1
|
Lemke S, de Andrade DF, de Fragas Hinnig P, da Silva SA, Vincenzi SL, Roberto DMT, Lobo AS, Vieira FGK, Di Pietro PF, de Assis MAA. Development and application of the Meal and Snack Assessment (MESA) quality scale for children and adolescents using item response theory. Nutr J 2024; 23:50. [PMID: 38745270 PMCID: PMC11092231 DOI: 10.1186/s12937-024-00948-y] [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: 02/21/2024] [Accepted: 04/10/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Meals differ in terms of food items and nutritional quality. The aim of the present study was to propose a scale to measure the meals quality of schoolchildren according to food processing degree, perform a preliminary evaluation of the scale's validity and reliability and apply the scale to a representative sample of schoolchildren in a city in southern Brazil. METHODS A methodological study based on the generalized graded unfolding model (GGUM) of item response theory (IRT) with analysis of secondary data was carried out in 6,399 schoolchildren of 6-15y-old attending 2nd to 5th grades of public elementary schools in Florianópolis, Brazil, in 2013-2015 who answered the validated Food Intake and Physical Activities of Schoolchildren (WebCAAFE) questionnaire. Meal quality was the latent trait. The steps for the development of the scale included: latent trait definition; item generation; dimensionality analysis; estimation of item parameters; scale levels definition; assessment of validity and reliability; and assessment of the meal quality of a subsample of schoolchildren aged 7 to 12 years (n = 6,372). RESULTS Eleven out of eighteen items had adequate parameters, without differential item functioning for sex or age. Meal quality was categorized into three levels: healthy, mixed, and unhealthy. Higher scores indicate a greater prevalence of ultra-processed foods in daily meals. Most schoolchildren had mixed (40.6%) and unhealthy (41%) meal patterns. CONCLUSIONS IRT analysis allowed the development of the scale, which measures the quality of meals and snacks based on the degree of food processing. At all snack times, there was a higher frequency of ultra-processed foods consumption, therefore foods consumed as snacks are a potential focus for nutritional interventions.
Collapse
Affiliation(s)
- Stella Lemke
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Dalton Francisco de Andrade
- Informatics and Statistics Department, Technological Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Patrícia de Fragas Hinnig
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Silvio Aparecido da Silva
- Knowledge Management Department, Federal Institute of Education, Science and Technology of Santa Catarina, Florianópolis, Brazil
| | - Silvana Ligia Vincenzi
- Informatics and Statistics Department, Technological Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Denise Miguel Teixeira Roberto
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Adriana Soares Lobo
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Francilene Gracieli Kunradi Vieira
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Patricia Faria Di Pietro
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil.
- Federal University of Santa Catarina, Campus Trindade, Florianópolis, Santa Catarina, 88040-370, Brazil.
| | - Maria Alice Altenburg de Assis
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| |
Collapse
|
2
|
Roberto DMT, Pereira LJ, Vieira FGK, Di Pietro PF, de Assis MAA, Hinnig PDF. Association between Sleep Timing, Being Overweight and Meal and Snack Consumption in Children and Adolescents in Southern Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6791. [PMID: 37754650 PMCID: PMC10531239 DOI: 10.3390/ijerph20186791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/16/2023] [Accepted: 09/18/2023] [Indexed: 09/28/2023]
Abstract
Sleep timing is one of the dimensions of sleep that refers to the time of day when sleep occurs. It has been included in sleep-related research because of the potential associations between being overweight and the consumption of meals and snacks. This cross-sectional study aimed to investigate associations between sleep timing, meal and snack consumption and weight status in 1333 schoolchildren aged 7-14 years. The midpoint of sleep was used as a sleep timing measure obtained by the midpoint between bedtime and wake-up time, classified as Early, Intermediate, and Late. Schoolchildren in the Early group were less likely to be overweight (OR: 0.83, 95% CI 0.69; 0.99), and had higher odds of mid-morning snack consumption (OR: 1.95, 95% CI 1.56; 2.44) and lower probability to consume an evening snack (OR: 0.75, 95% CI 0.59; 0.94) compared with the Intermediate group. The Late group had lower odds of mid-morning snack consumption (OR: 0.67, 95% CI 0.55, 0.80) than the Intermediate group. The consumption of mid-morning and evening snacks was associated with the Early and Late midpoints of sleep. These results suggest that bedtime and wake-up time are relevant to consuming meals and snacks and may also be related to a greater probability of being overweight in children and adolescents.
