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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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Avital K, Tepper S, Ben‑Avraham S, Shahar DR. Development and validation of the MY-VEG-FFQ: A modular web-based food-frequency questionnaire for vegetarians and vegans. PLoS One 2024; 19:e0299515. [PMID: 38625868 PMCID: PMC11020715 DOI: 10.1371/journal.pone.0299515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 02/09/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND AND OBJECTIVE The adoption of plant-based diets in recent years has increased the need for accurate assessments of dietary intake among vegans, vegetarians, semi-vegetarians, and omnivores. This study aimed at developing and validating a modular web-based food-frequency questionnaire (FFQ), the MY-VEG-FFQ. This FFQ was based on the original FFQ (O-FFQ) designed for the Israeli population and incorporates a skip algorithm tailored for different dietary patterns. METHODS A convenience sample of 101 participants, recruited via social media, completed the MY-VEG FFQ, as well as a three-day food records, which served as the gold standard for this research. Relative validity of the new FFQ was evaluated by comparing nutrients with those in the three-day food records, using Pearson correlation coefficients, Bland-Altman plots, and cross-classification. The results were compared with 90 O-FFQs that previously had been completed by vegans. RESULTS The validation analysis showed that nutrient-intake estimates were generally higher for the MY-VEG-FFQ than those of the three-day food records. Pearson correlation coefficients ranged between 0.25-0.63, indicating an acceptable agreement between the two tools. The proportion of participants with exact or adjacent quartile agreement was between 73%-82%. The Bland-Altman analysis revealed overestimation of nutrient intake via the MY-VEG-FFQ. Compared to the O-FFQ, vegans who completed the MY-VEG-FFQ reported consumption of more food items. Additionally, the MY-VEG-FFQ showed a significantly higher intake of most macro- and micronutrients. CONCLUSIONS The My-VEG-FFQ demonstrated reasonable validity in assessing dietary intake among people who followed a plant-based diet. However, it tended to overestimate nutrient intake compared to the three-day food records. The development of a modular web-based FFQ with a skip algorithm tailored for specific dietary patterns, fills a crucial gap in accurately assessing the dietary intake of these populations. The MY-VEG-FFQ offers a practical and cost-effective tool for evaluating long-term dietary consumption among people who follow different dietary patterns.
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Affiliation(s)
- Kerem Avital
- The International Center for Health Innovation & Nutrition, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Sigal Tepper
- Department of Nutritional Sciences, Tel-Hai College, Tel Hai, Israel
| | - Sivan Ben‑Avraham
- The International Center for Health Innovation & Nutrition, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Danit Rivka Shahar
- The International Center for Health Innovation & Nutrition, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Lithander FE, Parry Strong A, Braakhuis A, Worthington A, Foster M, Rolleston A, Davies C, Mullaney J, Ross C, Conroy D, Merry TL, Gearry R, Weatherall M, Krebs JD. He Rourou Whai Painga, an Aotearoa New Zealand dietary pattern for metabolic health and whānau wellbeing: protocol for a randomized controlled trial. Front Nutr 2023; 10:1298743. [PMID: 38148791 PMCID: PMC10750413 DOI: 10.3389/fnut.2023.1298743] [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: 09/22/2023] [Accepted: 11/13/2023] [Indexed: 12/28/2023] Open
Abstract
Background Cardiometabolic diseases are highly prevalent in Aotearoa New Zealand. Dietary intake is a modifiable risk factor for such diseases and certain dietary patterns, specifically the Mediterranean diet (MedDiet), are associated with improved metabolic health. This study aims to test whether an intervention including a Mediterranean dietary pattern incorporating high quality New Zealand foods (NZMedDiet pattern) and behavior change science can improve the metabolic health of participants and their household/whānau. Methods and analysis This is a multi-center, three-stage trial with two parallel group superiority randomized controlled trials (RCTs), and a longitudinal cohort study embedded within the trial design. The first RCT (RCT 1) is a comparison of the NZMedDiet pattern compared to usual diet for 12 weeks. The Behavior Change Wheel was used to select and implement strategies to support participant adherence to the NZMedDiet, such as web-based nutrition education on healthy shopping and cooking. The second (RCT 2) compares online social support to no online social support for 12 weeks, administered to participants immediately following RCT 1. The third stage is a longitudinal cohort study where all participants are followed from the beginning of their start of the active intervention for 12 months in total. The primary outcome measure for each stage is the metabolic syndrome severity score (MetSSS). The duration of enrolment is 12-15 months. The total recruitment target is 200 index participants and their household/whānau members who participate with them, and the primary analyses will be intention to treat on index participants. Discussion The trial will test whether the NZMedDiet pattern and behavior change support improves the cardiometabolic health of people in Aotearoa New Zealand. Clinical trial registration https://www.anzctr.org.au/Default.aspx, identifier ACTRN12622000906752 and https://www.isrctn.com/, identifier ISRCTN89011056 (Spirit 2).
