. The range of mean correlation coefficients between questionnaire and reference methods were 0.35-0.57 for nutrients and 0.28-0.52 for food groups. When selecting a survey instrument in the NHNS from the 11 existing questionnaires identified in this study, it is important to select one with high group-level comparison and correlation coefficient values on the intended assessment items after scrutinizing the design and results of the validation study. This review may serve as a reference for future studies that explore dietary assessment tools used for assessing dietary intake in specific representative populations.
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Affiliation(s)
- Mai Matsumoto
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health, and Nutrition, Settsu-shi, Osaka, Japan
| | - Kentaro Murakami
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Xiaoyi Yuan
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health, and Nutrition, Settsu-shi, Osaka, Japan
| | - Fumi Oono
- Department of Social and Preventive Epidemiology, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Riho Adachi
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ryoko Tajima
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health, and Nutrition, Settsu-shi, Osaka, Japan
| | - Emiko Okada
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health, and Nutrition, Settsu-shi, Osaka, Japan
- The Health Care Science Institute, Minato-ku, Tokyo, Japan
| | - Makiko Nakade
- Department of Food Science and Nutrition, University of Hyogo, Himeji, Hyogo, Japan
- Research Institute for Food and Nutritional Sciences, Himeji, Hyogo, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hidemi Takimoto
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health, and Nutrition, Settsu-shi, Osaka, Japan
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15
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Buso ME, Boshuizen HC, Naomi ND, Maho W, Diepeveen-de Bruin M, Balvers MG, de Vries JH, Harrold JA, Halford JC, Raben A, Feskens EJ, Brouwer-Brolsma EM. Relative validity of habitual sugar and low/no-calorie sweetener consumption assessed by food frequency questionnaire, multiple 24-h dietary recalls and urinary biomarkers: an observational study within the SWEET project. Am J Clin Nutr 2024; 119:546-559. [PMID: 38043866 DOI: 10.1016/j.ajcnut.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 11/22/2023] [Accepted: 11/28/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Studies investigating associations between sweeteners and health yield inconsistent results, possibly due to subjective self-report dietary assessment methods. OBJECTIVES We compared the performance of a food frequency questionnaire (FFQ), multiple 24-h dietary recalls (24hRs), and urinary biomarkers to estimate intake of sugars and low/no-calorie sweeteners (LNCSs). METHODS Participants (n = 848, age 54 ± 12 y) from a 2-y observational study completed 1 semiquantitative FFQ and ≥ 3 nonconsecutive 24hRs. Both methods assessed intake of sugars (mono- and disaccharides, sucrose, fructose, free and added sugars) and sweetened foods and beverages (sugary foods, fruit juice, and sugar or LNCS-containing beverages [sugar-sweetened beverages and low/no-calorie sweetened beverages (LNCSBs)]); 24hRs also included LNCS-containing foods and tabletop sweeteners (low/no-calorie sweetened foods [LNCSFs]). Urinary excretion of sugars (fructose+sucrose) and LNCSs (acesulfame K+sucralose+steviol glucuronide+cyclamate+saccharin) were simultaneously assessed using ultrapressure liquid chromatography coupled to tandem mass spectrometry in 288 participants with 3 annual 24-h urine samples. Methods were compared using, amongst others, validity coefficients (correlations corrected for measurement error). RESULTS Median (interquartile range) FFQ intakes ranged from 0 (0-7) g/d for LNCSBs to 94 (73-117) g/d for mono- and disaccharides. LNCSB use was reported by 32% of participants. Median LNCSB+LNCSF intake using 24hRs was 1 (0-50) g/d and reported by 58%. Total sugar excretions were detected in 100% of samples [56 (37-85) mg/d] and LNCSs in 99% of urine samples [3 (1-10) mg/d]. Comparing FFQ against 24hRs showed VCs ranging from 0.38 (fruit juice) to 0.74 (LNCSB). VCs for comparing FFQ with urinary excretions were 0.25 to 0.29 for sugars and 0.39 for LNCSBs; for 24hR they amounted to 0.31-0.38 for sugars, 0.37 for LNCSBs, and 0.45 for LNCSFs. CONCLUSIONS The validity of the FFQ against 24hRs for the assessment of sugars and LNCSBs ranged from moderate to good. Comparing self-reports and urine excretions showed moderate agreement but highlighted an important underestimation of LNCS exposure using self-reports.
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Affiliation(s)
- Marion Ec Buso
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Hendriek C Boshuizen
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Novita D Naomi
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Walid Maho
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | | | - Michiel Gj Balvers
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Jeanne Hm de Vries
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Joanne A Harrold
- Department of Psychology, University of Liverpool, United Kingdom
| | - Jason Cg Halford
- Department of Psychology, University of Liverpool, United Kingdom; School of Psychology, University of Leeds, United Kingdom
| | - Anne Raben
- Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Denmark; Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Edith Jm Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Elske M Brouwer-Brolsma
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands.
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Almulla AA, Ahmed LA, Hesselink A, Augustin H, Bärebring L. The relative validity of a semiquantitative food frequency questionnaire among pregnant women in the United Arab Emirates: The Mutaba'ah study. Nutr Health 2024:2601060231224010. [PMID: 38295352 DOI: 10.1177/02601060231224010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Background: Food frequency questionnaire (FFQ) is the most frequently used dietary assessment method in estimating dietary intakes in epidemiological studies. Aim: This study aimed to assess the relative validity of a semiquantitative FFQ in evaluating dietary intake among pregnant women in the United Arab Emirates. Methods: Within the Mutaba'ah study, a subsample of 111 pregnant women completed a semiquantitative FFQ and a single 24-hour dietary recall (24-HDR) regarded as the reference method. Absolute and energy-adjusted nutrient and food intakes between the FFQ and 24-HDR were compared using the Wilcoxon signed ranks test, correlations, Bland-Altman analysis, cross-classification, and weighted kappa analysis. Results: There were no significant differences in reported absolute intakes between the FFQ and 24-HDR for carbohydrates, whole grains, white meat, beta-carotene, vitamin K, sodium, and selenium. Spearman's correlation coefficients between the FFQ and 24-HDR ranged from 0.09 (trans fatty acids) to 0.5 (potassium) for absolute intakes. Correlation decreased after energy adjustment. Bland-Altman analysis showed that the FFQ overestimated intakes compared with 24-HDR and that the limits of agreement were wide. The average percentage of pregnant women classified into the same or adjacent quartile of intake by both methods was 73%. Weighted kappa values ranged from -0.02 (white meat) to 0.33 (magnesium). Conclusion: Our findings showed that the semi-quantitative FFQ is a useful tool in ranking pregnant women from the Emirati population according to their dietary intake. However, the validity of some estimated intakes was poor; hence, certain intakes should be interpreted with caution.
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Affiliation(s)
- Aisha A Almulla
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Dietary Services, Tawam Hospital, Abu Dhabi Health Services Company (SEHA), Abu Dhabi, United Arab Emirates
| | - Luai A Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - André Hesselink
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hanna Augustin
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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17
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Ajabnoor SM, Jambi H, Bahijri S. Development and validation of a food frequency questionnaire in adult Saudi subjects in Jeddah city. BMC Public Health 2024; 24:9. [PMID: 38166899 PMCID: PMC10759497 DOI: 10.1186/s12889-023-17511-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND AND AIMS In Saudi Arabia, very limited studies have been conducted to evaluate the validity of culturally appropriate food frequency questionnaire (FFQ). The aim of this study was to validate a newly designed FFQ against two reference methods in Saudi adults. METHODS A new FFQ adapted from the Block FFQ was completed via interview and validated against three-day food records (3DFRs; n = 126) and 24-hour urinary urea nitrogen (UUN)-based protein intake estimates (n = 118) in adult Saudis living in Jeddah. FFQ-estimated nutrient intake was compared to the 3DFR and UUN methods using Pearson's correlations (r), Bland-Altman plots, and weighted kappa (κw) statistics. RESULTS This study included 126 participants (80 females and 46 males). The FFQ generally overreported nutrient intakes compared to the reference methods. The FFQ was strongly correlated with 3DFRs for energy, protein, carbohydrate, and total fat (r > 0.7); moderately correlated with cholesterol (r = 0.55) and iron (r = 0.44); and weakly correlated with the other micronutrients (r = 0.1-0.3). A moderate positive correlation for protein intake was found (r = 0.62) between the FFQ and 24-hour UUN method. The Bland-Altman analysis indicated the FFQ had an acceptable level of agreement with no significant proportional bias (P > 0.05) with the 3DFRs for energy, protein, total fat, and iron and with protein intake. Similarly, an acceptable level of agreement was found between the FFQ and the 24-hour UUN method for estimating protein intake. Cross-classification analysis showed that ≥ 50% of participants were ranked within the same quartile for energy, protein, and total fat. The FFQ showed good agreement with the 3DFRs for energy and protein (κw ≥ 0.61) and acceptable agreement with protein intake. An acceptable agreement was reported between the FFQ and 24-hour UUN method (κw = 0.56). Separate analyses of females and males showed stronger correlations and agreements between the FFQ and the two reference methods only in females. CONCLUSION The developed FFQ is an effective and valid tool for assessing dietary intake in Saudi adults. However, it still requires future optimization to improve its validity.
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Affiliation(s)
- Sarah M Ajabnoor
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
- Food, Nutrition and Lifestyle Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Hanan Jambi
- Food, Nutrition and Lifestyle Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia
- Saudi Diabetes Research Group, Deanship of Scientific Research, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Suhad Bahijri
- Food, Nutrition and Lifestyle Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia
- Saudi Diabetes Research Group, Deanship of Scientific Research, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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18
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Baart AM, Brouwer-Brolsma EM, de Jong HBT, de Vries JHM, Feskens EJM. RETRACTED ARTICLE: Assessment of the Dutch Healthy Diet index 2015 in the Lifelines cohort study at baseline. Eur J Clin Nutr 2024; 78:77. [PMID: 35577925 DOI: 10.1038/s41430-022-01163-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 11/09/2022]
Affiliation(s)
- A Mireille Baart
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, The Netherlands.
| | - Elske M Brouwer-Brolsma
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, The Netherlands
| | - Hanne B T de Jong
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, The Netherlands
| | - Jeanne H M de Vries
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, The Netherlands
| | - Edith J M Feskens
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, The Netherlands
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19
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Aarsland TE, Solvik BS, Bakken KS, Sleire SN, Kaldenbach S, Holten-Andersen MN, Nermo KR, Fauskerud IT, Østvedt TH, Lohne S, Gjengedal ELF, Strand TA. Iodine Nutrition in Children ≤2 years of Age in Norway. J Nutr 2023; 153:3237-3246. [PMID: 37742796 PMCID: PMC10687616 DOI: 10.1016/j.tjnut.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND As a component of the thyroid hormones (THs), iodine is vital for normal neurodevelopment during early life. However, both deficient and excess iodine may affect TH production, and data on iodine status in young children are scarce. OBJECTIVES To describe iodine nutrition (iodine status and intake) in children ≤2 y of age in Innlandet County (Norway) and to describe the associations with maternal iodine nutrition. METHODS A cross-sectional study was performed in a representative sample of mother-child pairs selected from 30 municipalities from November 2020 until October 2021. Iodine status [child urinary iodine concentration (UIC), maternal UIC, and breast milk iodine concentration (BMIC)] was measured. Child's iodine intake was estimated using 2 24-h dietary recalls (24-HR) and a food frequency questionnaire. The Multiple Source Method was used to estimate the usual iodine intake distributions from the 24-HR assessments. RESULTS The median UIC in 333 children was 145 μg/L, indicating adequate iodine status according to the WHO cutoff (100 μg/L). The median usual iodine intake was 83 μg/d. Furthermore, 35% had suboptimal usual iodine intakes [below the proposed Estimated average requirement (72 μg/d)], whereas <1% had excessive usual iodine intakes [above the Upper intake level (200 μg/d)]. There was a positive correlation between children's iodine intake and BMIC (Spearman rank correlation coefficient r = 0.67, P < 0.001), and between children's UIC and BMIC (r = 0.43, P < 0.001), maternal UIC (r = 0.23, P = 0.001), and maternal iodine intake (r = 0.20, P = 0.004). CONCLUSION Despite a median UIC above the cutoff for iodine sufficiency, more than a third of the children had suboptimal usual iodine intakes. Our findings suggest that many children will benefit from iodine fortification and that risk of iodine excess in this age group is low.
