Assessing dietary intake in children and adolescents: Considerations and recommendations for obesity research.
ABSTRACT Abstract Dietary intake and food habits are important contributors to the obesity epidemic. They are highly modifiable components of energy balance and are usually targeted in both obesity prevention and treatment programs. However, measurement of total diet creates challenges and can convey a large burden in terms of cost, technical expertise, impact on respondents and time. It is not surprising therefore that comprehensive reports of dietary intake in children are uncommon and, when reported, have limitations. The aim of this paper is to guide researchers and practitioners in selecting the most appropriate dietary assessment method for situations involving children and adolescents. This paper presents a summary of the issues to consider when choosing a method, a description of some of the more commonly used dietary assessment methods for young people and a series of case-studies to illustrate the range of circumstances faced when measuring dietary intake. We recommend that researchers consider the specific components of dietary intake addressed in their research and practice, and whether diet should be reported comprehensively or as targeted components. Other considerations include age, cognitive ability, weight status, physical activity level, respondent burden, and reliability and validity in the context of program goals and research questions. A checklist for selecting the appropriate dietary methodology is provided. This guide aims to facilitate the reporting of dietary intake and food habits in the context of obesity using valid and reliable measures, thus contributing to the evidence-base for nutrition policies and programs relating to obesity.
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ABSTRACT: BackgroundThe Food Intake and Physical Activity of School Children (CAAFE) comprises an online questionnaire to self-report diet and physical activity of Brazilian schoolchildren.Background The present study aimed to assess the validity (matches, omissions and intrusions) and moderating factors of the CAAFE.Methods Direct observation was made of foods consumed (five public schools) and child self-reporting on the CAAFE. Additional data included school grade, gender, body mass index, completion of food diary, socioeconomic status and access to computer. Data were analysed using regression.ResultsIn total, 602 children participated in the study [mean (SD) age 9.5 (1.24) years; 53.6% boys]. On average, there were 43% matches, 29% intrusions and 28% omissions. Matches doubled in third grade compared to the second grade (P = 0.004); matches almost tripled for afternoon snack compared to morning snack (P < 0.001); and matches were 69% higher for children with access to a computer at home (P < 0.01). Intrusions decreased by almost one-half in fifth compared to fourth grades (P = 0.004). Omissions declined significantly in the third and fourth grades but increased in the fifth grade. Omissions were 47% lower for children in the highest income and lower among children who completed the food diary. No differences were found for gender or body mass index.Conclusions Children older than 8 years old, who owned a computer and completed a food diary, performed better in the CAAFE. A high incidence of disagreement was found in relation to the schools and the type of meal. Overall matches (43%), intrusions (29%) and omissions (28%) indicate that further studies are required to improve the validity of the CAAFE.Journal of Human Nutrition and Dietetics 08/2014; 28. DOI:10.1111/jhn.12262 · 2.07 Impact Factor
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ABSTRACT: The Consumo Alimentar e Atividade Fisica de Escolares (CAAFE) questionnaire is an online research tool that has been developed to enable the self-report of physical activity and diet by Brazilian schoolchildren aged 7-10 years. Formative research was conducted with nutritionists during the development of the web-based questionnaire. The suggestions and insights obtained were used to design a tool to monitor schoolchildren's food consumption based on the concept of healthy and unhealthy food indicators. The present study aimed to report the focus group discussions conducted with nutritionists concerning the CAAFE questionnaire. Focus group discussions were conducted using a semi-structured questionnaire, and these were then analysed thematically. Twenty-four nutritionists participated (four focus groups; average per group: six people); the majority (n = 22) had experience with 7-10-year-old children. Four themes emerged: (i) healthy and unhealthy food indicators; (ii) suggestions for the online instrument; (iii) potential applications; and (iv) challenges for its construction. Comments made by nutritionists enabled the construction of an instrument that is able to answer questions related to food consumption in schools and at home.Journal of Human Nutrition and Dietetics 01/2014; 28. DOI:10.1111/jhn.12209 · 2.07 Impact Factor
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ABSTRACT: Dietary indices evaluate diet quality, usually based on current dietary guidelines. Indices can therefore contribute to our understanding of early-life obesity-risk dietary behaviours. Yet indices are commonly applied to dietary data collected by onerous methods (e.g., recalls or records). Short dietary assessment instruments are an attractive alternative to collect data from which to derive an index score. A systematic review of studies published before April 2013 was conducted to identify short (≤50 items) tools that measure whole-of-diet intake of young children (birth-five years) and are applicable to dietary indices, in particular screening obesogenic dietary behaviours. The search identified 3686 papers of which 16, reporting on 15 tools (n = 7, infants and toddlers birth-24 months; n = 8, preschoolers 2-5 years), met the inclusion criteria. Most tools were food frequency questionnaires (n = 14), with one innovative dietary questionnaire identified. Seven were tested for validity or reliability, and one was tested for both. Six tools (n = 2, infants and toddlers; n = 4, preschoolers) are applicable for use with current dietary indices, five of which screen obesogenic dietary behaviours. Given the limited number of brief, valid and reliable dietary assessment tools for young children to which an index can be applied, future short tool development is warranted, particularly for screening obesogenic dietary behaviours.Journal of obesity 09/2013; 2013:709626. DOI:10.1155/2013/709626