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Affiliation(s)
- Fiona E. Lithander
- New Zealand National Science Challenge High Value Nutrition, Liggins Institute, University of Auckland, Auckland, New Zealand
- Discipline of Nutrition, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
- The Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Amber Parry Strong
- The Liggins Institute, The University of Auckland, Auckland, New Zealand
- Centre for Endocrine, Diabetes and Obesity Research, Te Whatu Ora New Zealand Capital, Coast and Hutt Valley, Wellington, New Zealand
| | - Andrea Braakhuis
- Discipline of Nutrition, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
| | - Anna Worthington
- Discipline of Nutrition, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
| | | | - Anna Rolleston
- Centre for Health, Manawa Ora Centre, Tauranga, New Zealand
| | - Cheryl Davies
- Tū Kotahi Māori Asthma and Research Trust, Kōkiri Marae, Lower Hutt, New Zealand
| | - Jane Mullaney
- New Zealand National Science Challenge High Value Nutrition, Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Cecilia Ross
- Centre for Endocrine, Diabetes and Obesity Research, Te Whatu Ora New Zealand Capital, Coast and Hutt Valley, Wellington, New Zealand
| | - Denise Conroy
- New Zealand National Science Challenge High Value Nutrition, Liggins Institute, University of Auckland, Auckland, New Zealand
- The New Zealand Institute for Plant & Food Research Ltd., Auckland, New Zealand
| | - Troy L. Merry
- Discipline of Nutrition, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
| | - Richard Gearry
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Mark Weatherall
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Jeremy D. Krebs
- Centre for Endocrine, Diabetes and Obesity Research, Te Whatu Ora New Zealand Capital, Coast and Hutt Valley, Wellington, New Zealand
- Department of Medicine, University of Otago, Wellington, New Zealand
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Reynolds AN, Hood F, Wilson R, Ross A, Neumann S, Turner R, Iosua E, Katare R, Shahin A, Kok ZY, Chan H, Coffey S, Mann J. Healthy grocery delivery in the usual care for adults recovering from an acute coronary event: protocol for a three-arm randomised controlled trial. BMJ Open 2023; 13:e074278. [PMID: 38035748 PMCID: PMC10689354 DOI: 10.1136/bmjopen-2023-074278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 11/08/2023] [Indexed: 12/02/2023] Open
Abstract
INTRODUCTION Coronary heart disease is a major contributor to the global burden of disease. Appropriate nutrition is a cornerstone of the prevention and treatment of coronary heart disease; however, barriers including cost and access to recommended foods limits long-term adherence for many. We are conducting, in adults with coronary heart disease, a randomised controlled trial comparing usual care with two dietary interventions in which usual care is augmented by 12 weeks free delivered groceries. METHODS AND ANALYSIS Three hundred adults recovering from an acute coronary event will be recruited from outpatient cardiovascular services in three regions of Aotearoa New Zealand. Participants will be randomly allocated to three arms: usual care (control group), usual care and the free delivery of foods high in dietary fibre or usual care and the free delivery of foods high in unsaturated fats. Interventions duration is 12 weeks, with a further 12 months follow-up. The primary outcome measures are change in low-density lipoprotein (LDL) cholesterol concentration following the intervention, and a cost-effectiveness analysis of healthcare access and social costs in the year after the intervention. A broad range of secondary outcome measures include other blood lipids, anthropometry, glycaemia, inflammatory markers, gut microbiome, dietary biomarkers, food acceptability, dietary change and the facilitators and barriers to dietary change. The trial will determine whether the free provision of groceries known to reduce cardiovascular risk within usual care will be clinically beneficial and justify the cost of doing so. Results may also provide an indication of the relative benefit of foods rich in dietary fibre or unsaturated fats in coronary heart disease management. ETHICS AND DISSEMINATION This trial, The Healthy Heart Study, has Health and Disability Ethics Committee approval (20/NTB/121), underwent Māori consultation, and has locality authority to be conducted in Canterbury, Otago and Southland. TRIAL REGISTRATION NUMBER ACTRN12620000689976, U1111-1250-1499.
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Affiliation(s)
- Andrew N Reynolds
- Department of Medicine, University of Otago, Dunedin, New Zealand
- Riddet Institute, Palmerston North, New Zealand
| | - Fiona Hood
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Ross Wilson
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand
| | - Alastair Ross
- Metabolomics Laboratory, AgResearch Ltd, Lincoln, New Zealand
| | - Silke Neumann
- Department of Pathology, University of Otago, Dunedin, New Zealand
| | - Robin Turner
- Biostatistics Centre, University of Otago, Dunedin, New Zealand
| | - Ella Iosua
- Biostatistics Centre, University of Otago, Dunedin, New Zealand
| | - Rajesh Katare
- Department of Physiology, University of Otago, Dunedin, New Zealand
| | - Aysu Shahin
- Department of Medicine, University of Otago, Dunedin, New Zealand
- Riddet Institute, Palmerston North, New Zealand
| | - Zi-Yi Kok
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Huan Chan
- Te Whatu Ora Health New Zealand Waitaha Canterbury, Christchurch, New Zealand
| | - Sean Coffey
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Jim Mann
- Department of Medicine, University of Otago, Dunedin, New Zealand
- Riddet Institute, Palmerston North, New Zealand
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Worthington A, Gillies N, Hannaford R, Roy R, Braakhuis A. Implementing multicomponent, eHealth-based behaviour change support within a dietary intervention trial improves adherence to study-related behaviours in healthy young adults. BMC Nutr 2023; 9:134. [PMID: 37990250 PMCID: PMC10664496 DOI: 10.1186/s40795-023-00798-7] [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: 02/20/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Behaviour change science is proposed to improve participant retention and enhance the validity of trials. However, researchers seldom systematically consider and implement behaviour change strategies within trials for this purpose. The objective of this article is to evaluate how an eHealth behaviour change support (BCS) program enhances young adults' adherence to behaviours required within a dietary intervention. METHODS The Nine Principles framework was used to develop BCS to implement across both arms of a 10-week randomised parallel-group intervention to enhance adherence to (i) eating healthily and (ii) reporting dietary intake. Key components of the BCS included access to a dietitian-led Facebook group, text reminders, and food delivery. Effectiveness was measured using the following analyses of the 78 participants who completed the study; pre-post change in targeted dietary habits over time using a subscore of the Healthy Diet Habits Index, questionnaire to assess change in perception of barriers to eating healthily over time, Facebook group engagement, and impact evaluation of the BCS. Participants received a dietary reporting score out of 100 to assess adherence across the 10 weeks. RESULTS The total Healthy Diet Habits Index subscore out of 16 significantly increased from baseline to week 10 (10.6 ± 2.6 to 11.2 ± 2.6, p value < 0.05), driven primarily by an increase in vegetable consumption. Overall adherence to reporting was high across the 10 weeks, with the total population mean reporting score 90.4 ± 14.6 out of 100. Relatively low Facebook engagement was observed. Adding objects to the environment, prompts/cues and removing reward appeared to be effective components of the BCS for enhancing adherence to the target behaviours. CONCLUSION Using a behaviour change framework to support the design of randomised trials is a promising way to enhance participant adherence to study requirements that are typically considered burdensome, such as dietary reporting. It also enables researchers to identify and replicate effective components of BCS, including behaviour change techniques and modes of delivery. Further research into the use of different behaviour change frameworks for this purpose is warranted. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04869163; https://clinicaltrials.gov/ct2/show/NCT04869163 . (03/05/2021).
