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Introduction: Introduction: assessing the relationship between childhood diseases and nutrient intake is a crucial issue that requires valid and reliable dietary assessment tools in this period of physical and physiological development. Objective: the present study aimed to develop and validate a food frequency questionnaire (FFQ) to assess nutrient intake in Jordanian children. Methods: in this validation study, nutrient intake as obtained from a culturally sensitive quantitative FFQ was compared to nutrient intake as assessed by four 24-hour dietary recalls (24-HRs) between September 2017 and May 2018. One hundred and thirty-six children aged 6-18 years were enrolled from selected schools in Amman, Jordan. Children or their caregivers were asked to complete the FFQ during an initial face-to-face interview. Four 24-HRs were collected weekly over one month. Of these children, 50 also took part in the reproducibility phase, which involved a repeat completion of the FFQ within 1 month. Results: the intraclass correlation coefficients between the two FFQs ranged from 0.5 for trans-fats to 0.96 for calcium. Correlation coefficients between dietary intake estimates derived from the FFQ and 24-HRs were significant at p < 0.05. The highest correlation was detected for energy (0.8) while the lowest was identified for trans-fatty acids (0.04). For all nutrients, over 60 % of participants were classified into the same or adjacent quartile of crude and adjusted intake. Bland-Altman plots showed a satisfactory agreement between the two methods for energy and proteins. Conclusion: the FFQ showed a good reproducibility and a reasonable relative validity for most nutrients.

Background and Objectives: To evaluate the reproducibility and construct validity of the Madras Diabetes Research Foundation FFQ (MDRF-FFQ) with biomarkers for its use in epidemiological settings in India., Methods and Study Design: The MDRF-FFQ was administered to 500 participants representing rural and urban areas of 10 Indian states, twice at an interval of 12 months. Reproducibility was assessed using intra cluster correlation coefficients (ICC). Construct validity of carbohydrate and fat intake was assessed using baseline serum lipids by regression analysis., Results: Reproducibility as measured by ICC was 0.50-0.77 for saturated fatty acids (SFA) and energy in urban and 0.61-0.72 for protein and SFA in rural areas. The ICC for food groups was 0.53-0.77 for whole grains, fruits and vegetables in urban and 0.50-0.89 for animal foods and whole grains in rural areas. After adjusting for potential confounders, carbohydrate intake was positively associated with serum triglycerides (TG) (β [SE]: +2.3 [0.72] mg/dL; p=0.002) and inversely with high density lipoprotein cholesterol (HDL) (β [SE]:-0.48 [0.12], p<0.001), while dietary fat and SFA (% Energy) were positively associated with HDL, low density lipoprotein (LDL) and total cholesterol and inversely with TG., Conclusions: The MDRF-FFQ can be considered as a reliable and valid tool to measure the long-term dietary exposure in respect of macronutrient intakes in Indian populations despite diverse dietary practices.

Dietary assessment in infants is challenging but necessary to understand the relationship between nutrition and growth and development. Currently no simple, validated methods exist to assess nutrient intake in New Zealand (NZ) infants. Therefore, this study aimed to assess the relative validity and reproducibility of a Complementary Food Frequency Questionnaire (CFFQ) to determine nutrient intakes of NZ infants. Ninety-five parent-infant pairs (infant age 10 ± 1 months) completed the CFFQ twice (CFFQ-1 and CFFQ-2), 4 weeks apart (to assess reproducibility). A 4-day weighed food record (4dWFR) was collected between CFFQ administrations (to assess validity). Validity and reproducibility were assessed for intakes of energy and 18 nutrients using Bland-Altman analysis, Pearson's correlation coefficients, cross-classification, and weighted Kappa (κ). The CFFQ showed acceptable validity: Nutrients from the CFFQ were comparable with the 4dWFR (bias, 9-28%), correlation between methods ranged from r = .18 (saturated fat) to r = .81 (iron; mean r = .52), 54% (mean) of participants were correctly classified (range 39% to 67%), and 7.1% (mean) misclassified into opposite tertiles (range 2.1% to 14.7%). There was acceptable agreement between the CFFQ and 4dWFR (κ = 0.20-0.60). The CFFQ showed good reproducibility: Correlations ranged from r = .34 (folate) to r = .80 (zinc); for 16 nutrients, >50% of participants were correctly classified, and for all nutrients, <10% of participants were grossly misclassified. All nutrients showed acceptable to good agreement (κ > 0.20). The CFFQ has acceptable relative validity and good reproducibility for assessing nutrient intake in NZ infants aged 9-12 months, making it a useful tool for use in future research., (© 2019 The Authors. Maternal & Child Nutrition published by John Wiley & Sons, Ltd.)