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Affiliation(s)
- Tonje E Aarsland
- Center of International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Women's Clinic at Lillehammer Hospital, Innlandet Hospital Trust, Lillehammer, Norway.
| | - Beate S Solvik
- Center of International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Women's Clinic at Lillehammer Hospital, Innlandet Hospital Trust, Lillehammer, Norway
| | - Kjersti S Bakken
- Center of International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Women's Clinic at Lillehammer Hospital, Innlandet Hospital Trust, Lillehammer, Norway
| | - Synnøve Næss Sleire
- Seafood, Nutrition and Environmental State, Institute of Marine Research, Bergen, Norway
| | - Siri Kaldenbach
- Department of Paediatric and Adolescent Medicine, Innlandet Hospital Trust, Lillehammer, Norway; Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Mads N Holten-Andersen
- Department of Paediatric and Adolescent Medicine, Innlandet Hospital Trust, Lillehammer, Norway; Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kristina R Nermo
- Center of International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Department of Microbiology, Innlandet Hospital Trust, Lillehammer, Norway
| | - Ingunn T Fauskerud
- Department of Microbiology, Innlandet Hospital Trust, Lillehammer, Norway
| | - Thobias H Østvedt
- Faculty of Environmental Sciences and Natural Resource Management, Norwegian University of Life Sciences, Ås, Norway
| | - Solfrid Lohne
- Faculty of Environmental Sciences and Natural Resource Management, Norwegian University of Life Sciences, Ås, Norway
| | - Elin L F Gjengedal
- Faculty of Environmental Sciences and Natural Resource Management, Norwegian University of Life Sciences, Ås, Norway
| | - Tor A Strand
- Center of International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
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20
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Zhai L, Pan H, Cao H, Zhao S, Yao P. Reliability and validity of a semi-quantitative food frequency questionnaire: dietary intake assessment among multi-ethnic populations in Northwest China. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:111. [PMID: 37858218 PMCID: PMC10585915 DOI: 10.1186/s41043-023-00452-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 10/06/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Few multi-ethnic dietary culture-sensitive food frequency questionnaires (FFQ) have been developed due to the complexity and diversity of cooking methods and styles. This study aimed to develop and validate a specific FFQ among multi-ethnic groups in Northwest China. METHODS In the reliability study, 139 participants aged 20-65 completed two identical FFQs separated by 3 months. The relative validation of the FFQ was assessed by three 24-h recalls (24HR) employed in the interval of two FFQs, as a reference. Stratified analyses were also conducted by the major ethnic groups (Han nationality or Ethnic minority). RESULTS For reproducibility, the median (range) of Spearman's correlation coefficients (SCC) was 0.71 (0.43-0.84) for nutrients. The intra-class correlation coefficients (ICC) covered a spectrum from 0.39 to 0.78 (median: 0.64). Meanwhile, the weighted kappa values ranged from 0.11 to 0.64. For validity, the median (range) of Pearson's correlation coefficients derived from the energy unadjusted and the adjusted values between FFQ and 24HR were 0.61 (0.12-0.79) and 0.56 (0.12-0.77), respectively. The results of correlation coefficients were similar between the two ethnic groups. Moreover, the Bland-Altman plots likewise demonstrated a satisfactory level of agreement between the two methods. CONCLUSIONS The FFQ showed acceptable reproducibility and moderate relative validity for evaluating dietary intake among multi-ethnic groups in northwest China. It could be a credible nutritional screening tool for forthcoming epidemiological surveys of these populations.
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Affiliation(s)
- Leilei Zhai
- The First Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, No.393, Xinyi Road, Urumqi, 830011, Xinjiang Uygur Autonomous Region, China
| | - Huiyue Pan
- The First Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, No.393, Xinyi Road, Urumqi, 830011, Xinjiang Uygur Autonomous Region, China
| | - Hanqi Cao
- The First Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, No.393, Xinyi Road, Urumqi, 830011, Xinjiang Uygur Autonomous Region, China
| | - Shupeng Zhao
- The First Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, No.393, Xinyi Road, Urumqi, 830011, Xinjiang Uygur Autonomous Region, China
| | - Ping Yao
- The First Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, No.393, Xinyi Road, Urumqi, 830011, Xinjiang Uygur Autonomous Region, China.
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21
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Serra M, Alceste D, Hauser F, Hulshof PJM, Meijer HAJ, Thalheimer A, Steinert RE, Gerber PA, Spector AC, Gero D, Bueter M. Assessing daily energy intake in adult women: validity of a food-recognition mobile application compared to doubly labelled water. Front Nutr 2023; 10:1255499. [PMID: 37810925 PMCID: PMC10556674 DOI: 10.3389/fnut.2023.1255499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Accurate dietary assessment is crucial for nutrition and health research. Traditional methods, such as food records, food frequency questionnaires, and 24-hour dietary recalls (24HR), have limitations, such as the need for trained interviewers, time-consuming procedures, and inaccuracies in estimations. Novel technologies, such as image-based dietary assessment apps, have been developed to overcome these limitations. SNAQ is a novel image-based food-recognition app which, based on computer vision, assesses food type and volume, and provides nutritional information about dietary intake. This cross-sectional observational study aimed to investigate the validity of SNAQ as a dietary assessment tool for measuring energy and macronutrient intake in adult women with normal body weight (n = 30), compared to doubly labeled water (DLW), a reference method for total daily energy expenditure (TDEE). Energy intake was also estimated using a one-day 24HR for direct comparison. Bland-Altman plots, paired difference tests, and Pearson's correlation coefficient were used to assess agreement and relationships between the methods. SNAQ showed a slightly higher agreement (bias = -329.6 kcal/day) with DLW for total daily energy intake (TDEI) compared to 24HR (bias = -543.0 kcal/day). While both SNAQ and 24HR tended to underestimate TDEI, only 24HR significantly differed from DLW in this regard (p < 0.001). There was no significant relationship between estimated TDEI and TDEE using SNAQ (R2 = 27%, p = 0.50) or 24HR (R2 = 34%, p = 0.20) and there were no significant differences in energy and macronutrient intake estimates between SNAQ and 24HR (Δ = 213.4 kcal/day). In conclusion, these results indicate that SNAQ provides a closer representation of energy intake in adult women with normal body weight than 24HR when compared to DLW, but no relationship was found between the energy estimates of DLW and of the two dietary assessment tools. Further research is needed to determine the clinical relevance and support the implementation of SNAQ in research and clinical settings. Clinical trial registration: This study is registered on ClinicalTrials.gov with the unique identifier NCT04600596 (https://clinicaltrials.gov/ct2/show/NCT04600596).
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Affiliation(s)
- Michele Serra
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich (UZH), Zurich, Switzerland
| | - Daniela Alceste
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich (UZH), Zurich, Switzerland
| | - Florian Hauser
- Faculty of Medicine, University of Zurich (UZH), Zurich, Switzerland
| | - Paul J. M. Hulshof
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | - Harro A. J. Meijer
- Centre for Isotope Research (CIO), Energy and Sustainability Research Institute Groningen, University of Groningen, Groningen, Netherlands
| | - Andreas Thalheimer
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
| | - Robert E. Steinert
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
| | - Philipp A. Gerber
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland
| | - Alan C. Spector
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL, United States
| | - Daniel Gero
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
| | - Marco Bueter
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
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22
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Jobarteh ML, McCrory MA, Lo B, Triantafyllidis KK, Qiu J, Griffin JP, Sazonov E, Sun M, Jia W, Baranowski T, Anderson AK, Maitland K, Frost G. Evaluation of Acceptability, Functionality, and Validity of a Passive Image-Based Dietary Intake Assessment Method in Adults and Children of Ghanaian and Kenyan Origin Living in London, UK. Nutrients 2023; 15:4075. [PMID: 37764857 PMCID: PMC10537234 DOI: 10.3390/nu15184075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Accurate estimation of dietary intake is challenging. However, whilst some progress has been made in high-income countries, low- and middle-income countries (LMICs) remain behind, contributing to critical nutritional data gaps. This study aimed to validate an objective, passive image-based dietary intake assessment method against weighed food records in London, UK, for onward deployment to LMICs. METHODS Wearable camera devices were used to capture food intake on eating occasions in 18 adults and 17 children of Ghanaian and Kenyan origin living in London. Participants were provided pre-weighed meals of Ghanaian and Kenyan cuisine and camera devices to automatically capture images of the eating occasions. Food images were assessed for portion size, energy, nutrient intake, and the relative validity of the method compared to the weighed food records. RESULTS The Pearson and Intraclass correlation coefficients of estimates of intakes of food, energy, and 19 nutrients ranged from 0.60 to 0.95 and 0.67 to 0.90, respectively. Bland-Altman analysis showed good agreement between the image-based method and the weighed food record. Under-estimation of dietary intake by the image-based method ranged from 4 to 23%. CONCLUSIONS Passive food image capture and analysis provides an objective assessment of dietary intake comparable to weighed food records.
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Affiliation(s)
- Modou L. Jobarteh
- Department of Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Megan A. McCrory
- Department of Health Sciences, Boston University, Boston, MA 02215, USA;
| | - Benny Lo
- Hamlyn Centre, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK; (B.L.); (J.Q.)
| | - Konstantinos K. Triantafyllidis
- Section for Nutrition Research, Department of Metabolism, Digestion and Reproduction, Imperial College London, London SW7 2BX, UK; (K.K.T.); (J.P.G.); (G.F.)
| | - Jianing Qiu
- Hamlyn Centre, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK; (B.L.); (J.Q.)
| | - Jennifer P. Griffin
- Section for Nutrition Research, Department of Metabolism, Digestion and Reproduction, Imperial College London, London SW7 2BX, UK; (K.K.T.); (J.P.G.); (G.F.)
| | - Edward Sazonov
- Department of Electrical and Computer Engineering, University of Alabama, Tuscaloosa, AL 35487, USA;
| | - Mingui Sun
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15261, USA; (M.S.); (W.J.)
| | - Wenyan Jia
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15261, USA; (M.S.); (W.J.)
| | - Tom Baranowski
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA;
| | - Alex K. Anderson
- Department of Nutritional Sciences, University of Georgia, Athens, GA 30602, USA;
| | | | - Gary Frost
- Section for Nutrition Research, Department of Metabolism, Digestion and Reproduction, Imperial College London, London SW7 2BX, UK; (K.K.T.); (J.P.G.); (G.F.)