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Affiliation(s)
- Anna Worthington
- Discipline of Nutrition, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
| | - Nicola Gillies
- Discipline of Nutrition, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Rina Hannaford
- Bioinformatics & Statistics Team, AgResearch Ltd, Palmerston North, New Zealand
| | - Rajshri Roy
- Discipline of Nutrition, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Andrea Braakhuis
- Discipline of Nutrition, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Gillies NA, Worthington A, Li L, Conner TS, Bermingham EN, Knowles SO, Cameron-Smith D, Hannaford R, Braakhuis A. Adherence and eating experiences differ between participants following a flexitarian diet including red meat or a vegetarian diet including plant-based meat alternatives: findings from a 10-week randomised dietary intervention trial. Front Nutr 2023; 10:1174726. [PMID: 37388633 PMCID: PMC10305861 DOI: 10.3389/fnut.2023.1174726] [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: 02/27/2023] [Accepted: 05/11/2023] [Indexed: 07/01/2023] Open
Abstract
Background Flexitarian, vegetarian and exclusively plant-based diets are increasingly popular, particularly amongst young adults. This is the first randomised dietary intervention to investigate the health, wellbeing, and behavioural implications of consuming a basal vegetarian diet that additionally includes low-to-moderate amounts of red meat (flexitarian) compared to one containing plant-based meat alternatives (PBMAs, vegetarian) in young adults (ClinicalTrials.gov NCT04869163). The objective for the current analysis is to measure adherence to the intervention, nutrition behaviours, and participants' experience with their allocated dietary group. Methods Eighty healthy young adults participated in this 10-week dietary intervention as household pairs. Household pairs were randomised to receive either approximately three serves of red meat (average of 390 g cooked weight per individual, flexitarian group) or PBMAs (350-400 g per individual, vegetarian group) per week on top of a basal vegetarian diet. Participants were supported to adopt healthy eating behaviours, and this intervention was developed and implemented using a behaviour change framework. Adherence (eating allocated red meat or PBMA, abstaining from animal-based foods not provided by researchers) was continuously monitored, with total scores calculated at the end of the 10-week intervention period. Eating experiences were measured by the Positive Eating Scale and a purpose-designed exit survey, and a food frequency questionnaire measured dietary intake. Analyses used mixed effects modeling taking household clustering into account. Results The total average adherence score was 91.5 (SD = 9.0) out of a possible 100, with participants in the flexitarian group scoring higher (96.1, SD = 4.6, compared to 86.7, SD = 10.0; p < 0.001). Those receiving red meat were generally more satisfied with this allocation compared to those receiving the PBMAs, even though a leading motivation for participants joining the study was an opportunity to try plant-based eating (35% expressed that their interest in taking part was related to trying plant-based eating). Participants in both intervention groups had increased vegetable intake (p < 0.001), and reported more positive eating experiences (p = 0.020) and satisfaction with eating (p = 0.021) at the end of the 10-week intervention relative to baseline values. Conclusion Methods to encourage engagement with the trial were successful, as participants demonstrated excellent adherence to the intervention. Observed differences in participants' adherence and experiences between flexitarian and vegetarian groups holds implications for the adoption of healthy, sustainable dietary patterns beyond this study alone.
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Affiliation(s)
- Nicola A. Gillies
- Discipline of Nutrition, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Anna Worthington
- Discipline of Nutrition, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Larissa Li
- Discipline of Nutrition, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Tamlin S. Conner
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Emma N. Bermingham
- Smart Foods and Bioproducts Group, AgResearch Ltd., Palmerston North, New Zealand
| | - Scott O. Knowles
- Smart Foods and Bioproducts Group, AgResearch Ltd., Palmerston North, New Zealand
| | - David Cameron-Smith
- School of Environmental and Life Sciences, College of Engineering, Science and Environment, University of Newcastle, Sydney, NSW, Australia
| | - Rina Hannaford
- Digital Agriculture Group, AgResearch Ltd., Palmerston North, New Zealand
| | - Andrea Braakhuis
- Discipline of Nutrition, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Lovell AL, Roy R, Klein A, Cavadino A, Foster M, Krebs JD, Braakhuis A, Merry TL. Habitual Dietary Patterns, Nutrient Intakes, and Adherence to the Mediterranean Diet among New Zealand Adults: The NZ MED Cross-Sectional Study. Nutrients 2023; 15:2663. [PMID: 37375568 DOI: 10.3390/nu15122663] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/27/2023] [Accepted: 06/03/2023] [Indexed: 06/29/2023] Open
Abstract
There is increasing evidence that adherence to a Mediterranean dietary pattern reduces the incidence of diet-related diseases. To date, the habitual dietary intake of New Zealand (NZ) adults has not been examined in relation to its alignment with a Mediterranean-style dietary pattern. This study aimed to define the habitual dietary patterns, nutrient intakes, and adherence to the Mediterranean Diet in a sample of 1012 NZ adults (86% female, mean age 48 ± 16 years) who had their diabetes risk defined by the Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK). Dietary intakes were collected using a validated semi-quantitative NZ food frequency questionnaire, and dietary patterns were identified using principal component analysis. Reported intakes from the FFQ were used in conjunction with the Mediterranean-Style Dietary Pattern Score (MSDPS) to determine adherence to a Mediterranean dietary pattern. Mixed linear models were used to analyze the association between dietary patterns and MSDPS with demographics, health factors, and nutrient intakes. Two distinct dietary patterns were identified: Discretionary (positive loadings on processed meat, meat/poultry, fast food, sweet drinks, and sugar, sweets, and baked good) and Guideline (positive loadings on vegetables, eggs/beans, and fruits). Adherence to dietary patterns and diet quality was associated with age and ethnicity. Dietary patterns were also associated with sex. Adherence to a Mediterranean dietary pattern defined by the MSDPS was low, indicating that a significant shift in food choices will be required if the Mediterranean Diet is to be adopted in the NZ population.