Collapse
Affiliation(s)
| | | | | | | | | | - Patrícia de Fragas Hinnig
- Post-Graduation Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| |
Collapse
|
3
|
Pereira LJ, Lopes CP, Martins ML, de Fragas Hinnig P, Di Pietro PF, de Moura Araujo PH, de Andrade DF, De Assis MAA, Vieira FGK. How Brazilian Schoolchildren Identify, Classify, and Label Foods and Beverages-A Card Sorting Methodology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1296. [PMID: 36674051 PMCID: PMC9859169 DOI: 10.3390/ijerph20021296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
This study examined how Brazilian schoolchildren identified, classified, and labeled foods and beverages. Semi-structured interviews were conducted with 133 schoolchildren aged 7 to 10 years old from a public school located in southern Brazil in 2015. A set of cards with pictures of 32 food and beverage items from the web-based Food Intake and Physical Activity of Schoolchildren tool (Web-CAAFE) were used. Participants identified each item, formed groups for them based on similarity, and assigned labels for those groups. Student's t-tests and analysis of variance (ANOVA) tests were used to verify the mean difference between the groups of items. K-means cluster analysis was applied to identify similar clusters. Schoolchildren made an average of 9.1 piles of foods and beverages that they thought were similar (±2.4) with 3.0 cards (±1.8) each. Five groups were identified: meats, snacks and pasta, sweets, milk and dairy products, and fruits and vegetables. The most frequently used nomenclature for labeling groups was taxonomic-professional (47.4%), followed by the specific food item name (16.4%), do not know/not sure (13.3%), and evaluative (health perception) (8.8%). The taxonomic-professional category could be applied to promote improvements in the identification process of food and beverage items by children in self-reported computerized dietary questionnaires.
Collapse
Affiliation(s)
- Luciana Jeremias Pereira
- Post-Graduation Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Clarice Perucchi Lopes
- Post-Graduation Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Mayara Lopes Martins
- Doctoral School of Nutrition and Food Sciences, Institute of Nutrition, University of Debrecen, H-4002 Debrecen, Hungary
| | - Patrícia de Fragas Hinnig
- Post-Graduation Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Patricia Faria Di Pietro
- Post-Graduation Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Pedro Henrique de Moura Araujo
- Informatics and Statistics Department, Technological Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Dalton Francisco de Andrade
- Informatics and Statistics Department, Technological Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Maria Alice Altenburg De Assis
- Post-Graduation Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | | |
Collapse
|
4
|
Mata JDS, Freitas JV, Crispim SP, Interlenghi GS, Magno MB, Ferreira DMTP, Araujo MC. Technological tools for assessing children's food intake: a scoping review. J Nutr Sci 2023; 12:e43. [PMID: 37123397 PMCID: PMC10131056 DOI: 10.1017/jns.2023.27] [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: 10/27/2022] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 05/02/2023] Open
Abstract
Technological innovations can standardise and minimise reporting errors in dietary assessment. This scoping review aimed to summarise the characteristics of technological tools used to assess children's food intake. The review followed the Joanna Briggs Institute's manual. The main inclusion criterion was studied that assessed the dietary intake of children 0-9 years of age using technology. We also considered articles on validation and calibration of technologies. We retrieved 15 119 studies and 279 articles were read in full, after which we selected 93 works that met the eligibility criteria. Forty-six technologies were identified, 37 % of which had been developed in Europe and 32⋅6 % in North America; 65⋅2 % were self-administered; 27 % were used exclusively at home; 37 % involved web-based software and more than 80 % were in children over 6 years of age. 24HR was the most widely used traditional method in the technologies (56⋅5 %), and 47⋅8 % of the tools were validated. The review summarised helpful information for studies on using existing tools or that intend to develop or validate tools with various innovations. It focused on places with a shortage of such technologies.