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23
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Yi J, Song G, Lin Z, Peng Y, Wu J. Validity and Reproducibility of Food Group-Based Food Frequency Questionnaires in Assessing Sugar-Sweetened Beverage Consumption Habits among Chinese Middle-School Students. Nutrients 2023; 15:3928. [PMID: 37764712 PMCID: PMC10537416 DOI: 10.3390/nu15183928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Assessing the intake of sugar-sweetened beverages (SSBs) is crucial for reducing obesity; however, a simple but relatively accurate method for determining added sugar consumption among school adolescents is lacking. The aim of this study was to evaluate the reproducibility and validity of a food group-based food frequency questionnaire (FG-FFQ) for SSBs in assessing SSB consumption and added sugar among middle-school students. A total of 242 school students completed the FG-FFQs twice and four discontinuous 24-h dietary records (24HDR) over a three-month period. A weighted average approach was used to obtain the average sugar content in the sugary drink food group (FG). Correlation coefficient, weighted kappa statistic, misclassification analysis, and Bland-Altman plot were used to evaluate the validity and reproducibility of the FG-FFQ. Linear regression was utilized to obtain the calibration formulas. The average content of added sugar in sugary drink FG was 8.1 g/100 mL. SSB consumption frequency, consumption amount, and added sugar had correlation coefficients of 0.81, 0.87, and 0.87, respectively, in the validity analysis (p < 0.05). The majority of scatter plots were covered by 95% confidence intervals in the Bland-Altman bias analysis. The intra-class correlation coefficient of SSB consumption frequency and Spearman correlation coefficient of SSB consumption amount and added sugar were 0.74, 0.81, and 0.90, respectively, in the reproducibility analysis (p < 0.05). Results produced by the FG-FFQ calibration formula were more comparable to 24HDR. The FG-FFQ for SSB consumption showed acceptable validity and reproducibility, making it a viable instrument for epidemiological studies on sugary drinks in adolescents.
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Affiliation(s)
- Junyao Yi
- School of Public Health, Nanjing Medical University, Nanjing 211166, China; (J.Y.); (G.S.)
| | - Guoye Song
- School of Public Health, Nanjing Medical University, Nanjing 211166, China; (J.Y.); (G.S.)
| | - Zhenghao Lin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Z.L.); (Y.P.)
| | - Yuting Peng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Z.L.); (Y.P.)
| | - Jieshu Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Z.L.); (Y.P.)
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24
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Vézina-Im LA, Beaulieu D, Turcotte S, Savard C, Lemieux S, Boucher D, Gallani MC, Paquette MC. Validation d’un questionnaire mesurant la consommation de boissons sucrées, jus et eau auprès d’adolescents francophones. CAN J DIET PRACT RES 2023; 84:141-148. [PMID: 36939653 DOI: 10.3148/cjdpr-2023-002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
Purpose: To examine the temporal stability and relative validity of the adapted French version of an English self-reported questionnaire measuring the beverage intake (BEVQ) of adolescents.Methods: The French adaptation of the BEVQ (AF-BEVQ) included conversion from the imperial to the metric system and the adjustment of some formats to those available in Canada. Next, 60 adolescents from two regions in Quebec completed the AF-BEVQ and two web-based 24-hour dietary recalls (R24W) (one for a weekday and one for a weekend day) on two occasions, two weeks apart.Results: The AF-BEVQ had moderate intraclass correlation coefficients (ICC) for amounts of sugar-sweetened beverages (ICC: 0.68; 95% confidence interval [CI]: 0.46-0.81), fruit juice (ICC: 0.54; 95% CI: 0.23-0.72) and water (ICC: 0.66; 95% CI: 0.38-0.81) consumed. The amounts of sugar-sweetened beverages (rs = 0.49; p < 0.0001), fruit juice (rs = 0.38; p = 0.0024) and water (rs = 0.65; p < 0.0001) reported in the AF-BEVQ were significantly correlated with those of both R24Ws.Conclusions: For the most part, the AF-BEVQ had adequate metrological properties. It is an interesting tool to quickly measure the sugar-sweetened beverage, fruit juice and water intake of French-speaking adolescents.
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Affiliation(s)
- Lydi-Anne Vézina-Im
- Département des sciences de la santé, Université du Québec à Rimouski (UQAR), Lévis, QC
- Centre de recherche du CISSS de Chaudière-Appalaches, Lévis, QC
| | - Dominique Beaulieu
- Département des sciences de la santé, Université du Québec à Rimouski (UQAR), Lévis, QC
- Centre de recherche du CISSS de Chaudière-Appalaches, Lévis, QC
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Québec, QC
- Collectif de recherche sur la santé en région (CoRSeR), Université du Québec à Rimouski (UQAR), Lévis, QC
| | | | - Catherine Savard
- Département des sciences de la santé, Université du Québec à Rimouski (UQAR), Lévis, QC
| | - Simone Lemieux
- École de nutrition, Université Laval, Pavillon Paul-Comtois, Québec, QC
- Centre nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC
| | - Danielle Boucher
- Département des sciences de la santé, Université du Québec à Rimouski (UQAR), Lévis, QC
- Centre de recherche du CISSS de Chaudière-Appalaches, Lévis, QC
| | - Maria-Cecilia Gallani
- Faculté des sciences infirmières, Université Laval, Pavillon Ferdinand-Vandry, Québec, QC
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, QC
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25
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Rosendahl-Riise H, Aksnes S, Sabir Z, Ulleberg EK, Myklebust-Hansen T, Aakre I. Comparison of a digital iodine-specific dietary screener with 24-hour recall and urinary iodine concentration. J Nutr Sci 2023; 12:e90. [PMID: 37592931 PMCID: PMC10427488 DOI: 10.1017/jns.2023.74] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/12/2023] [Accepted: 07/12/2023] [Indexed: 08/19/2023] Open
Abstract
Mild-to-moderate iodine deficiency remains a problem worldwide, including in Norway. Of particular, concern is fertile, pregnant and lactating women. The Norwegian Dairy Council developed a digital iodine-specific dietary screener (I-screener) for the assessment of iodine intake levels but has yet to be validated. The aim was thus to investigate the relative validity of the I-screener by comparing estimates of iodine intake from the I-screener against a single 24-hour recall (24HR) and urinary iodine concentration (UIC) in fertile women. Healthy females were recruited in Bergen in August-December 2021. Six spot-urine samples from six consecutive days were collected into a pooled sample to assess UIC. Each participant completed a single administration of the I-screener and the 24HR. The estimated daily iodine intake from the I-screener was compared with the estimations from the 24HR and UIC. Seventy-two women aged 19-39 completed the study. The median UIC was 76 μg/l. Compared with the 24HR, the I-screener placed 83 % of the participants in the same/adjacent tertial, with a slight agreement between the methods (Cohen's kappa = 0⋅187). The present study shows an acceptable correlation between the I-screener and the 24HR (r = 0⋅318), but not between the I-screener and UIC (r = 0⋅122). Despite its varying iodine estimate abilities, the I-screener may be used as an initial screening tool to rank fertile women on an individual level into deficient inadequate, and sufficient iodine intake. However, due to the relatively high risk of misclassification, further assessment of iodine status should follow.
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Affiliation(s)
- Hanne Rosendahl-Riise
- Mohn Nutrition Research Laboratory and Center for Nutrition, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Siri Aksnes
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Zoya Sabir
- Mohn Nutrition Research Laboratory and Center for Nutrition, Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Xi Y, Xiang C, Liang J, Huo J, Yong C, Zou H, Pan Y, Wu M, Xie Q, Deng J, Yang L, Chen J, Qi Y, Li Y, Lin Q. Be aware of the sodium intake outside student canteens: development and validation of a sodium food frequency questionnaire in Chinese undergraduates. Front Nutr 2023; 10:1062845. [PMID: 37360293 PMCID: PMC10285065 DOI: 10.3389/fnut.2023.1062845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/26/2023] [Indexed: 06/28/2023] Open
Abstract
Background Chinese college students used to eat in student canteens, making dietary consumption outside the cafeterias the main reason for the difference in sodium intake. This study aims to develop and validate a food frequency questionnaire (Sodium-FFQ) targeting dietary sodium intake outside the canteens among undergraduates in China. Methods This cross-sectional study included 124 and 81 college students from comprehensive universities in the development and validation stage. A 24 h dietary recall and a food frequency questionnaire were used to develop the Sodium-FFQ. Food items were selected according to the foods that contributed more to the total sodium intake. Test-retest correlation coefficients with an interval of 14 days were employed to evaluate reproducibility. Validity was assessed against a single 24 h urine collection and a 3-day dietary record using correlation coefficients, Bland-Altman analyses, and cross-classification analysis of Kappa coefficients. Results The Sodium-FFQ consists of 12 groups of foods with 48 items. The Spearman correlation coefficient of test-retest on sodium intake was 0.654 (p < 0.05), and that between the Sodium-FFQ, 3 × 24 h dietary record, and 24-h urinary sodium were 0.393 (p < 0.05) and 0.342 (p < 0.05), respectively. The Sodium-FFQ was correlated to 24 h urinary sodium-to-potassium ratio, with a Spearman coefficient of 0.370 (p < 0.05). The classification agreement of the Sodium-FFQ and 24 h urinary sodium was 68.4%, and the Kappa coefficient was 0.371 (p < 0.001). Conclusion The Sodium-FFQ developed in this study presented an acceptable reproducibility, validity, and classification agreement. It indicates that the Sodium-FFQ could be a potential tool for promoting sodium restriction in college students.
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Affiliation(s)
- Yue Xi
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha, China
| | - Caihong Xiang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha, China
- Department of Preventive Medicine and Hospital-acquired Infection Control, Shenzhen People’s Hospital, Shenzhen, China
| | - Jiajing Liang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jiaqi Huo
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha, China
| | - Cuiting Yong
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha, China
- The Biobank of Xiangya Hospital, Central South University, Changsha, China
| | - Hanshuang Zou
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yunfeng Pan
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha, China
| | - Minchan Wu
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha, China
| | - Qingqing Xie
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jing Deng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China
| | - Lina Yang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jihua Chen
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yufei Qi
- Department of Physical Education and Research, Central South University, Changsha, China
| | - Ying Li
- Department of Health Management, The Third Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha, China
| | - Qian Lin
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha, China
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Lucassen DA, Brouwer-Brolsma EM, Boshuizen HC, Mars M, de Vogel-Van den Bosch J, Feskens EJM. Validation of the smartphone-based dietary assessment tool 'Traqq' for assessing actual dietary intake by repeated 2-hour recalls in adults: comparison with 24h recalls and urinary biomarkers. Am J Clin Nutr 2023:S0002-9165(23)46837-2. [PMID: 37054887 DOI: 10.1016/j.ajcnut.2023.04.008] [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: 10/27/2022] [Revised: 02/07/2023] [Accepted: 04/10/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Conventional dietary assessment methods are affected by measurement error. We developed a smartphone-based 2-hour recall (2hR) methodology to reduce participant burden and memory-related bias. OBJECTIVE Assessing the validity of the 2hR method against traditional 24-hour recalls (24hRs) and objective biomarkers. METHODS Dietary intake was assessed in 215 Dutch adults on six randomly selected non-consecutive days (i.e., three 2hR-days and three 24hRs) during a four-week period. Sixty-three participants provided four 24-hour urine samples, to assess urinary nitrogen and potassium concentrations. RESULTS Intake estimates of energy (2,052±503 kcal vs. 1,976±483 kcal) and nutrients (e.g., protein: 78±23 g vs. 71±19 g; fat: 84±30 g vs. 79±26 g; carbohydrates: 220±60 g vs. 216±60 g) were slightly higher with 2hR-days than 24hRs. Comparing self-reported protein and potassium intakes to urinary nitrogen and potassium concentrations indicated a slightly higher accuracy of 2hR-days than 24hRs (protein: -14% vs. -18%; potassium: -11% vs. -16%). Correlation coefficients between methods ranged from 0.41 to 0.75 for energy and macronutrients and from 0.41 to 0.62 for micronutrients. Generally regularly consumed food groups showed small differences in intake (<10%) and good correlations (>0.60). Intakes of and energy, nutrients and food groups showed similar reproducibility (ICC) for 2hR-days and 24hRs. CONCLUSIONS Comparing 2hR-days with 24hRs showed relatively similar group-level bias for energy, most nutrients, and food groups. Differences were mostly due to higher intake estimates by 2hR-days. Biomarker comparisons showed less underestimation by 2hR-days as compared to 24hRs, suggesting that 2hR-days are a valid approach to assess intake of energy, nutrients and food groups. TRIAL REGISTRATION This trial was registered at the Dutch Central Committee on Research Involving Human Subjects (CCMO) registry as ABR. No. NL69065.081.19.
