Evaluation of Three Short Dietary Instruments to Assess Fruit and Vegetable Intake: The National Cancer Institute's Food Attitudes and Behaviors Survey
ABSTRACT Fruit and vegetable (F/V) intake assessment tools that are valid, reliable, brief, and easy to administer and code are vital to the field of public health nutrition.
To evaluate three short F/V intake screeners (ie, a 2-item serving tool, a 2-item cup tool, and a 16-item F/V intake screener) among adults using multiple 24-hour dietary recalls (24-hour recalls) as the reference instrument and evaluate test-retest reliability of the screeners across a 2- to 3-week time period.
Validity and reliability study.
Two hundred forty-four adults for the validity study and 335 adults for test-retest reliability.
Median values for F/V intakes were calculated for the screeners and 24-hour recalls. The Wilcoxon signed rank test was used to compare screeners with the 24-hour recalls. Deattenuated Pearson correlations were reported for validity and intraclass correlation coefficient used for reliability.
The estimated median daily servings/cups of F/V for the 2-item serving screener was lower, for the 2-item cup screener was equivalent for men but higher for women, and for the 16-item F/V intake screener were about the same when compared with 24-hour recall values. The deattenuated correlations comparing the 24-hour recalls with the screeners were positive but weak for the 2-item serving screener, and were positive and moderate in strength for the 2-item cup and 16-item F/V intake screeners. The test-retest intraclass correlation coefficients were all positive and fairly strong for all of the screeners.
Although dietary screeners offer a more cost-effective, less burdensome way to obtain gross estimates to rank individuals with regard to F/V intake, these methods are not recommended for assessing precise intake levels.
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ABSTRACT: The existing evidence on food environments and diet is inconsistent, potentially because of heterogeneity in measures used to assess diet. The objective of this review, conducted in 2012-2013, was to examine measures of dietary intake utilized in food environment research. Included studies were published from January 2007 through June 2012 and assessed relationships between at least one food environment exposure and at least one dietary outcome. Fifty-one articles were identified using PubMed, SCOPUS, Web of Knowledge, and PsycINFO; references listed in the papers reviewed and relevant review articles; and the National Cancer Institute's Measures of the Food Environment website. The frequency of the use of dietary intake measures and assessment of specific dietary outcomes were examined, as were patterns of results among studies using different dietary measures. The majority of studies used brief instruments, such as screeners or one or two questions, to assess intake. Food frequency questionnaires were used in about a quarter of studies, one in ten used 24-hour recalls, and fewer than one in 20 used diaries. Little consideration of dietary measurement error was evident. Associations between the food environment and diet were more consistently in the expected direction in studies using less error-prone measures. There is a tendency toward the use of brief dietary assessment instruments with low cost and burden rather than more detailed instruments that capture intake with less bias. Use of error-prone dietary measures may lead to spurious findings and reduced power to detect associations.American journal of preventive medicine 01/2014; 46(1):94-102. DOI:10.1016/j.amepre.2013.08.015 · 4.24 Impact Factor
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ABSTRACT: Stroke is a leading cause of death for women, and midlife, low-income women are unlikely to appreciate their risk for stroke. The Well-Integrated Screening and Evaluation for Women Across the Nation program, administered by the Centers for Disease Control and Prevention Division for Heart Disease and Stroke Prevention, was developed for this population. The program offers screenings, referrals, and evidence-based lifestyle interventions targeting poor nutrition and physical inactivity. The goal of "Be Wise," the evidence-based lifestyle intervention developed for the Illinois Well-Integrated Screening and Evaluation for Women Across the Nation program, is for midlife women to develop healthier diet and physical-activity-related behaviors and, as a result, reduce their risk for heart disease and stroke. The goal of this project was to implement "Be Wise" at a federally funded community health center serving a primarily Hispanic population. The project's director, a stroke program coordinator and clinical nurse specialist, for the area's advanced primary stroke center collaborated with the community health center's medical staff and registered dietitian in delivering the program.
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ABSTRACT: Abstract Background: No national studies have examined associations between (1) school food availability and accessibility and (2) secondary student fruit and vegetable (FV) consumption. This article uses 5 years of nationally representative data from secondary school students to examine associations between the school food environment and student fruit and green vegetable consumption. Methods: From 2008 to 2012, cross-sectional, nationally representative data from US middle and high school students were collected annually on self-reported fruit and green vegetable consumption. Each year, data from administrators at each relevant school were collected on food item availability (any venue) and accessibility (total number of school sources). Data were obtained from 10,254 eighth-grade students in 317 schools and 18,898 tenth- and 12th-grade students in 518 schools. Associations were estimated by multi-level models controlling for student- and school-level characteristics. Results: Availability showed minimal association with student consumption. Candy/regular-fat snack accessibility was associated negatively with middle school fruit consumption. Salad bar availability and accessibility were positively associated with middle school green vegetable consumption; FV accessibility was associated positively with high school fruit and green vegetable consumption. Significant associations were consistent across student racial/ethnic and socioeconomic groups. Conclusions: Forthcoming USDA nutrition standards for school foods and beverages sold outside of reimbursable meal programs should result in the removal of school candy/regular-fat snacks. In deciding which items to make available under the new standards, schools should consider increasing the number of FV sources-including salad bars-thereby potentially increasing student FV consumption.06/2014; 10(3):241-50. DOI:10.1089/chi.2014.0011