Purpose: This paper deals with the dietary daily intakes of main polyunsaturated fatty acids (PUFA) in French children and adolescents., Methods: Dietary intakes of main PUFA were determined from a general French population of 1500 children (3-10 years) and adolescents (11-17 years) by using the most recent set of national robust data on food (National Survey INCA 2 performed in 2006 and 2007)., Results: Main results showed that mean daily intakes of total fat and n-6 PUFA linoleic acid (LA, 18:2n-6) were close to current recommended values for children and adolescent populations. However, 80% (children) to 90% (adolescents) of our French populations not only ingested low quantities of n-3 long-chain PUFA (docosahexaenoic (22:6n-3) and eicosapentaenoic (20:5n-3) acids) but also very low quantities of alpha-linolenic acid (ALA, 18:3n-3) at the origin of a non-balanced n-6/n-3 ratio. Inadequate consumption of EPA + DHA was also observed in subgroups of infants and adolescent who consumed more than two servings/week of fish., Conclusions: Such disequilibrium in PUFA dietary intakes in favor of n-6 PUFA could have adverse impact on cell membrane incorporation of long-chain n-3 PUFA and deleterious impacts on the health of children and adolescents. Promoting the consumption of both vegetable oils and margarines rich in ALA, and oily fish rich in long-chain n-3 PUFA might improve such PUFA disequilibrium.

The Healthy Eating Index-2010 is a measure of diet quality as portrayed by the Dietary Guidelines for Americans; however, computing the Healthy Eating Index score is time consuming and requires trained personnel. The Rapid Eating Assessment for Participants [shortened version] is a simple measure that quickly, in less than 10 min, assesses diet quality in a clinical or research setting. This research evaluated the degree of correlation between these two methods of scoring diet quality, as well as between these methods and other indicators of diet quality, including the nutrient density of the diet, the dietary potential renal acid load, urine pH, and plasma vitamin C concentrations. The research design was a secondary data analysis, and participants were healthy adults (n = 81) self-classified as omnivorous, vegetarian, or vegan. Confounding variables were identified and controlled using partial correlations. The two methods of scoring diet quality were significantly correlated (r = 0.227, p = 0.047). Both the Healthy Eating Index and the Rapid Eating Assessment for Participants scoring methods were correlated to nutrient density of the diets (r = 0.474 and r = 0.472 respectively, p < 0.001) as well as to the dietary potential renal acid load and urinary pH (r ranging from 0.304-0.341, p ≤ 0.002). The Rapid Eating Assessment for Participants, but not the Healthy Eating Index, was significantly correlated to plasma vitamin C concentrations (r = 0.500, p < 0.001 and 0.192, p = 0.095 respectively). These results in combination with ease of use and low cost suggest that the Rapid Eating Assessment for Participants measure is a useful tool for assessing diet quality.