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Affiliation(s)
- Desiree A Lucassen
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands.
| | - Elske M Brouwer-Brolsma
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Hendriek C Boshuizen
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands; National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Monica Mars
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | | | - Edith J M Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
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Ramírez-Contreras C, Farran-Codina A, Zerón-Rugerio MF, Izquierdo-Pulido M. Relative Validity and Reliability of the Remind App as an Image-Based Method to Assess Dietary Intake and Meal Timing in Young Adults. Nutrients 2023; 15:nu15081824. [PMID: 37111043 PMCID: PMC10146256 DOI: 10.3390/nu15081824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
Image-based dietary records have been validated as tools to evaluate dietary intake. However, to determine meal timing, previous studies have relied primarily on image-based smartphone applications without validation. Noteworthy, the validation process is necessary to determine how accurately a test method measures meal timing compared with a reference method over the same time period. Thus, we aimed to assess the relative validity and reliability of the Remind® app as an image-based method to assess dietary intake and meal timing. For this purpose, 71 young adults (aged 20-33 years, 81.7% women) were recruited for a 3-day cross-sectional study, where they completed a 3-day image-based record using the Remind app (test method) and a 3-day handwritten food record (reference method). The relative validity of the test method versus the reference method was assessed using multiple tests including Bland-Altman, % difference, paired t-test/Wilcoxon signed-rank test, Pearson/Spearman correlation coefficients, and cross-classification. We also evaluated the reliability of the test method using an intra-class correlation (ICC) coefficient. The results showed that, compared to the reference method, the relative validity of the test method was good for assessing energy and macronutrient intake, as well as meal timing. Meanwhile, the relative validity of the test method to assess micronutrient intake was poor (p < 0.05) for some micronutrients (iron, phosphorus, potassium, zinc, vitamins B1, B2, B3, B6, C, and E, and folates) and some food groups (cereals and grains, legumes, tubers, oils, and fats). Regarding the reliability of an image-based method to assess dietary intake and meal timing, results ranged from moderate to excellent (ICC 95% confidence interval [95% CI]: 0.50-1.00) for all nutrients, food groups (except oils and fats, which had low to moderate reliability), and meal timings. Thus, the results obtained in this study provide evidence of the relative validity and reliability of image-based methods to assess dietary intake (energy, macronutrients, and most food groups) and meal timing. These results open up a new framework for chrononutrition, as these methods improve the quality of the data collected and also reduce the burden on users to accurately estimate portion size and the timing of meals.
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Affiliation(s)
- Catalina Ramírez-Contreras
- Department of Nutrition, Food Science and Gastronomy, Food Science Torribera Campus, University of Barcelona, 08921 Barcelona, Spain
- INSA-UB, Nutrition and Food Safety Research Institute, University of Barcelona, 08921 Barcelona, Spain
| | - Andreu Farran-Codina
- Department of Nutrition, Food Science and Gastronomy, Food Science Torribera Campus, University of Barcelona, 08921 Barcelona, Spain
- INSA-UB, Nutrition and Food Safety Research Institute, University of Barcelona, 08921 Barcelona, Spain
| | - María Fernanda Zerón-Rugerio
- Department of Nutrition, Food Science and Gastronomy, Food Science Torribera Campus, University of Barcelona, 08921 Barcelona, Spain
- INSA-UB, Nutrition and Food Safety Research Institute, University of Barcelona, 08921 Barcelona, Spain
- Department of Fundamental and Medical-Surgical Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
| | - Maria Izquierdo-Pulido
- Department of Nutrition, Food Science and Gastronomy, Food Science Torribera Campus, University of Barcelona, 08921 Barcelona, Spain
- INSA-UB, Nutrition and Food Safety Research Institute, University of Barcelona, 08921 Barcelona, Spain
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Murai U, Tajima R, Matsumoto M, Sato Y, Horie S, Fujiwara A, Koshida E, Okada E, Sumikura T, Yokoyama T, Ishikawa M, Kurotani K, Takimoto H. Validation of Dietary Intake Estimated by Web-Based Dietary Assessment Methods and Usability Using Dietary Records or 24-h Dietary Recalls: A Scoping Review. Nutrients 2023; 15:nu15081816. [PMID: 37111035 PMCID: PMC10141001 DOI: 10.3390/nu15081816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/29/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
The goal was to summarize studies comparing the accuracy of web-based dietary assessments with those of conventional face-to-face or paper-based assessments using 24-h dietary recall or dietary record methods in the general population. Using two databases, mean differences and correlation coefficients (CCs) for intakes of energy, macronutrients, sodium, vegetables, and fruits were extracted from each study independently by the authors. We also collected information regarding usability from articles reporting this. From 17 articles included in this review, the mean dietary intake differences in the web-based dietary assessment compared to conventional methods, were -11.5-16.1% for energy, -12.1-14.9% for protein, -16.7-17.6% for fat, -10.8-8.0% for carbohydrates, -11.2-9.6% for sodium, -27.4-3.9% for vegetables, and -5.1-47.6% for fruits. The CC was 0.17-0.88 for energy, protein, fat, carbohydrates, and sodium, and 0.23-0.85 for vegetables and fruits. In three out of four studies reporting usability, more than half of the participants preferred the web-based dietary assessment. In conclusion, % difference and CC of dietary intake were acceptable in both web-based dietary records and 24-h dietary recalls. The findings from this review highlight the possibility of wide-spread application of the web-based dietary assessment in the future.
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Affiliation(s)
- Utako Murai
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Ryoko Tajima
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Mai Matsumoto
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Yoko Sato
- Department of the Science of Living, Kyoritsu Women's Junior College, Tokyo 101-8437, Japan
| | - Saki Horie
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Aya Fujiwara
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Emiko Koshida
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Emiko Okada
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Tomoko Sumikura
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Tetsuji Yokoyama
- Department of Health Promotion, National Institute of Public Health, Wako 351-0197, Japan
| | - Midori Ishikawa
- Department of Health Promotion, National Institute of Public Health, Wako 351-0197, Japan
| | - Kayo Kurotani
- Faculty of Food and Health Sciences, Showa Women's University, Tokyo 154-8533, Japan
| | - Hidemi Takimoto
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
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Current Consumption of Traditional Cowpea-Based Dishes in South Benin Contributes to at Least 30% of the Recommended Intake of Dietary Fibre, Folate, and Magnesium. Nutrients 2023; 15:nu15061314. [PMID: 36986047 PMCID: PMC10056862 DOI: 10.3390/nu15061314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/21/2023] [Accepted: 03/01/2023] [Indexed: 03/11/2023] Open
Abstract
Regular consumption of legumes is recommended worldwide for its environmental and health benefits. Cowpea, the most frequently consumed pulse in West African countries, is rich in nutrients and health-promoting bioactive compounds. A one-week retrospective food frequency questionnaire was used to estimate the contribution of the cowpea-based dishes to the recommended nutrient intake (RNI), based on their consumption frequency, intake, and nutritional composition. Participants were 1217 adults (19–65 years) from three urban or rural areas in southern Benin. Out of all respondents, 98% reported that they usually consumed cowpea-based dishes. The mean consumption frequency was 0.1 to 2.4 times/week, depending on the type of cowpea-based dish. The mean amount consumed was 71 g and 58 g of seeds/adult/day in urban and rural areas respectively. The mean daily contribution of cowpea-based dishes to RNI was 15% for energy, 42% for fibre, 37% for magnesium, 30% for folate, 26% for protein, and just above 15% for zinc and potassium. Thus, such regular cowpea consumption should be maintained.
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Pilot Study of the Applicability, Usability, and Accuracy of the Nutricate© Online Application, a New Dietary Intake Assessment Tool for Managing Infant Cow's Milk Allergy. Nutrients 2023; 15:nu15041045. [PMID: 36839403 PMCID: PMC9960076 DOI: 10.3390/nu15041045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND/OBJECTIVES The mainstay treatment of cow's milk allergy (CMA) is to remove cow's milk proteins from children's dietary intake. In this context, dietary intake of children with CMA should be particularly checked and monitored. The objective of this study was to assess the applicability, usability, and accuracy of a new dietary intake (DI) assessment online tool (Nutricate© online application) for managing CMA in children. SUBJECTS/METHODS This study used a pre-existing database of DI from the Nutricate© online application. DIs from 30 CMA children were used to compare micro/macronutrients (energy, protein, calcium, and iron intakes) calculated by Nutricate© and NutriLog© as the reference method. Comparisons were performed using the Pearson correlation analysis and the Bland-Altman plot. The Nutricate© tool usability was assessed via a System Usability Scale questionnaire (SUSq). RESULTS Correlation coefficient between the levels of micro/macronutrients obtained by Nutrilog© and Nutricate© software were highly significant (p = 0.0001) and were well-correlated (R coefficient > 0.6), indicating a very good concordance between the two methods. This observation was reinforced by the Bland-Altman plot, indicating the absence of proportional or fixed bias for energy, protein, calcium, and iron intakes. The mean SUSq score obtained was 81 ± 14, which is considered to be an excellent score. CONCLUSIONS Nutricate© online application is a reliable method to assess micro/macronutrient (energy, protein, calcium, and iron intakes) intake in CMA children. Applicability and usability of this new dietary intake assessment online tool is excellent.
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Reproducibility and Validity of a Semi-Quantitative Food Frequency Questionnaire for Children Aged 6-12 in Western China. Nutrients 2023; 15:nu15040856. [PMID: 36839215 PMCID: PMC9959506 DOI: 10.3390/nu15040856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/04/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023] Open
Abstract
The Food Frequency Questionnaire (FFQ) is often used to assess dietary intake in large-scale epidemiological studies. This study aimed to evaluate the reproducibility and validity of the FFQ newly developed for children aged 6 to 12 in western China. A total of 133 children were included in the analysis, and all the children and their caregivers completed the FFQs twice with a three-month interval period, and three 24 h recalls were carried out one month after the first FFQ. We assessed the relative validity and reproducibility using various methods, such as the Spearman correlation coefficient, intra-class correlation coefficient, weighed Kappa, quartile agreement, and Bland-Altman analysis. The Spearman correlation coefficients for food ranged from 0.30 to 0.84, and for nutrients from 0.46 to 0.82 regarding reproducibility. The food intra-class correlation coefficients ranged from 0.20 to 0.85, while nutrients' ranged from 0.37 to 0.75. In terms of relative validity, the average Spearman correlation coefficients for food were 0.20, and 0.30 for energy and nutrients. The energy-adjusted and de-attenuation coefficients were calculated. Moreover, the average percentage of participants misclassified into the extreme quartile for food and nutrients was 8.0% and 7.0%, respectively. Weighted Kappa values indicated acceptable agreement between the FFQs and 24 h recalls. Furthermore, the percentage of results in the limits of agreement (LOA) were all above 93.0%. In conclusion, The FFQ showed good reproducibility and acceptable relative validity for assessing the dietary intake of children aged 6-12 in western China.