Collapse
Affiliation(s)
- Jonas de Souza Mata
- Emília de Jesus Ferreiro School of Nutrition, Federal Fluminense University, Niterói, RJ, Brazil
| | - Jade Veloso Freitas
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rua São Francisco Xavier, 524, 7° andar, bloco E, sala 6004, Maracanã, Rio de Janeiro, RJ CEP 20550-900, Brazil
- Corresponding author: Jade Veloso Freitas, Email
| | | | | | - Marcela Baraúna Magno
- Associate Professor of Graduate Studies in Dentistry, Veiga de Almeida University, Rio de Janeiro, RJ, Brazil
| | | | - Marina Campos Araujo
- Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Ministry of Health, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
5
|
Roberto DMT, Kupek E, Assis MAA, Lobo AS, Belchor ALL, Spanholi MW, Cezimbra VG, Oliveira MT, Pereira LJ, Vieira FGK, Hinnig PDF. Most meal and snack patterns are stable over a 3‐year period in schoolchildren in southern Brazil. NUTR BULL 2022; 47:79-92. [DOI: 10.1111/nbu.12541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Emil Kupek
- Department of Public Health Center for Health Sciences Federal University of Santa Catarina Florianópolis Brazil
| | | | - Adriana Soares Lobo
- Center for Health Sciences Federal University of Santa Catarina Florianópolis Brazil
| | - Ana Luisa Lages Belchor
- Department of Public Health Center for Health Sciences Federal University of Santa Catarina Florianópolis Brazil
| | | | - Vanessa Guimarães Cezimbra
- Department of Public Health Center for Health Sciences Federal University of Santa Catarina Florianópolis Brazil
| | | | | | | | | |
Collapse
|
6
|
Development of a Food-Based Diet Quality Scale for Brazilian Schoolchildren Using Item Response Theory. Nutrients 2021; 13:nu13093175. [PMID: 34579052 PMCID: PMC8469312 DOI: 10.3390/nu13093175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/05/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022] Open
Abstract
Item response theory (IRT) is a psychometric method that provides probabilistic model-based measurements. Its use is relatively recent in the assessment of food consumption, especially through dietary assessment tools. This study aims (1) to develop a food-based diet quality scale for Brazilian schoolchildren using IRT, and (2) to apply the scale to a representative sample of schoolchildren from a Southern Brazilian city. The scale was developed with daily consumption frequency of foods from 835 students who completed the Food Intake and Physical Activity of Schoolchildren questionnaire. Questionnaire foods were grouped into 10 items according to their nutritional similarities and were evaluated by full-information factor analysis that indicated a dominant factor explaining 28% of the variance. Psychometric item analysis was performed using Samejima’s model. The scale covered all levels of diet quality, from “very poor” (scores < 95) to “very good” (scores ≥ 130). Children who had higher diet quality scores consumed beans, meat, fish, eggs, fruits, vegetables, dairy products, and water more frequently, while reducing the consumption of ultraprocessed sugary foods, ultraprocessed savoury snacks and sausages, and sugary drinks. Of 6323 children, an average of less than 10% consumed the highest diet quality scores (good or very good diet quality) and about 60% of children consumed low diet quality scores. The scale can be applied to other schoolchildren with the same measure precision.
Collapse
|
7
|
Abstract
OBJECTIVE The aim of the current study was to identify and describe the meal and snack patterns (breakfast, mid-morning snack, lunch, mid-afternoon snack, dinner and evening snack) of public schoolchildren. DESIGN Cross-sectional study. Information on the previous day's food intake was obtained through the Web-CAAFE (Food Intake and Physical Activity of Schoolchildren), an interactive questionnaire, which divides daily food consumption into three meals (breakfast, lunch and dinner) and three snacks (mid-morning, mid-afternoon and evening). Each meal contains thirty-one food items and the schoolchildren clicked on the food items consumed in each meal. Factor analysis was used to identify meal and snack patterns. The descriptions of the dietary patterns (DP) were based on food items with factor loads ≥ 0·30 that were considered representative of each DP. SETTING Schoolchildren, Florianopolis, Brazil. PARTICIPANTS Children (n 1074) aged 7-13 years. RESULTS Lunch was the most consumed meal (96·0 %), followed by dinner (86·4 %), breakfast (85·3 %) and mid-afternoon snack (81·7 %). Four DP were identified for breakfast, mid-morning snack, lunch, dinner and evening snack, and three for mid-afternoon snack. Breakfast, lunch and dinner patterns included traditional Brazilian foods. DP consisting of fast foods and sugary beverages were also observed, mainly for the evening snack. CONCLUSIONS The results of the current study provide important information regarding the meal and snack patterns of schoolchildren to guide the development of nutrition interventions in public health.
Collapse
|