Background: Dietary assessment methods that can provide high quality data while limiting participant burden and resource requirements in epidemiological research are highly sought after and continue to evolve. The use of mobile phone technology in research has increased rapidly over the last decade and offers multiple advantages to the researcher over traditional data collection methods. This study tested the acceptability and relative validity of a commercial smart phone application (app) for use as an epidemiological dietary assessment tool, compared with a traditional dietary assessment method., Methods: Study participants completed a 4-d food diary using a modified version of the Easy Diet Diary app and two 24-h dietary recalls during the same week, for comparison. At the end of data collection, participants completed a questionnaire on their experience with both methods. Average proportions of energy from macronutrients and fibre, iron, and calcium densities from the app and 24-h recalls were compared after log transformation, by calculating mean agreement, limits of agreement (LOA), and Pearson's correlations. The prevalence of dietary under-reporting was compared in each method using the Goldberg method., Results: A total of 50 adults (82% women) provided data for analysis (mean age, 31 y; mean BMI, 22.4 kg/m 2 ; 14% overweight or obese). Participant feedback showed high levels of acceptance of the app; 83% preferred using the app to completing 24-h dietary recalls. The average difference in energy intake (mean agreement) between methods was 268 kJ/d. For all intakes except alcohol, the average difference between methods was not significantly different from zero. Most limits of agreement were within an acceptable range. The prevalence of dietary misreporting was similar in both methods., Conclusions: These findings demonstrate good feasibility for applying this commercially-developed smartphone app in epidemiological research.

As an increasing number of countries implement integrated food and nutrition security (FNS) and HIV programs, global stakeholders need clarity on how to best measure FNS at the individual and household level. This paper reviews prominent FNS measurement tools, and describes considerations for interpretation in the context of HIV. There exist a range of FNS measurement tools and many have been adapted for use in HIV-endemic settings. Considerations in selecting appropriate tools include sub-types (food sufficiency, dietary diversity and food safety); scope/level of application; and available resources. Tools need to reflect both the needs of PLHIV and affected households and FNS program objectives. Generalized food sufficiency and dietary diversity tools may provide adequate measures of FNS in PLHIV for programmatic applications. Food consumption measurement tools provide further data for clinical or research applications. Measurement of food safety is an important, but underdeveloped aspect of assessment, especially for PLHIV.

Objective: A simple FFQ which ranks young children's dietary habits is necessary for population-based monitoring and intervention programmes. The aim of the present study was to determine the reliability and validity of a short FFQ to assess the dietary habits of young children aged 2-5 years., Design: Parents completed a seventeen-item FFQ for their children by telephone on two occasions, two weeks apart. Sixty-four parents also completed 3 d food records for their children. The FFQ included daily servings of fruit and vegetables, frequency of eating lean meat, processed meats, take-away food, snack foods (biscuits, cakes, doughnuts, muesli bars), potato crisps and confectionery, and cups of soft drinks/cordials, juice, milk and water. Weighted kappa and intra-class correlation coefficients were used to assess FFQ reliability and the Bland-Altman method was used to assess validity of the FFQ compared with the 3 d food record., Setting: Seven pre-school centres in metropolitan Sydney, Australia., Subjects: Seventy-seven children aged 2-5 years., Results: The majority of questions had moderate to good reliability: κ w ranged from 0·37 (lean meat) to 0·85 (take-away food consumption). Validity analysis showed a significant increase in mean values from the food record with increasing ordered categories from the FFQ for servings of vegetables and fruit and cups of drinks (all trend P ≤ 0·01). Spearman rank correlation coefficient was >0·5 for vegetables, fruit, diet soft drinks and fruit juice., Conclusions: The FFQ provides reliable and moderately valid information about the dietary intakes and habits of children aged 2-5 years, in particular for fruit, vegetables and beverages.

