Validity and reproducibility of a semi-quantitative food frequency questionnaire in Spanish preschoolers - The SENDO project

Association between provegetarian food patterns and micronutrient adequacy in preschoolers: the SENDO project

This study aims to examine the association between different versions of a provegetarian food pattern and micronutrient adequacy in a population of children from the SENDO Project. Children aged 4-5 years old were recruited and baseline information on diet, lifestyle and socio-demographic characteristics was collected through self-administered online questionnaires completed by their parents. Scores were calculated for overall, healthful, and unhealthful provegetarian food patterns (FP) using an a priori approach. Participants were categorized into tertiles according to their scores. Micronutrient adequacy was assessed using the Estimated Average Requirement (EAR) cut-off point. Multivariate analyses were performed to evaluate the relationship between tertiles of each provegetarian FP and the risk of inadequate micronutrient intake (failing to meet ≥ 3 requirements). Despite lower intakes of certain micronutrients, children with higher scores in the healthful provegetarian FP did not exhibit a higher prevalence of inadequacy. Children in the highest tertile of this index had 0.47-fold lower odds (95%CI 0.23-0.95) of having ≥ 3 inadequate micronutrient intakes than their peers in the lowest tertile, after adjusting for potential confounders. In contrast, children in the highest tertile of the unhealthful provegetarian FP had 20.06-fold higher odds (95%CI 9.19-43.79) of having ≥ 3 inadequate micronutrient intakes compared to children in the lowest tertile.

CONCLUSIONS

Adherence to a healthful provegetarian food pattern is associated with improved nutritional adequacy in preschoolers, while following an unhealthful pattern is detrimental to micronutrient adequacy. These results suggest that moderate reductions in animal food consumption within a healthy diet may not compromise micronutrient adequacy in young children. Further research is needed to explore the impact of diets reduced in animal food intake on the health of children.

WHAT IS KNOWN

• There's a notable trend towards plant-based diets due to health and sustainability concerns. • Research links plant-based diets in adults with lower risks of obesity, cardiovascular disease, and cancer.

WHAT IS NEW

• A new study examines how different versions of a provegetarian food pattern affect micronutrient adequacy in children, using a moderate and stepwise approach. • Following a healthful provegetarian food pattern enhances nutritional adequacy in preschoolers, whereas an unhealthful pattern negatively impacts micronutrient adequacy.

Meeting the 24-h movement recommendations and its relationship with Mediterranean dietary patterns in early childhood: the SENDO project

The aim of this study was twofold: (1) to assess the association between meeting all three 24-h movement recommendations and adherence to the Mediterranean diet (MedDiet) in early childhood and (2) to examine whether participants who meet all three 24-h movement recommendations have greater adherence to the individual MedDiet foods/components than those who do not meet these recommendations. A cross-sectional study was conducted using a sample of 822 participants from the Seguimiento del Niño para un Desarrollo Óptimo (SENDO) project (Pamplona, Spain). Physical activity was assessed through a questionnaire that covered 17 different types of activities. Screen time was assessed by averaging the daily hours spent on activities such as watching TV, using a computer, or playing video games. Sleep duration was determined by taking the average of sleep durations during both weekdays and weekends. Adherence to the MedDiet was evaluated using the Mediterranean Diet Quality Index in children and adolescents (KIDMED). Greater odds of having an optimal adherence to the MedDiet were found for participants meeting all three 24-h movement recommendations (odds ratio (OR) = 1.96, 95% confidence interval (CI) 1.33-2.87, p = 0.001) in comparison with their counterparts not meeting these recommendations. Specifically, significant differences were found for "fruit or fruit juice every day" (p = 0.012), "second fruit every day" (p = 0.001), and "fresh or cooked vegetables regularly once a day" (p = 0.018) in relation to meeting all three 24-h movement recommendation status.    Conclusions: This study provides further evidence of the potential importance of meeting all three 24-h movement recommendations to adopt a healthier eating pattern. What is Known: • Only a limited number of studies have investigated the joint connection between the 24-h movement recommendations and dietary habits. • Integrating the 24-h movement recommendations with dietary recommendations could potentially yield greater effectiveness compared to promoting these recommendations independently within public health strategies. What is New: • This is the first study in assessing the relationship between 24-h movement recommendations and adherence to the Mediterranean diet in early childhood. • These findings provide further evidence of the potential importance of meeting all three 24-h movement recommendations to adopt a healthier eating pattern.