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Zouine N, Lhilali I, Menouni A, Godderis L, El Midaoui A, El Jaafari S, Zegzouti Filali Y. Development and Validation of Vitamin D- Food Frequency Questionnaire for Moroccan Women of Reproductive Age: Use of the Sun Exposure Score and the Method of Triad's Model. Nutrients 2023; 15:nu15040796. [PMID: 36839154 PMCID: PMC9967684 DOI: 10.3390/nu15040796] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 02/08/2023] Open
Abstract
This cross-sectional study aimed to develop and validate a vitamin D food frequency questionnaire (VitD-FFQ) to assess vitamin D intake in Moroccan women of reproductive age. Using the method of triads, the VitD-FFQ was validated against seven-day dietary records (7d-FR) and 25-hydroxyvitamin D (25(OH)D) as a biomarker of vitamin D status in 152 women (aged 18-45 years). Participants' sun exposure scores (SES) were assessed using a specific questionnaire (SEQ). Predictors of vitamin D status were identified via linear regression models. Several statistical tests were applied to evaluate the criterion validity of the FFQ against two references methods (7d-FR and the biomarker-serum 25(OH)D). Median (Interquartile range) intakes were 7.10 ± 6.95 µg /day and 6.33 ± 5.02 µg/ day, respectively, for VitD-FFQ and 7d-FR. Vitamin D status was mainly determined by SES (R = 0.47) and vitamin D absolute food intakes derived by the VitD-FFQ (R = 0.56), which demonstrated a more significant prediction ability compared to 7d-FR (R = 0.36). An agreement was observed between the VitD-FFQ and 7d-FR (BA index of 3.29%) with no proportional bias (R2 = 0.002, p = 0.54). <10% of participants were incorrectly classified, and weighted kappa statistics showed that VitD-FFQ had an acceptable ranking ability compared to the 7d-FR and the biomarker. The validity coefficient for the VitD-FFQ was high: ρQR = 0.90 (95%CI: 0.89-0.92), and a range from 0.46 to 0.90. Adjustment for the participants' SES and BMI (body mass index) improved the biomarker's validity coefficient (ρRB 0.63 (95% CI 0.39-0.82). Our results indicate that the VitD-FFQ is valid for estimating absolute vitamin D intake in Moroccan women of reproductive age.
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Affiliation(s)
- Noura Zouine
- Cluster of Competency “Environment and Health”, Faculty of Sciences, Moulay Ismail University, Meknes 50000, Morocco
- Higher Institute of Nursing and Health Professions of Fes-Meknes Annex, Meknes 50000, Morocco
| | - Ilham Lhilali
- Cluster of Competency “Environment and Health”, Faculty of Sciences, Moulay Ismail University, Meknes 50000, Morocco
- Higher Institute of Nursing and Health Professions of Fes-Meknes Annex, Meknes 50000, Morocco
| | - Aziza Menouni
- Cluster of Competency “Environment and Health”, Faculty of Sciences, Moulay Ismail University, Meknes 50000, Morocco
- Health and Environment Unit, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Lode Godderis
- Health and Environment Unit, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- IDEWE, External Service for Prevention and Protection at Work, 3001 Heverlee, Belgium
| | - Adil El Midaoui
- Faculty of Sciences and Techniques, Errachidia, Moulay Ismail University of Meknes, Errachidia 52000, Morocco
- Department of Pharmacology and Physiology, Faculty of Medicine, University of Montreal, Montreal, QC H3C 3J7, Canada
- Correspondence:
| | - Samir El Jaafari
- Cluster of Competency “Environment and Health”, Faculty of Sciences, Moulay Ismail University, Meknes 50000, Morocco
| | - Younes Zegzouti Filali
- Cluster of Competency “Environment and Health”, Faculty of Sciences, Moulay Ismail University, Meknes 50000, Morocco
- BASE Laboratory, FSM-FSTE, Moulay Ismail University of Meknes, Meknes 50000, Morocco
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Zheng M, Silva M, Heitkonig S, Abbott G, McNaughton SA, Campbell KJ. Evaluation of a Food Frequency Questionnaire for Capturing Free Sugars Intake in Australian Young Children: The InFANT FFQ. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1557. [PMID: 36674312 PMCID: PMC9864467 DOI: 10.3390/ijerph20021557] [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: 12/15/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Excess free sugars intake contributes to dental caries and obesity in children. Food frequency questionnaires (FFQ) that assess free sugars intake in young children are limited. This study evaluated the utility of a 68-item FFQ to assess free sugars intake in Australian young children against three 24-h recalls at ages 1.5, 3.5, and 5.0 years. Free sugars intakes estimated from two methods were compared using group- and individual-level validation tests. Group-level tests revealed that mean free sugars intakes estimated from two methods were similar and Bland-Altman tests revealed no presence of proportional bias at age 1.5 years. For ages 3.5 and 5.0 years, the FFQ underestimated the free sugars intake compared to the recalls, and Bland-Altman tests revealed proportional bias. For individual-level tests, the deattenuated correlation (R) between free sugars intakes estimated from two methods exhibited good agreement across three time-points (R: 0.54-0.62), as were the percentage agreement (68.5-73.6%) and weighted kappa (Kw: 0.26-0.39). The FFQ showed good validity at age 1.5 years. For ages 3.5 and 5.0 years, the FFQ showed good validity for individual-level tests only. The FFQ provided stronger validity in the ranking of individuals according to free sugars intake than comparing absolute free sugars intake at group level.
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Affiliation(s)
- Miaobing Zheng
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia
| | - Mihiri Silva
- Murdoch Childrens Research Institute, Department of Paediatrics, The University of Melbourne, Royal Children’s Hospital, Parkville, VIC 3052, Australia
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia
| | - Stephanie Heitkonig
- Murdoch Childrens Research Institute, Department of Paediatrics, The University of Melbourne, Royal Children’s Hospital, Parkville, VIC 3052, Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia
| | - Sarah A. McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia
| | - Karen J. Campbell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia
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Development and validation of a quantitative food frequency questionnaire to assess free sugar intake among Sri Lankan preschool children. J Nutr Sci 2023; 12:e14. [PMID: 36843966 PMCID: PMC9947589 DOI: 10.1017/jns.2023.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 02/09/2023] Open
Abstract
The present study aims to develop a quantitative food frequency questionnaire (FFQ) to assess free sugar intake as a whole and at the food group levels, retrospectively, over the past 3 months among 4 to 5-year-old preschool children in the Colombo district, Sri Lanka. Then, to assess its reliability and relative validity. In the development phase, three 24-hour dietary recalls (24 hDRs) of 518 preschool children were collected from caregivers. Based on that, a 67-item FFQ was developed, including commonly consumed free sugar-containing food items. The validation study was conducted among another 108 preschool children. The relative validity of the FFQ was assessed by comparing it with the 24 hDRs. The test-retest reliability was assessed by repeated application of the FFQ to the same population after 6 weeks. Wilcoxon sign rank test, cross-classification with weighted Kappa statistic, Spearman rank correlation and Bland-Altman plots were used for comparison. Comparing the free sugar intake calculated by the two methods showed no difference (P = 0⋅13), a good correlation (0⋅89), good agreement in cross-classifying participants (78⋅4 % correctly classified) and a good agreement in Bland-Altman plots. Repeated application of the FFQ yielded; no differences in free sugar intake values (P = 0⋅45) a good correlation (0⋅71), acceptable agreement in cross-classifying participants (52⋅3 % correctly classified) and acceptable agreement in the Bland-Altman plot. Results were the same for all food groups. According to the results, the newly developed quantitative FFQ provides a relatively valid and reliable measure for quantifying free sugar intake among preschool children as a whole or by food group.
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Moyen A, Rappaport AI, Fleurent-Grégoire C, Tessier AJ, Brazeau AS, Chevalier S. Relative Validation of an Artificial Intelligence–Enhanced, Image-Assisted Mobile App for Dietary Assessment in Adults: Randomized Crossover Study. J Med Internet Res 2022; 24:e40449. [DOI: 10.2196/40449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/09/2022] [Accepted: 10/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background
Thorough dietary assessment is essential to obtain accurate food and nutrient intake data yet challenging because of the limitations of current methods. Image-based methods may decrease energy underreporting and increase the validity of self-reported dietary intake. Keenoa is an image-assisted food diary that integrates artificial intelligence food recognition. We hypothesized that Keenoa is as valid for dietary assessment as the automated self-administered 24-hour recall (ASA24)–Canada and better appreciated by users.
Objective
We aimed to evaluate the relative validity of Keenoa against a 24-hour validated web-based food recall platform (ASA24) in both healthy individuals and those living with diabetes. Secondary objectives were to compare the proportion of under- and overreporters between tools and to assess the user’s appreciation of the tools.
Methods
We used a randomized crossover design, and participants completed 4 days of Keenoa food tracking and 4 days of ASA24 food recalls. The System Usability Scale was used to assess perceived ease of use. Differences in reported intakes were analyzed using 2-tailed paired t tests or Wilcoxon signed-rank test and deattenuated correlations by Spearman coefficient. Agreement and bias were determined using the Bland-Altman test. Weighted Cohen κ was used for cross-classification analysis. Energy underreporting was defined as a ratio of reported energy intake to estimated resting energy expenditure <0.9.
Results
A total of 136 participants were included (mean 46.1, SD 14.6 years; 49/136, 36% men; 31/136, 22.8% with diabetes). The average reported energy intakes (kcal/d) were 2171 (SD 553) in men with Keenoa and 2118 (SD 566) in men with ASA24 (P=.38) and, in women, 1804 (SD 404) with Keenoa and 1784 (SD 389) with ASA24 (P=.61). The overall mean difference (kcal/d) was −32 (95% CI −97 to 33), with limits of agreement of −789 to 725, indicating acceptable agreement between tools without bias. Mean reported macronutrient, calcium, potassium, and folate intakes did not significantly differ between tools. Reported fiber and iron intakes were higher, and sodium intake lower, with Keenoa than ASA24. Intakes in all macronutrients (r=0.48-0.73) and micronutrients analyzed (r=0.40-0.74) were correlated (all P<.05) between tools. Weighted Cohen κ scores ranged from 0.30 to 0.52 (all P<.001). The underreporting rate was 8.8% (12/136) with both tools. Mean System Usability Scale scores were higher for Keenoa than ASA24 (77/100, 77% vs 53/100, 53%; P<.001); 74.8% (101/135) of participants preferred Keenoa.
Conclusions
The Keenoa app showed moderate to strong relative validity against ASA24 for energy, macronutrient, and most micronutrient intakes analyzed in healthy adults and those with diabetes. Keenoa is a new, alternative tool that may facilitate the work of dietitians and nutrition researchers. The perceived ease of use may improve food-tracking adherence over longer periods.