Vitamin D deficiency is common in older women and can negatively impact bone status. A simple method by which clinicians and researchers can evaluate a patient's vitamin D dietary intake could help identify individuals at risk for vitamin D deficiency. This study was done to validate a short dietary vitamin D questionnaire. Postmenopausal women (n=122), with a mean age of 63.9 ± 7.8 years, completed a Brief Vitamin D Questionnaire (BVDQ), the Block Health History and Habits Questionnaire 1998 (BHHHQ98), a 3-day food record, and an evaluation of serum 25 hydroxyvitamin D (25[OH]D) levels. Data were analyzed using Pearson correlation coefficients, Wilcoxon signed ranks tests, and Bland-Altman analyses to compare the performance of the BVDQ to the BHHHQ98 and to the diet record. As assessed by the BVDQ, vitamin D intake averaged 178.7 ± 112.3 IU per day, correlating well with the Block HHHQ98 (r=0.51, P<0.001) and the 3-day food record (r=0.43, P<0.001). Compared with the food record, both the BVDQ and the BHHHQ98 overestimated dietary vitamin D intake by less than 100 IU/day. The two questionnaires performed nearly identically at all levels of vitamin D intake. Serum 25(OH)D was not related to vitamin D intake as measured by either the BVDQ or the BHHHQ98, but did correlate weakly with vitamin D intake from the 3-day diet record (r=0.20, P=0.04). The Brief Vitamin D Questionnaire correlated well with the longer and more intense dietary assessment methods, making it a simple and accurate instrument for assessing vitamin D intake.

Validated self-report methods of dietary assessment exist and might be improved in terms of both accuracy and cost-efficiency with computer technology. The objectives of this preliminary study were to develop an initial version of an interactive CD-ROM program to estimate fruit, vegetable, and fat intake, and to compare it to multiple 24-hour dietary recalls (averaged over 3 days). In 2009, overweight male and female adults (n=205) from Lane County, OR, completed computerized and paper versions of fruit, vegetable, and fat screening instruments, and multiple 24-hour dietary recalls. Summary scores from the 10-item National Cancer Institute Fruit and Vegetable Scan and the 18-item Block Fat Screener were compared to multiple 24-hour dietary recall-derived fruit/vegetable and fat intake estimates (criterion measures). Measurement models were used to derive deattenuated correlations with multiple 24-hour dietary recalls of paper and CD-ROM administrations of Fruit and Vegetable Scan fruit intake, vegetable intake, and fruit and vegetable intake, and Block Fat Screener fat intake. The computerized assessment and paper surveys were related to multiple 24-hour dietary recall-derived fruit/vegetable and fat intake. Deattenuated correlation coefficients ranged from 0.50 to 0.73 (all P≤0.0001). The CD-ROM-derived estimate of fruit intake was more closely associated with 24-hour dietary recall (r=0.73) than the paper-derived estimate (r=0.54; P<0.05), but the other comparisons did not differ significantly. Findings from this preliminary study with overweight adults indicate the need for additional enhancements to the CD-ROM assessment and more extensive validation studies., (Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.)

This paper describes qualitative and quantitative aspects of testing a 34-item Toddler-Feeding Questionnaire (TFQ), designed for use in Latino families, and the associations between feeding practices and toddler dietary outcomes. Qualitative methods included review by an expert panel for content validity and cognitive testing of the tool to assess face validity. Quantitative analyses included use of exploratory factor analysis for construct validity; Pearson's correlations for test-retest reliability; Cronbach's alpha (α) for internal reliability; and multivariate regression for investigating relationships between feeding practices and toddler diet and anthropometry. Interviews were conducted using a convenience sample of 94 Latino mother and toddler dyads obtained largely through the Supplemental Nutrition Program for Women, Infants and Children (WIC). Data collection included household characteristics, self-reported early-infant feeding practices, the toddler's dietary intake, and anthropometric measurements. Factor analysis suggests the TFQ contains three subscales: indulgent; authoritative; and environmental influences. The TFQ demonstrated acceptable reliability for most measures. As hypothesized, indulgent practices in Latino toddlers were associated with increased energy consumption and higher intakes of total fat, saturated fat, and sweetened beverages. This tool may be useful in future research exploring the relationship of toddler feeding practices to nutritional outcomes in Latino families., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Objective: We aimed to develop, test and describe the Exhaustive Home Food Inventory (EHFI), which measures foods in the home using scanning of the universal product code (UPC) and EHFI software to link codes to food identities and energy values., Design: Observational design with up to three repeated measures in each household yielded a total of 218 inventories., Setting: Eighty private households in North Carolina., Subjects: Low-income African-American women with an infant between the ages of 12 and 18 months. Recruitment rate was 71 %., Results: Approximately 12 200 different food items were successfully recorded using the EHFI method. The average number of food items within a household was 147. The time required for the first measurement in a home declined from 157 to 136 min (P < 0·05) for the first third compared to the last third of homes measured. In the sixty-four households in which three assessments were performed, the time required decreased from 145 to 97 min as did the time per item from 1·10 to 0·73 min., Conclusions: It is feasible to record all foods and drinks in the home using UPC scanning. Further development and enhancement of databases linking UPC to food identification, nutrients and other information are needed.