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Affiliation(s)
- Amy L Lovell
- Department of Nutrition and Dietetics, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
- High-Value Nutrition Ko Ngā Kai Whai Painga National Science Challenge, The Liggins Institute, Auckland 1023, New Zealand
| | - Rajshri Roy
- Department of Nutrition and Dietetics, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
- High-Value Nutrition Ko Ngā Kai Whai Painga National Science Challenge, The Liggins Institute, Auckland 1023, New Zealand
| | - Alana Klein
- Department of Nutrition and Dietetics, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
| | - Alana Cavadino
- Department of Nutrition and Dietetics, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
| | - Meika Foster
- High-Value Nutrition Ko Ngā Kai Whai Painga National Science Challenge, The Liggins Institute, Auckland 1023, New Zealand
- Edible Research Ltd., Canterbury 7692, New Zealand
| | - Jeremy D Krebs
- High-Value Nutrition Ko Ngā Kai Whai Painga National Science Challenge, The Liggins Institute, Auckland 1023, New Zealand
- Department of Medicine, University of Otago, Wellington 6242, New Zealand
| | - Andrea Braakhuis
- Department of Nutrition and Dietetics, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
- High-Value Nutrition Ko Ngā Kai Whai Painga National Science Challenge, The Liggins Institute, Auckland 1023, New Zealand
| | - Troy L Merry
- Department of Nutrition and Dietetics, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
- High-Value Nutrition Ko Ngā Kai Whai Painga National Science Challenge, The Liggins Institute, Auckland 1023, New Zealand
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Worthington A, Gillies N, Roy R, Braakhuis A. Development of eHealth-Based Behavior Change Support for Young Adults Using the Nine Principles Framework. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:38-47. [PMID: 36372660 DOI: 10.1016/j.jneb.2022.09.002] [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: 03/27/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
Implementing behavior strategies into nutrition research requires consideration. The Nine Principles framework was used to develop an eHealth behavior change support (BCS) program to enhance young adults' adherence to (1) eating healthily and (2) recording dietary intake when participating in a randomized control trial. The Theory of Planned Behavior and qualitative focus group data informed a 10-week pilot of the BCS delivered on Facebook and texts. The BCS appeared to support optimal dietary recording and maintained dietary behaviors, suggesting using a framework underpinned by theory and user-centered design may be a promising avenue to enhance adherence in randomized control trials.
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Affiliation(s)
- Anna Worthington
- Discipline of Nutrition, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand.
| | - Nicola Gillies
- Discipline of Nutrition, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Rajshri Roy
- Discipline of Nutrition, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Andrea Braakhuis
- Discipline of Nutrition, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
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Tippett LJ, Cawston EE, Morgan CA, Melzer TR, Brickell KL, Ilse C, Cheung G, Kirk IJ, Roberts RP, Govender J, Griner L, Le Heron C, Buchanan S, Port W, Dudley M, Anderson TJ, Williams JM, Cutfield NJ, Dalrymple-Alford JC, Wood P. Dementia Prevention Research Clinic: a longitudinal study investigating factors influencing the development of Alzheimer’s disease in Aotearoa, New Zealand. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2098780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Lynette J. Tippett
- NZ-Dementia Prevention Research Clinic, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
| | - Erin E. Cawston
- NZ-Dementia Prevention Research Clinic, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Department of Pharmacology, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
| | - Catherine A. Morgan
- NZ-Dementia Prevention Research Clinic, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
| | - Tracy R. Melzer
- NZ-Dementia Prevention Research Clinic, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
| | - Kiri L. Brickell
- NZ-Dementia Prevention Research Clinic, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- School of Medicine, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
| | - Christina Ilse
- NZ-Dementia Prevention Research Clinic, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
| | - Gary Cheung
- NZ-Dementia Prevention Research Clinic, New Zealand
- Department of Psychological Medicine, School of Medicine, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
| | - Ian J. Kirk
- NZ-Dementia Prevention Research Clinic, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
| | - Reece P. Roberts
- NZ-Dementia Prevention Research Clinic, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
| | - Jane Govender
- NZ-Dementia Prevention Research Clinic, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