Reproducibility and relative validity of a semi-quantitative food and beverage frequency questionnaire for Spanish children aged 3 to 11 years: the COME-Kids F&B-FQ

A reliable food and beverage frequency questionnaire (F&B-FQ) to measure dietary intakes for children across Spain is currently unavailable. Thus, we designed and assessed the reproducibility and relative validity of a new F&B-FQ in 210 Spanish children aged 3-11 years. COME-Kids F&B-FQ contained 125 items to assess the usual diet intake in the past year among children. To explore the reproducibility, caregivers answered COME-Kids F&B-FQ twice over a 15-day period (± 1 week). To evaluate the relative validity, estimates from a third COME-Kids F&B-FQ administered at 1 year of follow-up were compared with the mean estimates from 3-day dietary records (3d-DR) collected at baseline, 6 months, and after 1 year of follow-up. Reproducibility and relative validity of the COME-Kids F&B-FQ in estimating food groups and nutrients were assessed using Pearson (r) and intra-class (ICC) correlation coefficients. We used the kappa index to evaluate the agreement in repeat administrations or with the 3d-DR. We used Bland-Altman plots to identify bias across levels of intake. A total of 195 children (105 boys, 90 girls) completed the study. The reproducibility of data estimated from COME-Kids F&B-FQ was substantial with mean r and ICC being 0.65 and 0.64 for food groups and 0.63 and 0.62 for nutrients, respectively. Validation assessments comparing the FFQ and 3d-DRs showed r = 0.36 and ICC = 0.30 for food groups and r = 0.29 and ICC = 0.24 for nutrients. The mean agreement for food group reproducibility and relative validity was 86% and 65%, respectively. These estimates were 85% for reproducibility and 64% for relative validity in the case of nutrients. For reproducibility and relative validity, the overall mean kappa index was 63% and 37% for all food groups and 52% and 27% for nutrients, respectively. Bland-Altman plots showed no specific bias relating to the level of intake of nutrients and several food groups.

CONCLUSION

COME-Kids F&B-FQ showed substantial reproducibility and acceptable relative validity to assess food and beverage intake in Spanish children aged 3 to 11 years. Most children were correctly classified in relation to the intake of food groups and nutrients, and misclassification was unlikely with reference to 3d-DR.

WHAT IS KNOWN

• The estimation of dietary intake in children is complex, especially in large cohorts. • The food frequency questionnaire is a well-recognized and the most frequently used method for assessing food consumption.

WHAT IS NEW

• A new food and beverage frequency questionnaire including a beverage section and novel plant-based food items has been validated in Spanish children aged 3-11 years.

Pilot Study for the Dietary Assessment of Xenobiotics Derived from Food Processing in an Adult Spanish Sample

BACKGROUND

Although xenobiotics from food processing have gained support as possible drivers of the relationship between diet and some types of cancer, there are still few studies characterizing the intake of these compounds among different populations.

AIM

To describe the intake of heterocyclic amines (HAs), polycyclic aromatic hydrocarbons (PAHs), nitrates, nitrites, nitrosamines, and acrylamide; and to identify dietary and lifestyle related factors.

METHODS

This was a descriptive cross-sectional study in 70 adult volunteers. Intake was registered by means of a food frequency questionnaire, including cooking methods, temperature, and degree of browning. The European Prospective Investigation into Cancer (EPIC) and the Computerized Heterocyclic Amines Resource for Research in Epidemiology of Disease (CHARRED) databases were used for xenobiotic estimation in conjunction with data from the European Food Safety Authority (EFSA) and U.S. Food and Drug Administration (FDA).

RESULTS

Dietary HAs (amino-alpha-carboline (AαC), 2-amino-3-methylimidazo (4,5,f) quinoline (IQ), 2-amino-3,8 dimethylimidazo (4,5,f) quinoxaline (MeIQx), 2-amino-3,4,8 trime-thylimidazo (4,5,f) quinoxaline (DiMeIQx), and 2-amino-1-methyl-6-phenylimidazo (4,5,b) pyridine (PhIP)) were mainly derived from meat and meat products, while benzo (a) pyrene (B(a)P), dibenzo (a) anthracene (DiB(a)A), and total PAHs were explained by oils and fats, alcoholic beverages, and milk, respectively. Microwaved, fried, grilled, broiled, barbecued, and braised cooking methods were mainly responsible for HAs and PAHs consumption.

CONCLUSION

Based on the wide presence and levels of intake of these compounds in different sources, more efforts should be made to adjust their intake to the levels recommended by health agencies.

Parental perception of child's weight, their attitudes towards child's dietary habits and the risk of obesity

BACKGROUND

The association between parental perception of child's weight and their attitudes towards his/her dietary habits has not been reported yet. This study aimed to assess the association between parental underestimation of child's weight and parental attitudes towards child's dietary habits.

METHODS

We conducted a cross-sectional analysis of SENDO cohort participants recruited between January 2015 and June 2020. All information was collected through online questionnaires completed by parents. We calculated crude and multivariable-adjusted odds ratio (OR) and 95% confidence intervals (CI) for unhealthy attitudes towards child's dietary habits associated with parental underestimation of child's weight.

RESULTS

Sixteen percent of children in the SENDO project had parents who underestimated their weight. Parents who underestimated their child's weight status were more likely to have unhealthy attitudes toward his/her dietary habits [OR 3.35; 95% CI (1.71-6.53)].

CONCLUSIONS

Parental underestimation of child's weight was associated with unhealthy attitudes towards child's dietary habits. Pediatricians and public health practitioners should pay attention to the parental perception of child's weight to identify parents who underestimate it as an at-risk group in which to inquire about lifestyle and dietary habits.