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Cieśla E, Suliga E, Kadučáková H, Michel S, Ižová M, Simočková V, Martin T, Braun A, Kozieł D, Głuszek S. Reproducibility of the German and Slovakian Versions of the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN). Nutrients 2022; 14:nu14224893. [PMID: 36432579 PMCID: PMC9696161 DOI: 10.3390/nu14224893] [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: 10/20/2022] [Revised: 11/11/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
PURPOSE The aim of this study was to assess the reproducibility and reliability of the KomPAN questionnaire among two groups of university students from Germany and Slovakia. METHODS A total of 422 individuals (mean age 21.4 years, SD 4.0), including 197 from Slovakia (men 26.2%) and 225 from Germany (men 22.3%), were tested using the self-administered (SA-Q) version of the KomPAN questionnaire and then retested two weeks later. A cross-classification analysis, kappa coefficients, Cronbach's ɑ coefficients, and a test-retest result comparison were conducted separately for each group of students to assess the reproducibility and reliability of the questionnaire. RESULTS The cross-classification values were higher than 46.2% among the German students and higher than 55.8% among the Slovakian students. The kappa coefficients ranged from 0.21 to 0.90 in the German students and from 0.38 to 0.94 in the Slovakian students. Cronbach's ɑ ranged from 0.58 to 0.78. CONCLUSION The questionnaire displayed a moderate to very good reproducibility, which was slightly higher in the Slovakian group than in the German group. Therefore, the questionnaire can be recommended for further analysis and comparison of the dietary habits among Germans and Slovakians on a larger scale.
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Affiliation(s)
- Elżbieta Cieśla
- Institute of Health Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland
- Correspondence:
| | - Edyta Suliga
- Institute of Health Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland
| | - Helena Kadučáková
- Department of Nursing, Faculty of Health, Catholic University in Ružomberok, 03401 Ružomberok, Slovakia
| | - Sven Michel
- Institute for Health, Faculty of Social Work, Health and Music, Brandenburg University of Technology Cottbus-Senftenberg, 03048 Cottbus, Germany
| | - Marcela Ižová
- Institute for Health, Faculty of Social Work, Health and Music, Brandenburg University of Technology Cottbus-Senftenberg, 03048 Cottbus, Germany
| | - Viera Simočková
- Department of Nursing, Faculty of Health, Catholic University in Ružomberok, 03401 Ružomberok, Slovakia
| | - Titus Martin
- Institute for Health, Faculty of Social Work, Health and Music, Brandenburg University of Technology Cottbus-Senftenberg, 03048 Cottbus, Germany
| | - Alexander Braun
- Institute for Health, Faculty of Social Work, Health and Music, Brandenburg University of Technology Cottbus-Senftenberg, 03048 Cottbus, Germany
| | - Dorota Kozieł
- Institute of Medical Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland
| | - Stanisław Głuszek
- Institute of Medical Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland
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Comparison of dietary intake measured by a web-based FFQ and repeated 24-hour dietary recalls: the Hordaland Health Study. J Nutr Sci 2022; 11:e98. [PMID: 36405094 PMCID: PMC9641502 DOI: 10.1017/jns.2022.97] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/22/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
All dietary assessment methods inevitably introduce measurement errors, which should ideally be considered during data analysis and interpretation. Methodological studies should be conducted to address how well a given assessment method captures dietary intake and to highlight the extent and direction of the measurement error. Within a subgroup of the Hordaland Health Study (HUSK3), we examined the relative validity of a web-based food frequency questionnaire (WebFFQ) by comparing its estimates of mean daily intake of nutrients and foods with estimated mean daily intakes from repeated administrations of 24-hour dietary recall interviews (24-HDRs). Men and women born between 1950 and 1951 were recruited from HUSK3. The participants (n = 67) completed a WebFFQ and three non-consecutive 24-HDRs over the course of a year. Relative validity was assessed using Spearman's rank correlation, crosstab analysis and Bland-Altman plots. Linear regression models were used to compute the calibration coefficients. The estimated correlation coefficients were acceptable or strong for all nutrients and foods except iodine (rs = 0⋅19). The highest correlation coefficient was found for juice (rs = 0⋅71), whereas the lowest correlation coefficient was found for iodine (rs = 0⋅19). Cross-classification by quartiles categorised more than 72 % of the participants into the same or adjacent quartiles using the two methods. Few data points fell outside the limits of agreement in the Bland-Altman plots. Calibration coefficients ranged from 0⋅10 (wholegrain) to 0⋅81 (alcohol). Our findings suggest that the WebFFQ has reasonable ranking abilities for all the included nutrients and foods, except for iodine.
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Key Words
- 24-HDR, 24-hour dietary recall interviews
- BMI, body mass index
- CI, confidence interval
- DLW, doubly labelled water
- Dietary assessment
- FFQ
- FFQ, food frequency questionnaire
- HUSK3, The Hordaland Health Study
- KBS, KostBeregningsSystemet
- LOA, limits of agreement
- The Hordaland Health Study
- Validation
- WebFFQ
- WebFFQ, web-based food frequency questionnaire
- kJ, kilojoule
- p25–p75, 25th percentile–75th percentile
- sd, standard deviation
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Goletzke J, Weber KS, Kössler T, Zaharia OP, Bódis K, Müssig K, Szendroedi J, Burkart V, Stutz B, Nöthlings U, Buyken AE, Roden M. Relative validity of a glycemic index extended food-frequency questionnaire. Nutr Metab Cardiovasc Dis 2022; 32:2310-2320. [PMID: 35973887 DOI: 10.1016/j.numecd.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/15/2022] [Accepted: 07/11/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS The dietary glycemic index (GI) and glycemic load (GL) are increasingly recognized as important for the prevention and management of diabetes mellitus. To extend the portfolio of assessment methods for large-scale epidemiological studies, we propose a GI-specific addition to an already established FFQ. METHODS AND RESULTS The German version of the EPIC-FFQ was extended by GI-specific questions for major carbohydrate sources varying notably in GI (breakfast cereals, bread, pasta, rice, potato etc.). We performed relative validation analyses comparing the GI-extended FFQ to three to four 3-day weighted dietary records (3-d WDR) in 100 middle-aged individuals with diabetes mellitus participating in the German Diabetes Study (GDS). Level of agreement between the two methods was assessed by correlation and cross-classification analyses as well as Bland-Altman-Plots, conducted separately for women and men. Spearman correlation analysis for female participants suggested good agreement between the GI-extended FFQ and 3-d WDRs for energy adjusted dietary GL (r = 0.52, p = 0.0004). For both women and men, agreement with the estimations of dietary GI, GL (for men) and carbohydrates from low and higher-GI food sources from the GI-extended FFQ was acceptable (r: 0.28-0.45). Classification of the dietary GI and GL in the opposite quartile was <10% comparing the GI-extended FFQ and 3-d WDR. Bland-Altman plots suggested a tendency for an overestimation of the dietary GI from the GI-extended FFQ in the lower GI-ranges, particularly for men. CONCLUSION Compared to the 3-d WDR, the GI-extended FFQ showed a moderate to good relative validity for parameters of carbohydrate quality.
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Affiliation(s)
- Janina Goletzke
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, 33098 Paderborn, Germany
| | - Katharina S Weber
- Institute of Epidemiology, Kiel University, Kiel, Germany; Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
| | - Theresa Kössler
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Oana-Patricia Zaharia
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Kálmán Bódis
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Karsten Müssig
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Department of Internal Medicine, Gastroenterology and Diabetology, Niels Stensen Hospitals, Franziskus Hospital Harderberg, Georgsmarienhütte, Germany
| | - Julia Szendroedi
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Clinic for Endocrinology, Diabetology, Metabolic Diseases and Clinical Chemistry at Heidelberg University Hospital, Germany
| | - Volker Burkart
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
| | - Bianca Stutz
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, 33098 Paderborn, Germany
| | - Ute Nöthlings
- Institute of Nutrition and Food Sciences, Faculty of Agriculture, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Anette E Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, 33098 Paderborn, Germany.
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Mai TMT, Tran QC, Nambiar S, der Pols JCV, Gallegos D. Development and Validation of the Vietnamese Children’s Short Dietary Questionnaire to Evaluate Food Groups Intakes and Dietary Practices among 9–11-Year-Olds Children in Urban Vietnam. Nutrients 2022; 14:nu14193996. [PMID: 36235649 PMCID: PMC9570706 DOI: 10.3390/nu14193996] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/21/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
This study aims to develop and assess the reproducibility and validity of the Vietnamese Children’s Short Dietary Questionnaire (VCSDQ) in evaluating food groups intakes and dietary practices among school-aged children 9–11 years old in urban Vietnam. A 26-item questionnaire covering frequency intakes of five core food groups, five non-core food groups, five dietary practices over a week, and daily intakes of fruits, vegetables, and water was developed. Children (n = 144) from four primary schools in four areas of Ho Chi Minh City, Vietnam completed the VCSDQ twice, as well as three consecutive 24 h recalls over a week. Intra-class correlation, Spearman correlation, weighted kappa, cross-classification, and Bland–Altman plots were used to evaluate the reproducibility and validity. The direct validity of food groups from VCSDQ against the 24 h recalls was examined using Wilcoxon-test for trend. The VCSDQ had good reproducibility in 12 out of 15 group items; the ICC ranged from 0.33 (grains) to 0.84 (eating while watching screens). This VCSDQ had low relative validity, two items (instant noodles, eating while watching screens) had a moderate to good agreement (k = 0.43, k = 0.84). There was good direct validity in three core-food groups (fruits, vegetables, dairy) and three non-core food groups (sweetened beverages, instant noodles, processed meat). In addition, the VCSDQ can also be used to classify daily intakes of fruits and vegetables from low to high.
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Affiliation(s)
- Thi My Thien Mai
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Victoria Park Rd., Kelvin Grove, QLD 4059, Australia
- Ho Chi Minh City Center for Disease Control, Ho Chi Minh City 700000, Vietnam
- Correspondence:
| | - Quoc Cuong Tran
- Department of Nutrition and Food Safety, Faculty of Public Health, Pham Ngoc Thach Medical University, Ho Chi Minh City 700000, Vietnam
| | - Smita Nambiar
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Victoria Park Rd., Kelvin Grove, QLD 4059, Australia
| | - Jolieke C. Van der Pols
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Victoria Park Rd., Kelvin Grove, QLD 4059, Australia
| | - Danielle Gallegos
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Victoria Park Rd., Kelvin Grove, QLD 4059, Australia
- Woolworths Centre for Childhood Nutrition Research, Queensland University of Technology (QUT), Graham St., South Brisbane, QLD 4101, Australia
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Hribar M, Žlavs K, Pravst I, Žmitek K. Validation of the food frequency questionnaire for the assessment of dietary vitamin D intake. Front Nutr 2022; 9:950874. [PMID: 36211494 PMCID: PMC9537601 DOI: 10.3389/fnut.2022.950874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/26/2022] [Indexed: 11/14/2022] Open
Abstract
Vitamin D and its adequate status are related to many aspects of human health; therefore, an appropriate tool is needed for the valid assessment of vitamin D status. The main contributor to vitamin D status is endogenous synthesis after cutaneous exposure to ultraviolet B light (UVB), but in the absence of UVB radiation, vitamin D intake becomes an important source of vitamin D. Various tools are available for vitamin D intake assessments, with the Food Frequency Questionnaire (FFQ) being among the fastest, cheapest, and most convenient; however, until now, these tools have not been adapted for the Slovenia (SI). To enable valid vitamin D intake estimation, we developed a simple one-page semi-quantitative FFQ (sqFFQ/SI) and tested its validity using a 5-day dietary record (DR) as a reference method. The reproducibility was tested with the second sqFFQ/SI (sqFFQ/SI2) 6 weeks after the first (sqFFQ/SI1). The validity and reproducibility of this method were tested on 54 participants using Bland–Altman plots, Spearman’s correlation, and Kappa analyses of tertiles. The mean daily vitamin D intake was 3.50 ± 1.91 μg according to the 5-day DR, and 2.99 ± 1.35 and 3.31 ± 1.67 μg according to the sqFFQ/SI1 and repeated sqFFQ/SI (sqFFQ/SI2), respectively. When analyzing for validity, the sqFFQ/SI1 was found to be significantly correlated (p < 0.05) with the 5-day DR, with an acceptable correlation coefficient of 0.268 and a Bland–Altman index of 3.7%. For reproducibility, the correlation between the sqFFQ/SI1 and sqFFQ/SI2 was highly significant (p < 0.001), with a good correlation coefficient of 0.689 and a Bland–Altman index of 3.7%. Kappa analyses of tertiles showed a poor validity and acceptable reproducibility. Overall, we observed a higher reproducibility than validity. Validation and reproducibility analyses demonstrated that the proposed sqFFQ/SI is acceptable and is, therefore, an appropriate tool for the effective assessment of habitual vitamin D intake on an individual level. With this consideration, this tool will be used in further population studies to assess vitamin D intake and for the development of a screening tool for the assessment of the risk for vitamin D deficiency, which will be used as a foundation for evidence-based policy-making decisions.