| | - Leon Griner
- NZ-Dementia Prevention Research Clinic, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Department of Pharmacology, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
| | - Campbell Le Heron
- NZ-Dementia Prevention Research Clinic, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
- Dept of Neurology, Canterbury District Health Board, Christchurch, New Zealand
| | - Sarah Buchanan
- NZ-Dementia Prevention Research Clinic, New Zealand
- Department of Neurology, Southern District Health Board, Dunedin, New Zealand
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Waiora Port
- NZ-Dementia Prevention Research Clinic, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
| | - Makarena Dudley
- NZ-Dementia Prevention Research Clinic, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
| | - Tim J. Anderson
- NZ-Dementia Prevention Research Clinic, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
- Dept of Neurology, Canterbury District Health Board, Christchurch, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
| | - Joanna M. Williams
- NZ-Dementia Prevention Research Clinic, New Zealand
- Brain Health Research Centre, University of Otago, Dunedin, New Zealand
- Department of Anatomy, University of Otago, Dunedin, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
| | - Nicholas J. Cutfield
- NZ-Dementia Prevention Research Clinic, New Zealand
- Department of Neurology, Southern District Health Board, Dunedin, New Zealand
- Department of Medicine, University of Otago, Dunedin, New Zealand
- Brain Health Research Centre, University of Otago, Dunedin, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
| | - John C. Dalrymple-Alford
- NZ-Dementia Prevention Research Clinic, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
| | - Phil Wood
- NZ-Dementia Prevention Research Clinic, New Zealand
- School of Medicine, University of Auckland, Auckland, New Zealand
- Ministry of Health, Wellington, New Zealand
- Department of Older Adults and Home Health, Waitemata District Health Board, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, Dunedin, New Zealand
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10
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Lim SX, Cox V, Rodrigues N, Colega MT, Barton SJ, Childs CE, Conlon CA, Wall CR, Cutfield WS, Chan SY, Godfrey KM, Chong MFF. Evaluation of Preconception Dietary Patterns in Women Enrolled in a Multisite Study. Curr Dev Nutr 2022; 6:nzac106. [PMID: 36628060 PMCID: PMC9817353 DOI: 10.1093/cdn/nzac106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/27/2022] [Accepted: 06/07/2022] [Indexed: 01/13/2023] Open
Abstract
Background Diet indices are widely used in nutritional research across communities but do not "capture" the full extent of diet variability across multiple countries. Empirically derived dietary patterns can provide additional information because they reflect combinations of foods potentially associated with health outcomes. Limited studies have evaluated preconception dietary patterns in heterogeneous populations. Objectives In the multisite Nutritional Intervention Preconception and During Pregnancy to Maintain Healthy Glucose Metabolism and Offspring Health (NiPPeR) study, the secondary aims included: 1) derive pooled and site-specific preconception dietary patterns, and 2) evaluate these patterns using anthropometric measures and metabolic biomarkers. Methods Women planning pregnancy (n = 1720) in the United Kingdom, Singapore, and New Zealand completed interviewer-administered harmonized FFQs and lifestyle questionnaires at recruitment. Across-cohort ("pooled") and site-specific dietary patterns were derived, and associations between dietary pattern scores and BMI, waist-to-hip ratio, plasma lipids, and glycemia assessed using multivariable linear regression, expressing results as SD change in outcome per SD change in dietary pattern score. Results The pooled analysis identified 3 dietary patterns: "Vegetables/Fruits/Nuts" ("Healthy"), "Fried potatoes/Processed meat/Sweetened beverages" ("Less Healthy"), and "Fish/Poultry/Noodles/Rice" ("Mixed"). The "Healthy" and "Less Healthy" pooled pattern scores were highly correlated with their corresponding site-specific dietary pattern scores ("Healthy": ρ = 0.87-0.93; "Less Healthy": ρ = 0.65-0.88). Women with higher scores for the "Healthy" pooled pattern had a lower waist-to-hip ratio (standardized β: -0.10; 95% CI: -0.18, -0.01); those with higher scores for the "Less Healthy" pooled pattern had a higher BMI (standardized β: 0.17; 95% CI: 0.09, 0.24), higher LDL cholesterol (standardized β: 0.10; 95% CI: 0.01, 0.19), and less optimal glucose profiles. However, we noted higher adherence to the "Healthy" pooled pattern with higher BMI. Conclusions The "Healthy" and "Less Healthy" pooled patterns were comparable to the corresponding site-specific patterns. Although the associations between these patterns and objective anthropometric/metabolic measures were largely in the expected directions, future studies are required to confirm these findings.This trial is registered at clinicaltrials.gov (NCT02509988).