Objective: To develop an index that assesses the degree of adherence to existing diet-lifestyle recommendations for preschoolers (Preschoolers Diet-Lifestyle Index (PDL-Index)) and to investigate its association with obesity., Design: The PDL-Index was constructed using eleven components (i.e. questions regarding the frequency of consumption of selected foods/food groups, time spent on television watching and on moderate-to-vigorous physical activities)., Setting: Scores from 0 to 4 were assigned to all components of the index. The PDL-Index total score ranged from 0 to 44. Higher values of the PDL-Index indicate greater adherence to dietary and lifestyle recommendations for preschoolers or otherwise greater adherence to healthier dietary-lifestyle patterns., Subjects: As a validation procedure, a sample of 2287 preschoolers from Greece (GENESIS study) was used., Results: The participants following healthier diet-lifestyle patterns (third tertile of PDL-Index) were less likely to be obese or overweight/obese compared to those following unhealthy diet-lifestyle patterns (first tertile of PDL-Index). It was observed that a 1/44 unit increase in the score of the PDL-Index was associated with approximately 5 % and 3 % lower odds of being obese and overweight/obese, respectively. Statistically significant results were observed after adjusting for potential confounders., Conclusions: The suggested PDL-Index could help public health policy makers in identifying vulnerable population subgroups and developing cost-effective, targeted intervention actions both in family and preschool settings. In addition, health-care professionals can use the PDL-Index to evaluate diet quality, lifestyle and risk for overweight/obesity at an individual level and counsel parents accordingly.

Objective: To evaluate the reproducibility of a semi-quantitative FFQ used in the Seguimiento Universidad de Navarra (SUN) project., Design: The data that were analysed were collected from an FFQ answered twice by a 326-participant subsample of the SUN project (115 men, 35.3 %; 211 women, 64.7 %), with either less than 1 year or more than 1 year between responses. The questionnaire included 136 items. Pearson correlation coefficients (r) were calculated to evaluate the magnitude of the association between both measures after energy adjustment and correcting for within-person variability. We also evaluated misclassification by quintiles distribution., Results: The highest corrected correlations among participants who answered before 1 year were found for PUFA (r = 0.99). Among participants who answered after 1 year between both questionnaires, olive oil had the highest corrected correlation (r = 0.99). The highest percentage of gross misclassification, lowest quintile in FFQ1 and highest quintile in FFQ2 or highest quintile in FFQ1 and lowest quintile in FFQ2 was for cereals, fish or seafood, and n-3 fatty acids (7.6 %). Alcoholic drinks had the highest percentage of reasonable classification, same or adjacent quintile, in FFQ1 and FFQ2 (86.4 %)., Conclusions: Our study suggests that FFQ reproducibility is acceptable for participants who answered the same questionnaire twice less than 1 year apart. Participants who answered FFQ more than 1 year apart showed worse values on reproducibility. We consider this Spanish FFQ as an important, valid and reproducible tool in nutritional epidemiology.