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Affiliation(s)
- Maša Hribar
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Katarina Žlavs
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Igor Pravst
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
- VIST–Faculty of Applied Sciences, Ljubljana, Slovenia
- *Correspondence: Igor Pravst,
| | - Katja Žmitek
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
- VIST–Faculty of Applied Sciences, Ljubljana, Slovenia
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Mercier AP, Rochefort G, Fortier J, Parent G, Provencher V, Lemieux S, Lamarche B. Development and Validation of a Short Questionnaire Assessing the Behavior of Local Food Procurement in Quebec, Canada. Curr Dev Nutr 2022; 6:nzac097. [PMID: 36110102 PMCID: PMC9470036 DOI: 10.1093/cdn/nzac097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 04/12/2022] [Accepted: 05/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background Very few validated instruments, particularly screening tools applicable to large-cohort studies, are available to assess the behavior of local food procurement. Objective The aim was to develop and validate a short questionnaire that measures local food procurement in a sample of French-speaking adults from Quebec, Canada, and to assess the association between local food-procurement behavior and diet quality. Methods A comprehensive questionnaire developed previously to measure local food procurement [Locavore-Index (Locavore-I)] was simplified through a series of steps that included face-validity, exploratory factor analysis, and reliability testing (internal consistency). Construct validity of the resulting short Locavore-I Short Form (Locavore-I-SF) was examined in a sample of 299 adults (85% women) from the Quebec City metropolitan community. Results The Locavore-I-SF comprises 12 questions that measure the frequency of short food supply chain use (self-production, farmers' markets, and community-supported agriculture box scheme) for 3 locally produced foods (carrot, tomato, and lettuce) as well as the geographical origin of those 3 foods. The Locavore-I-SF, which is scored on a 12-point scale, had a high internal consistency (Cronbach ɑ: 0.74). The Locavore-I-SF scores were strongly correlated with the reference scores obtained from the Locavore-I from which it was developed (r = 0.84, P < 0.0001). Locavore-I-SF scores also correlated (r = 0.50, P < 0.0001) with the geographical origin of foods measured by pictures of food labels taken by participants. Higher Locavore-I-SF scores were associated with behaviors consistent with eating local foods, such as gardening (vs. not gardening; mean ± SEM difference: 2.3 ± 0.4 points; P < 0.0001) and not being preoccupied by the foods' appearance standards (vs. being preoccupied; 1.4 ± 0.4 points; P = 0.0002). Finally, the Locavore-I-SF scores were weakly associated with the Healthy Eating Food Index-2019 score (B = 0.05 ± 0.02; P = 0.02). Conclusions The Locavore-I-SF, a short questionnaire based on 3 locally produced foods in Quebec, measures the behavior of local food procurement with good reliability and acceptable validity metrics.
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Affiliation(s)
- Annie-Pier Mercier
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec, Canada
- École de Nutrition, Université Laval, Quebec, Canada
| | - Gabrielle Rochefort
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec, Canada
- École de Nutrition, Université Laval, Quebec, Canada
| | - Julie Fortier
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec, Canada
| | - Geneviève Parent
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec, Canada
- Faculté de Droit, Université Laval, Quebec, Canada
| | - Véronique Provencher
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec, Canada
- École de Nutrition, Université Laval, Quebec, Canada
| | - Simone Lemieux
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec, Canada
- École de Nutrition, Université Laval, Quebec, Canada
| | - Benoît Lamarche
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec, Canada
- École de Nutrition, Université Laval, Quebec, Canada
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Heusschen L, Berendsen AAM, Balvers MGJ, Deden LN, de Vries JHM, Hazebroek EJ. Relative validity of a short screener to assess diet quality in patients with severe obesity before and after bariatric surgery. Public Health Nutr 2022; 25:1-11. [PMID: 35786490 PMCID: PMC9991825 DOI: 10.1017/s1368980022001501] [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: 02/15/2022] [Revised: 05/12/2022] [Accepted: 06/14/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To determine the relative validity and reproducibility of the Eetscore FFQ, a short screener for assessing diet quality, in patients with (severe) obesity before and after bariatric surgery (BS). DESIGN The Eetscore FFQ was evaluated against 3-d food records (3d-FR) before (T0) and 6 months after BS (T6) by comparing index scores of the Dutch Healthy Diet index 2015 (DHD2015-index). Relative validity was assessed using paired t tests, Kendall's tau-b correlation coefficients (τb), cross-classification by tertiles, weighted kappa values (k w ) and Bland-Altman plots. Reproducibility of the Eetscore FFQ was assessed using intraclass correlation coefficients (ICC). SETTING Regional hospital, the Netherlands. PARTICIPANTS Hundred and forty participants with obesity who were scheduled for BS. RESULTS At T0, mean total DHD2015-index score derived from the Eetscore FFQ was 10·2 points higher than the food record-derived score (P < 0·001) and showed an acceptable correlation (τb = 0·42, 95 % CI: 0·27, 0·55). There was a fair agreement with a correct classification of 50 % (k w = 0·37, 95 % CI: 0·25, 0·49). Correlation coefficients of the individual DHD components varied from 0·01-0·54. Similar results were observed at T6 (τb = 0·31, 95 % CI: 0·12, 0·48, correct classification of 43·7 %; k w = 0·25, 95 % CI: 0·11, 0·40). Reproducibility of the Eetscore FFQ was good (ICC = 0·78, 95 % CI: 0·69, 0·84). CONCLUSION The Eetscore FFQ showed to be acceptably correlated with the DHD2015-index derived from 3d-FR, but absolute agreement was poor. Considering the need for dietary assessment methods that reduce the burden for patients, practitioners and researchers, the Eetscore FFQ can be used for ranking according to diet quality and for monitoring changes over time.
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Affiliation(s)
- Laura Heusschen
- Vitalys Obesity Clinic, Part of Rijnstate Hospital, Arnhem, 6800 TA, The Netherlands
- Divison of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Agnes AM Berendsen
- Divison of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Michiel GJ Balvers
- Divison of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Laura N Deden
- Vitalys Obesity Clinic, Part of Rijnstate Hospital, Arnhem, 6800 TA, The Netherlands
| | - Jeanne HM de Vries
- Divison of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Eric J Hazebroek
- Vitalys Obesity Clinic, Part of Rijnstate Hospital, Arnhem, 6800 TA, The Netherlands
- Divison of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
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The Relative Validity and Reproducibility of Food Frequency Questionnaires in the China Kadoorie Biobank Study. Nutrients 2022; 14:nu14040794. [PMID: 35215443 PMCID: PMC8879142 DOI: 10.3390/nu14040794] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 01/29/2022] [Accepted: 02/08/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Short versions of qualitative and quantitative food frequency questionnaires (FFQs) are widely used to assess usual food intake. However, fewer studies evaluated their relative validity and reproducibility in the Chinese population. METHODS This study compared 12-day 24-h dietary recalls with qualitative and quantitative FFQs designed by the China Kadoorie Biobank (CKB) study to assess the relative validity. Two FFQs were administered in the second and third seasons and compared to evaluate the reproducibility. Statistical tests included Spearman correlation coefficients, weighted kappa, and cross-classification. RESULTS A total of 432 participants were eligible after stratifying by age, sex, and four regions. In the validation of qualitative FFQ, adjusted Spearman coefficients were between 0.23 and 0.59, and weighted kappa coefficients ranged from 0.61 to 0.88, except for fresh vegetables. The percentage of correct classification was highest in fresh vegetables and lowest in fresh fruit, but the percentages of extreme classification were below 3.0%. Corresponding Spearman and kappa coefficients for the reproducibility were 0.17-0.56 and 0.62-0.90. Furthermore, the correct classification constituted between 35.6 and 93.3% of all participants. Regarding the relative validity of the quantitative FFQ, Spearman coefficients ranged from 0.14 to 0.69 in addition to dried vegetables and carbonated soft drinks. For items with more than two-thirds of total participants consumed, weighted kappa coefficients were from 0.57 to 0.79; correct classification percentages were between 34.6% and 67.5%. Spearman and kappa coefficients for the reproducibility of the quantitative FFQ were 0.15-0.71 and 0.60-0.86, respectively; correct classification percentages varied from 47.8% to 71.6%. CONCLUSION Most food items from the qualitative FFQ showed acceptable or even good relative validity and reproducibility in the CKB study. Likewise, major food items in the quantitative FFQ were valid and reproducible, but poor performances of dried vegetables and carbonated soft drinks indicated the need for modification and validation in future research.
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Mohammadifard N, Grau N, Khosravi A, Esmaillzadeh A, Feizi A, Abdollahi Z, Sarrafzadegan N. Validation and reproducibility of a semi-qualitative food frequency questionnaire for assessment of sodium intake in Iranian population. Nutr J 2022; 21:9. [PMID: 35114984 PMCID: PMC8815124 DOI: 10.1186/s12937-021-00749-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/09/2021] [Indexed: 11/16/2022] Open
Abstract
Background Few semi-quantitative food frequency questionnaires (SFFQ)s has yet been developed to assess sodium intake in Middle East region. This study was performed to validate a SFFQ for assessment of sodium consumption and food groups΄ contribution to sodium intake. Methods This study was performed on 219 healthy participants including 113 adults aged ≥19 years and 106 children aged 6–18 years in Isfahan, Iran. They were administered two SFFQ at the beginning and after 1 year to evaluate the reproducibility. The validity of SFFQ for assessment of sodium intake was compared with 24-h urine sodium and twelve 24-h dietary recalls which were completed monthly during a year as two standard methods. Results Correlation coefficient between the contribution of food groups to sodium intake based on SFFQ and 24-h dietary recalls varied from 0.04 for legumes (P = 0.667) to 0.47 for added salt (P < 0.001). There was a significant correlation between the estimated total sodium intake based on SFFQ and both standard methods (P < 0.01). Intraclass correlation coefficient (95% CI) between first and second SFFQ had a diverse range from 0.10 (-0.05, 0.17) for fats and oils to 0.49 (0.28, 0.69) for bread. According to the Bland-Altman plots, we observed an acceptable level of agreement between the two methods for sodium intake. Conclusions The SFFQ was a relatively valid and reproducible method for estimating sodium intake. Combination of this SFFQ with a valid prediction of 24-h urinary sodium excretion can be useful in achieving more accurate results. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00749-7.