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Affiliation(s)
- Shan Xuan Lim
- Saw Swee Hock School of Public Health, National University of Singapore and
National University Health System, Singapore
| | - Vanessa Cox
- Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of
Southampton, Southampton, United
Kingdom
| | - Natasha Rodrigues
- Nutrition and Dietetics, Faculty of Medical and Health Sciences, University
of Auckland, Auckland, New Zealand
| | - Marjorelee T Colega
- Singapore Institute for Clinical Sciences, Agency for Science, Technology
and Research (A*STAR), Singapore
| | - Sheila J Barton
- Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of
Southampton, Southampton, United
Kingdom
- National Institute for Health Research Southampton Biomedical Research
Center, University of Southampton and University Hospital Southampton National Health
Service Foundation Trust, Southampton, United
Kingdom
| | - Caroline E Childs
- Human Development and Health, Faculty of Medicine, University of
Southampton, Southampton, United
Kingdom
| | | | - Clare R Wall
- Nutrition and Dietetics, Faculty of Medical and Health Sciences, University
of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand
- A Better Start—National Science Challenge, New Zealand
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology
and Research (A*STAR), Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of
Medicine, National University of Singapore, Singapore
| | - Keith M Godfrey
- Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of
Southampton, Southampton, United
Kingdom
- National Institute for Health Research Southampton Biomedical Research
Center, University of Southampton and University Hospital Southampton National Health
Service Foundation Trust, Southampton, United
Kingdom
| | - Mary F-F Chong
- Saw Swee Hock School of Public Health, National University of Singapore and
National University Health System, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology
and Research (A*STAR), Singapore
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11
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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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12
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Braakhuis A, Gillies N, Worthington A, Knowles S, Conner T, Roy R, Pham T, Bermingham E, Cameron-Smith D. A Modern Flexitarian Dietary Intervention Incorporating Web-Based Nutrition Education in Healthy Young Adults: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e30909. [PMID: 34931994 PMCID: PMC8734916 DOI: 10.2196/30909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/09/2021] [Accepted: 09/24/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The trend of flexitarian eating patterns is on the rise, with young adults among the biggest adopters claiming health and environmental reasons to reduce red meat intake. Nutrient-dense meat and animal products are often the lynchpin of these diets, even when consumed only occasionally and in moderate amounts. Red meat provides forms and concentrations of essential proteins, lipids, and micronutrients that are scarce in exclusively vegetarian regimens. OBJECTIVE The aim of this study is to consider the effects of moderate consumption of lean red meat as part of an otherwise vegetarian balanced diet and its impact on biomarkers of sustained health and well-being. METHODS A cohort of healthy, young (20-34 years old, n=80) male and female participants will take part in a 2-arm, parallel randomized controlled trial (RCT) for a duration of 12 weeks, with a 3-month posttrial follow-up. The trial will commence with a 2-week assessment period followed by allocation to the intervention arms. The intervention will include the consumption of red meat or meat alternatives 3 times per week for 10 weeks. Blood samples of the participants will be collected to measure changes in erythrocyte fatty acid distribution, circulating amino acids, neurotransmitters, markers of mineral status, and inflammatory markers. Questionnaires to assess well-being and mental health will be undertaken every 2 weeks. Body composition, physical function, and blood parameters will be assessed at allocation (t0), week 5 into the intervention (t5), and post intervention (t10). RESULTS The protocol has been developed using the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) checklist and the outcomes will be reported in accordance with the CONSORT (Consolidated Standards of Reporting Trials) guidelines. The trial was approved by the New Zealand Ministry of Health's Health and Disability Ethics Committees (protocol 20/STH/157). The results of this study will be communicated via publication. CONCLUSIONS To our knowledge, this is the first RCT investigating the overarching health consequences of consuming pasture-fed red meat or no meat as part of a healthy diet. TRIAL REGISTRATION ClinicalTrials.gov NCT04869163; https://clinicaltrials.gov/ct2/show/NCT04869163. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/30909.
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Affiliation(s)
- Andrea Braakhuis
- Discipline of Nutrition, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Nicola Gillies
- Discipline of Nutrition, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Anna Worthington
- Discipline of Nutrition, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Scott Knowles
- AgResearch Ltd, Smart Foods Innovation Centre of Excellence, Te Ohu Rangahau Kai, Palmerston North, New Zealand
| | - Tamlin Conner
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Rajshri Roy
- Discipline of Nutrition, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Toan Pham
- Discipline of Nutrition, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Emma Bermingham
- AgResearch Ltd, Smart Foods Innovation Centre of Excellence, Te Ohu Rangahau Kai, Palmerston North, New Zealand
| | - David Cameron-Smith
- Agency for Science, Technology and Research, Singapore Institute for Clinical Sciences, Singapore, Singapore
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Ahmed S, Rahman T, Ripon MSH, Rashid HU, Kashem T, Md Ali MS, Khor BH, Khosla P, Karupaiah T, Daud ZAM. A Food Frequency Questionnaire for Hemodialysis Patients in Bangladesh (BDHD-FFQ): Development and Validation. Nutrients 2021; 13:4521. [PMID: 34960076 PMCID: PMC8707927 DOI: 10.3390/nu13124521] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/12/2021] [Accepted: 12/14/2021] [Indexed: 11/17/2022] Open
Abstract
Diet is a recognized risk factor and cornerstone for chronic kidney disease (CKD) management; however, a tool to assess dietary intake among Bangladeshi dialysis patients is scarce. This study aims to validate a prototype Bangladeshi Hemodialysis Food Frequency Questionnaire (BDHD-FFQ) against 3-day dietary recall (3DDR) and corresponding serum biomarkers. Nutrients of interest were energy, macronutrients, potassium, phosphate, iron, sodium and calcium. The BDHD-FFQ, comprising 132 food items, was developed from 606 24-h recalls and had undergone face and content validation. Comprehensive facets of relative validity were ascertained using six statistical tests (correlation coefficient, percent difference, paired t-test, cross-quartiles classification, weighted kappa, and Bland-Altman analysis). Overall, the BDHD-FFQ showed acceptable to good correlations (p < 0.05) with 3DDR for the concerned nutrients in unadjusted and energy-adjusted models, but this correlation was diminished when adjusted for other covariates (age, gender, and BMI). Phosphate and potassium intake, estimated by the BDHD-FFQ, also correlated well with the corresponding serum biomarkers (p < 0.01) when compared to 3DDR (p > 0.05). Cross-quartile classification indicated that <10% of patients were incorrectly classified. Weighted kappa statistics showed agreement with all but iron. Bland-Altman analysis showed positive mean differences were observed for all nutrients when compared to 3DDR, whilst energy, carbohydrates, fat, iron, sodium, and potassium had percentage data points within the limit of agreement (mean ± 1.96 SD), above 95%. In summary, the BDHD-FFQ demonstrated an acceptable relative validity for most of the nutrients as four out of the six statistical tests fulfilled the cut-off standard in assessing dietary intake of CKD patients in Bangladesh.
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Affiliation(s)
- Shakil Ahmed
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Sonapur 3814, Bangladesh; (S.A.); (M.S.H.R.)
| | - Tanjina Rahman
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka 1000, Bangladesh;
| | - Md Sajjadul Haque Ripon
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Sonapur 3814, Bangladesh; (S.A.); (M.S.H.R.)
| | - Harun-Ur Rashid
- Kidney Foundation Hospital and Research Institute, Dhaka 1216, Bangladesh; (H.-U.R.); (T.K.)
| | - Tasnuva Kashem
- Kidney Foundation Hospital and Research Institute, Dhaka 1216, Bangladesh; (H.-U.R.); (T.K.)
| | - Mohammad Syafiq Md Ali
- Department of Nutrition Sciences, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia;
| | - Ban-Hock Khor
- Faculty of Food Science and Nutrition, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia;
| | - Pramod Khosla
- Department of Nutrition and Food Science, Wayne State University, Detroit, MI 48202, USA;
| | - Tilakavati Karupaiah
- School of Biosciences, Taylors’ University, Subang Jaya 47500, Selangor, Malaysia;
| | - Zulfitri Azuan Mat Daud
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
- Research Center of Excellence (RCoE) Nutrition and Non-Communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
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14
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Cui Q, Xia Y, Wu Q, Chang Q, Niu K, Zhao Y. Validity of the food frequency questionnaire for adults in nutritional epidemiological studies: A systematic review and meta-analysis. Crit Rev Food Sci Nutr 2021; 63:1670-1688. [PMID: 34520300 DOI: 10.1080/10408398.2021.1966737] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
As the most widely used tool for assessing dietary intake, the validity of food frequency questionnaires (FFQs) should be evaluated before application. A comprehensive search of the PubMed and Web of Science databases was conducted for publications from January 2000 to April 1, 2020. Pooled estimates were calculated for correlation coefficients and mean differences for energy and 61 nutrients between FFQs and standard methods. The literature search identified 130 articles that included 21,494 participants. Subgroup analyses according to the number of administrations of the reference method, sample size, administration methods, FFQ items, reference periods, quality of the studies, gender, and regions were also performed. We conducted a meta-analysis by summarizing the available evidence to comprehensively assess the validity of FFQs stratified by the reference method type (24-hour recall (24HRs) and food records (FRs). We also performed subgroup analyses to examine the impact on the final summary estimates. After a meta-analysis of the FFQs' validity correlation coefficients of the included studies, this study showed that the range (median) of the validity coefficients of the 24HRs as reference methods was 0.220-0.770 (0.416), and for the FRs, it was 0.173-0.735 (0.373), which indicated that FFQs were suitable to assess the overall dietary intake in nutritional epidemiological studies. The results of the subgroup analysis showed that the number of administrations of the reference method, administration mode, number of items, reference periods, sample size, and gender mainly affected the validity correlation of FFQs.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.1966737 .
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Affiliation(s)
- Qi Cui
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qijun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qing Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
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15
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Serban CL, Banu AM, Putnoky S, Butica SI, Niculescu MD, Putnoky S. Relative Validation of a Four Weeks Retrospective Food Frequency Questionnaire versus 7-Day Paper-Based Food Records in Estimating the Intake of Energy and Nutrients in Adults. NUTRITION AND DIETARY SUPPLEMENTS 2021. [DOI: 10.2147/nds.s310260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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16
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Stepwise tailoring and test-retest of reproducibility of an ethnic-specific FFQ to estimate nutrient intakes for South Asians in New Zealand. Public Health Nutr 2021; 24:2447-2454. [PMID: 33745497 DOI: 10.1017/s1368980021001208] [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: 11/07/2022]
Abstract
OBJECTIVE To develop and test-retest the reproducibility of an ethnic-specific FFQ to estimate nutrient intakes for South Asians (SA) in New Zealand (NZ). DESIGN Using culturally appropriate methods, the NZFFQ, a validated dietary assessment tool for NZ adults, was modified to include SA food items by analysing foods consumed by SA participants of the Adult Nutrition Survey, in-person audit of ethnic food stores and a web scan of ethnic food store websites in NZ. This was further refined via three focus group discussions, and the resulting New Zealand South Asian Food Frequency Questionnaire (NZSAFFQ) was tested for reproducibility. SETTING Auckland and Dunedin, NZ. PARTICIPANTS Twenty-nine and 110 males and females aged 25-59 years of SA ethnicity participated in the focus group discussions and the test-retest, respectively. RESULTS The development phase resulted in a SA-specific FFQ comprising of 11 food groups and 180 food items. Test-retest of the NZSAFFQ showed good reproducibility between the two FFQ administrations, 6 months apart. Most reproducibility coefficients were within or higher than the acceptable range of 0·5-0·7. The lowest intraclass correlation coefficients (ICC) were observed for β-carotene (0·47), vitamin B12 (0·50), fructose (0·55), vitamin C (0·57) and selenium (0·58), and the highest ICC were observed for alcohol (0·81), iodine (0·79) and folate (0·77). The ICC for fat ranged from 0·70 for saturated fats to 0·77 for polyunsaturated fats. The ICC for protein and energy were 0·68 and 0·72, respectively. CONCLUSIONS The developed FFQ showed good reproducibility to estimate nutrient intakes and warrants the need for validation of the instrument.