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Affiliation(s)
- Noushin Mohammadifard
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Narges Grau
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Awat Feizi
- Epidemiology and Biostatistics Department, Health School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Abdollahi
- Nutrition Department, The Ministry of Health and Medical Education, Tehran, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. .,School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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Terminel-Zaragoza R, Vega-López S, Ulloa-Mercado G, Serna-Gutiérrez A, Gortares-Moroyoqui P, Díaz-Tenorio L, Rentería-Mexía A. Reproducibility and validity of a food frequency questionnaire to assess cardiovascular health-related food intake among Mexican adolescents. J Nutr Sci 2022; 11:e3. [PMID: 35291283 PMCID: PMC8889230 DOI: 10.1017/jns.2022.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/14/2021] [Accepted: 12/26/2021] [Indexed: 12/21/2022] Open
Abstract
There is a lack of region-adapted tools to evaluate diet as a risk factor for cardiovascular disease (CVD) in adolescents. The study aim was to evaluate the reproducibility and validity of a paper-based and region-adapted food frequency questionnaire (FFQ) designed to assess CVD-related food and nutrient intakes of adolescents from Northwest México. The study design was cross-sectional. The FFQ was developed in a two-step process: prototype designing and a pilot test, with re-tested in a 3-month period, along with two administrations of 24 h-recall (24 hR). Pearson's and intra-class correlation coefficients (PCC and ICC) were assessed. Bland-Altman plots, limits of agreement and quintile classifications were carried out. Participants (n 221) were 53·8 % male, 18·5 ± 0·4 years old. Reproducibility had a median PCC = 0·66 for processed meats, ranging from 0·40 (saturated fat) to 0·74 (fish & shellfish), P = 0·001. ICC ranged from 0·53 (saturated fat) to 0·80 (sodium; and nuts, seeds and legumes), P = 0·001. Validity comparing FFQ1 v. 24 hR mean, PCCs ranged from 0·12 (P = 0·06) to 0·95 (P = 0·001), and ICC from 0·20 (P = 0·048) to 0·88 (P = 0·001); comparing FFQ2 v. 24 hR mean, PCCs ranged from 0·07 (P = 0·25) to 0·46 (P = 0·001), and ICC from 0·15 (P = 0·106) to 0·58 (P = 0·001). The FFQ overestimated the intake of all food groups and nutrients (P < 0·05), while Cohen's κ showed coefficients lower than 0·20. The proposed FFQ represents a moderately validated tool to estimate CVD-related food and nutrient intakes as a risk factor, which can be used in combination with multiple administrations of 24 hRs, as a critical mean in future interventions intended to reduce cardiometabolic risk in adolescents.
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Affiliation(s)
- Ricardo Terminel-Zaragoza
- Maestría en Ciencias en Recursos Naturales, Instituto Tecnológico de Sonora, Ciudad Obregón, Sonora, México
| | - Sonia Vega-López
- College of Health Solutions, Arizona State University, Phoenix, AZ85004, USA
| | - Gabriela Ulloa-Mercado
- Departamento de Biotecnología y Ciencias Alimentarias, Instituto Tecnológico de Sonora, Ciudad Obregón, Sonora, México
| | - Araceli Serna-Gutiérrez
- Departamento de Sociocultural, Instituto Tecnológico de Sonora, Ciudad Obregón, Sonora, México
| | - Pablo Gortares-Moroyoqui
- Departamento de Biotecnología y Ciencias Alimentarias, Instituto Tecnológico de Sonora, Ciudad Obregón, Sonora, México
| | - Lourdes Díaz-Tenorio
- Departamento de Biotecnología y Ciencias Alimentarias, Instituto Tecnológico de Sonora, Ciudad Obregón, Sonora, México
| | - Ana Rentería-Mexía
- Departamento de Biotecnología y Ciencias Alimentarias, Instituto Tecnológico de Sonora, Ciudad Obregón, Sonora, México
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Paradis F, Lamarche B, Robitaille J, Couillard C, Lafrenière J, Tremblay AJ, Corneau L, Lemieux S. Validation of an automated self-administered 24-hour dietary recall web application against urinary recovery biomarkers in a sample of French-speaking adults of the province of Québec, Canada. Appl Physiol Nutr Metab 2022; 47:173-182. [PMID: 35057638 DOI: 10.1139/apnm-2021-0445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective of this study was to validate an automated self-administered 24-hour dietary recall web application (R24W) against recovery biomarkers for sodium, potassium and protein intakes and to identify individual characteristics associated with misreporting in a sample of 61 men and 69 women aged 20-65 years from Québec City, Canada. Each participant completed 3 dietary recalls using the R24W, provided two 24-hour urinary samples and completed questionnaires to document psychosocial factors. Mean reported intakes were 2.2%, 2.1% and 5.0% lower than the urinary reference values, respectively, for sodium, potassium and proteins (significant difference for proteins only (p = 0.04)). Deattenuated correlations between the self-reported intake and biomarkers were significant for sodium (r = 0.48), potassium (r = 0.56) and proteins (r = 0.68). Cross-classification showed that 39.7% (sodium), 42.9% (potassium) and 42.1% (proteins) of participants were ranked into the same quartile with both methods and only 4.8% (sodium), 3.2% (potassium) and 0.8% (proteins) were ranked in opposite quartiles. Lower body esteem related to appearance was associated with sodium underreporting in women (r = 0.33, p = 0.006). No other individual factor was found to be associated with misreporting. These results suggest that the R24W has a good validity for the assessment of sodium, potassium and protein intakes in a sample of French-speaking adults. Novelty: The validity of an automated self-administered 24-hour dietary recall web application named the R24W was tested using urinary biomarkers. According to 7 criteria, the R24W was found to have a good validity to assess self-reported intakes of sodium, potassium and proteins.
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Affiliation(s)
- Frédérique Paradis
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada.,École de nutrition, Université Laval, Québec, QC G1V 0A6, Canada
| | - Benoît Lamarche
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada.,École de nutrition, Université Laval, Québec, QC G1V 0A6, Canada
| | - Julie Robitaille
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada.,École de nutrition, Université Laval, Québec, QC G1V 0A6, Canada
| | - Charles Couillard
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada.,École de nutrition, Université Laval, Québec, QC G1V 0A6, Canada
| | - Jacynthe Lafrenière
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada
| | - André J Tremblay
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada
| | - Louise Corneau
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada
| | - Simone Lemieux
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada.,École de nutrition, Université Laval, Québec, QC G1V 0A6, Canada
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El Mesmoudi N, Al Dhaheri AS, Feehan J, Stojanovska L, Ali HI. Validation of a quantitative web-based food frequency questionnaire to assess dietary intake in the adult Emirati population. PLoS One 2022; 17:e0262150. [PMID: 35085272 PMCID: PMC8794217 DOI: 10.1371/journal.pone.0262150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/17/2021] [Indexed: 12/12/2022] Open
Abstract
Background and objective A culture-specific web-based food frequency questionnaire (FFQ) to assess dietary intake in the United Arab Emirates (UAE) adult population was developed using data from the 2009–2010 national nutrition survey. The objective of this study was to assess the relative validity of the newly developed FFQ for use in the adult Emirati population (AE-FFQ), which contained a list of 139 food lines. Methods A convenient sample of 60 (36 females and 24 males) adult Emiratis completed 3 non-consecutive 24HRs over a period of one month, followed by the AE-FFQ, which assessed the intake over the previous month. Relative validity was evaluated by comparing nutrient and food group intakes from the AE-FFQ with the average three 24HRs using Wilcoxon signed-rank tests, Spearman’s correlation coefficients (CC), Bland-Altman analysis, and cross-classification. Results The AE-FFQ overestimated energy and most nutrients and food groups. Bland–Altman analysis showed significant proportional bias between the 2 methods. Deattenuated energy-adjusted Spearman correlation coefficients were poor to good ranging from 0.06 (iron) to 0.62 (fiber) for nutrients, 0.39 median value, and from –0.01 (cruciferous vegetables) to 0.64 (eggs) for food groups, 0.41 median value. A fairly acceptable agreement was obtained, with correct classification into the same or adjacent quartile ranging from 34% (vitamin B12) to 78% (pyridoxine), median 69% for nutrients and from 55% (diet soft drinks) to 87% (soft drinks), median 67% for food groups. Conclusions The AE-FFQ is an acceptable tool for ranking UAE adults (aged 18 to 50) according to their dietary intake to investigate the role of Emirati dietary patterns on health and disease. Caution is needed for assessing absolute intake, however, given the bias observed in assessing group-level agreement.
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Affiliation(s)
- Najoua El Mesmoudi
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Ayesha S. Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Jack Feehan
- The Department of Medicine–Western Health, The University of Melbourne, Melbourne, Australia
- The Institute for Health and Sport, Victoria University, Melbourne Australia
| | - Lily Stojanovska
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- The Institute for Health and Sport, Victoria University, Melbourne Australia
| | - Habiba I. Ali
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- * E-mail:
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Relative Validity and Reproducibility of a Semi-Quantitative Food Frequency Questionnaire for Determining Nutrient Intake in Older Adults in New Zealand: The REACH Study. Nutrients 2022; 14:nu14030519. [PMID: 35276880 PMCID: PMC8838043 DOI: 10.3390/nu14030519] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/17/2022] [Accepted: 01/23/2022] [Indexed: 01/27/2023] Open
Abstract
Dietary intake is an important predictor of health and disease outcomes. This cross-sectional study evaluated the relative validity and reproducibility of a semi-quantitative food frequency questionnaire (FFQ) for assessing energy and nutrient intake in older adults. Dietary data were collected 2018–2019 in Auckland, New Zealand from a convenience sample of community-dwelling adults (65–74 years, n = 294, 37% male) using a 109-item self-administered FFQ at baseline (FFQ1) and four weeks later to assess reproducibility. FFQ1 was compared to a four-day food record to determine relative validity. Agreement between dietary assessment tools was assessed for both raw and energy-adjusted nutrient intakes using paired t-tests, correlation coefficients, weighted kappa statistic, Bland–Altman plots, and linear regression analysis. Energy adjustments moderately improved the relative validity and reproducibility for most nutrients. For energy and energy-adjusted nutrient intakes, the mean correlation coefficients were 0.38 (validity) and 0.65 (reproducibility); the mean weighted kappa statistics were 0.27 (validity) and 0.51 (reproducibility). A significant slope of bias was present in 54% (validity) and 25% (reproducibility) of Bland–Altman plots. The Researching Eating, Activity, and Cognitive Health (REACH) FFQ has acceptable relative validity and good reproducibility for ranking nutrient intakes in older New Zealand adults, but is less suitable for assessing absolute nutrient intakes.
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Technology characteristics as predictors of psychological strain. INTERNATIONAL JOURNAL OF TECHNOLOGY AND HUMAN INTERACTION 2022. [DOI: 10.4018/ijthi.297620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Drawing on the work system misfit model, the present research developed and tested a model consisting of three technology characteristics (usefulness, presenteeism, and responsiveness) as antecedents, five techno-stressors (techno-overload, techno-complexity, techno-uncertainty, techno-invasion, and techno-insecurity) as mediators, and psychological strain as an outcome. A web-based survey questionnaire was utilized by surveying 163 employees from different financial and technological organizations. Two contributions with practical and theoretical significance were offered by the current research. First, this research delivered new insights for organizations to develop their technological environments and consequently, improve their employees’ mental health. Second, this research developed a short measure of a new dynamic technology feature (i.e., responsiveness) that may be used by scholars and practitioners in the broad Information Systems discipline.
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