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17
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Cui Q, Xia Y, Wu Q, Chang Q, Niu K, Zhao Y. A meta-analysis of the reproducibility of food frequency questionnaires in nutritional epidemiological studies. Int J Behav Nutr Phys Act 2021; 18:12. [PMID: 33430897 PMCID: PMC7802360 DOI: 10.1186/s12966-020-01078-4] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 12/17/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Reproducibility of FFQs measures the consistency of the same subject at different time points. We performed a meta-analysis to explore the reproducibility of FFQs and factors related to reproducibility of FFQs. METHODS AND FINDINGS A systematic literature review was performed before July 2020 using PubMed and Web of Science databases. Pooled intraclass and Spearman correlation coefficients (95% confidence interval) were calculated to assess the reproducibility of FFQs. Subgroup analyses based on characteristics of study populations, FFQs, or study design were performed to investigate factors related to the reproducibility of FFQs. A total of 123 studies comprising 20,542 participants were eligible for the meta-analysis. The pooled crude intraclass correlation coefficients ranged from 0.499 to 0.803 and 0.499 to 0.723 for macronutrients and micronutrients, respectively. Energy-adjusted intraclass correlation coefficients ranged from 0.420 to 0.803 and 0.507 to 0.712 for macronutrients and micronutrients, respectively. The pooled crude and energy-adjusted Spearman correlation coefficients ranged from 0.548 to 0.851 and 0.441 to 0.793, respectively, for macronutrients; and from 0.573 to 0.828 and 0.510 to 0.744, respectively, for micronutrients. FFQs with more food items, 12 months as dietary recall interval (compared to less than 12 months), and a shorter time period between repeated FFQs resulted in superior FFQ reproducibility. CONCLUSIONS In conclusion, FFQs with correlation coefficients greater than 0.5 for most nutrients may be considered a reliable tool to measure dietary intake. To develop FFQs with higher reproducibility, the number of food items and dietary recall interval should be taken into consideration.
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Affiliation(s)
- Qi Cui
- Present address: Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Present address: Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qijun Wu
- Present address: Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qing Chang
- Present address: Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Kaijun Niu
- Present address: Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.
| | - Yuhong Zhao
- Present address: Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
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18
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CHIARELLI G, HÖFELMANN DA, SILVEIRA JLGCD, ALVES MU, AZEVEDO LCD. Validity and reproducibility of a Food Frequency Questionnaire for German descendants living in Brazil. REV NUTR 2021. [DOI: 10.1590/1678-9865202134e200048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective This study evaluated reproducibility, relative validity, using a 24-hour recall questionnaire as a reference standard, and estimated calibration factors for a food frequency questionnaire adapted for use with German descendants living in Brazil. Methods The target population consisted of 50 volunteers, of both genders, aged over 20 years, living in a German colonization city in southern Brazil. The food frequency questionnaire was applied twice, in the first and third months of the investigation. During this period, three 24-hour recalls were applied, with an interval of one month between them. Reproducibility was estimated by the intraclass correlation coefficient. Validity was tested by the intraclass correlation coefficient, weighted kappa test and Bland-Altman method. Calibration factors were estimated using linear regression. Results Among the food frequency questionnaires, there was a strong correlation for energy and most of the nutrients corrected for energy. There was a weak correlation between a food frequency questionnaire and a 24-hour dietary recall. However, the exact concordance in the categorization in tertiles among the instruments ranged from 28% (vitamin A) to 52% (fiber and potassium). Gross values of the food frequency questionnaire were reduced with the calibration and approached the consumption data estimated by the 24-hour dietary recall. Conclusions The food frequency questionnaire showed good reproducibility, however, weak correlation with the 24-hour dietary recall. The calibration of the data obtained by the food frequency questionnaire brought them closer to the reference method.
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Amissah E, Gamble GD, Wall CR, Crowther CA, Harding JE. The relationship between maternal dietary patterns during pregnancy in women with gestational diabetes mellitus and infant appetitive feeding behaviour at 6 months. Sci Rep 2020; 10:20516. [PMID: 33239632 PMCID: PMC7689419 DOI: 10.1038/s41598-020-77388-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/09/2020] [Indexed: 11/21/2022] Open
Abstract
Early dietary exposure may influence infant appetitive feeding behaviour, and therefore their later health. Maternal diabetes in pregnancy is associated with an increased risk of obesity in the offspring. We, therefore, examined third-trimester dietary patterns of women with gestational diabetes, their offspring's appetitive feeding behaviour at 6 months of age, and relationships between these. We used data from a prospective cohort of women with gestational diabetes and assessed maternal dietary patterns at 36 weeks' gestation using principal component analysis; infant appetitive feeding behaviour at 6 months of age using the Baby Eating Behaviour Questionnaire; and relationships between these using general linear modelling and chi-square tests. In 325 mother-infant dyads, we identified three distinct maternal dietary patterns: 'Junk,' 'Mixed,' and 'Health-conscious.' The maternal 'Health-conscious' pattern was inversely associated with 'enjoyment of food' in their sons (β - 0.24, 95% CI - 0.36 to - 0.11, p = 0.0003), but not daughters (β - 0.02, 95% CI - 0.12 to 0.08, p = 0.70), and was positively associated with 'slowness in eating,' (β 0.13, 95% CI 0.02 to 0.24, p = 0.01). Third-trimester dietary patterns in women with gestational diabetes may have sex-specific effects on infant appetitive feeding behaviour at 6 months of age.
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Affiliation(s)
- Emma Amissah
- Liggins Institute, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand
| | - Gregory D Gamble
- Liggins Institute, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand
| | - Clare R Wall
- Centre for Longitudinal Research-He Ara ki Mua, University of Auckland, Auckland, 1072, New Zealand
- Discipline of Nutrition and Dietetics, School of Medical Sciences, University of Auckland, Auckland, 1072, New Zealand
| | - Caroline A Crowther
- Liggins Institute, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand
| | - Jane E Harding
- Liggins Institute, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand.
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