Marc Covents

Development and evaluation of a self-administered computerized 24-h dietary recall method for adolescents in Europe

Objective:To describe the development of a European computerized 24-h dietary recall method for adolescents, and to investigate the feasibility of self-administration (self report) by comparison with administration by a dietician (interview).Methods:Two hundred and thirty-six adolescents (mean age 14.6 years (s.d.=1.7)) of eight European cities completed the 24-h recall (Young Adolescents Nutrition Assessment on Computer (YANA-C)) twice (once by self-report and once by interview).Results:A small but significant underestimate in energy (61 (s.e.=31) kcal) and fat (4.2 (s.e.=1.7) g) intake was found in the self-reports in comparison with the interviews; no significant differences were found for the intake of carbohydrates, proteins, fibre, calcium, iron and ascorbic acid. Spearmans correlations were highly significant for all nutrients and energy ranging between 0.86 and 0.91. Agreement in categorizing the respondents as consumers and non-consumers for the 29 food groups was high (kappa statistics ⩾0.73). Percentage omissions were on average 3.7%; percentage intrusions: 2.0%. Spearmans correlations between both modes were high for all food groups, for the total sample (⩾0.76) as well as for the consumers only (⩾0.72). Analysing the consumer only, on an average 54% of the consumed amounts were exactly the same; nevertheless, only for one group ‘rice and pasta’ a significant difference in consumption was found.Conclusion:Adaptation, translation and standardization of YANA-C make it possible to assess the dietary intake of adolescents in a broad international context. In general, good agreement between the administration modes was found, the latter offering significant potential for large-scale surveys where the amount of resources to gather data is limited.

Young adolescents' nutrition assessment on computer (YANA-C).

Objective:To assess the relative validity and acceptability of the computerised 24-h recall ‘Young Adolescents Nutrition Assessment on Computer (YANA-C)’.Design:Food and nutrient intakes assessed with YANA-C were compared with food records (study 1) and 24-h dietary recall interviews (study 2).Main outcome measures:Intakes of food groups (fruit, fruit juice, vegetables, potatoes, bread, cereals, milk, cheese, other milk products, soft drinks, diet soft drinks, sugar/sweets, pastry/cookies, savoury snacks, butter/sauces, eggs, fish, meat) and nutrients (energy, carbohydrates, protein, fat, fiber, calcium, vitamin C and iron).Subjects and setting:A total of 237 pupils (11–14 y) from two primary and four secondary schools (study 1: n=136; study 2: n=101) in Belgium-Flanders.Results:YANA-C proved to agree well with both standard methods in categorizing subjects in consumers and nonconsumers (κstudy 1=0.48–0.92; κstudy 2=0.38–0.90). Spearmans correlations for energy and nutrient intakes ranged between 0.44 and 0.79 for study 1 and between 0.44 and 0.86 for study 2. Nutrient and energy intakes were in general (excluding calcium) significantly higher in YANA-C in comparison with the food record, but not in comparison with the interview (only fiber). Statistics used to investigate whether YANA-C agreed with the other methods in ranking portions/amounts in consumers only were fair to moderate for most of the food groups (weighted κ study 1=0.11–0.55; study 2=0.04–0.73); amounts in consumers only, were significantly lower in YANA-C against both standards for cereals; amounts were significantly higher in YANA-C against the food record for milk, soft drinks, sugar/sweets and savoury snacks and against the interview for potatoes. Only a few pupils evaluated the program negatively.Conclusion:YANA-C is a promising method to collect detailed dietary information from young adolescents with relatively low staff resources, useful in many nutrition research applications.

Feasibility of the Young Children's Nutrition Assessment on the Web

Methods to assess detailed dietary data are cumbersome, expensive, and difficult to implement with large samples. The purpose of the present article was to evaluate the feasibility of collecting data from parents about their childs diet using an online dietary assessment tool. The Young Childrens Nutrition Assessment on the Web was developed as part of a longitudinal study of familial influences on food intake of preschool children. A sample of 862 parents from 56 nursery schools completed a paper-and-pencil questionnaire containing sociodemographic variables and a food frequency questionnaire about their childs diet and psychosocial variables. Subsequently, a subset of parents was asked to either complete a paper-and-pencil food diary or the Young Childrens Nutrition Assessment on the Web (n=88); those remaining who provided e-mail addresses were asked to complete the Young Childrens Nutrition Assessment on the Web (n=467) and a user-acceptability questionnaire. This resulted in 39 useful paper-and-pencil diaries, 217 useful Young Childrens Nutrition Assessments on the Web, and 164 user-acceptability questionnaires. Mann-Whitney U tests comparing nutrient (macronutrients, vitamin C, calcium, and fiber) and food group intakes from data collected with the Young Childrens Nutrition Assessment on the Web vs paper-and-pencil diaries resulted in no substantial differences except for water. Attrition analyses indicated that dropout for the online assessment was associated with the sex of the respondent (father completing the questionnaire), lower social status, being a smoker, and lower nutrition knowledge. The online measure was well-received by respondents. The majority found it user-friendly (79%), attractive (68%), and clear (93%). The Young Childrens Nutrition Assessment on the Web is a promising tool to collect online dietary data in large-scale surveys.

Comparison of a food frequency questionnaire with an online dietary assessment tool for assessing preschool children’s dietary intake

BACKGROUND It is important to assess the dietary habits of children as they progress from early childhood to adolescence. However, there are few validated tools available to assess the diet of this group of children. The present study aimed to investigate the relative validity of a food frequency questionnaire (FFQ) developed for use in a biennial longitudinal study. METHODS The parents of 216 Belgian-Flemish preschool children completed a FFQ (including questions on 77 food groups) and an online dietary assessment tool for three nonconsecutive days on their childs diet. Intakes of energy, macronutrients, fibre, calcium and 20 food groups recorded by both methods were compared using Spearmans correlations, Wilcoxons signed rank test and Bland and Altman analyses. RESULTS At the group level, good agreement was found for energy, fat and protein intake, an overestimation was found for carbohydrates (5.6%) and fibre (13.3%), and an underestimation was found for calcium (9%). For the food groups, overestimation as well as underestimation and good agreement were found, although overestimation was most common. Good agreement was found in ranking the childrens fruit (r = 0.53), beverages (r = 0.58-0.76), soup (r = 0.51), breakfast cereals (r = 0.55) and calcium (r = 0.59) intake according to both methods. CONCLUSION The results obtained revealed that the FFQ was a useful alternative for estimating energy and macronutrient intake at a group level; however, when used to estimate fibre and calcium intake, respectively, over- and underestimation need to be considered. The short reference period (3 days) may have compromised agreement in ranking and agreement at the individual level.

Changes in children's food group intake from age 3 to 7 years: comparison of a FFQ with an online food record.

Few studies have investigated the relative validity of FFQ in young children and no study has investigated the relative validity of changes in childrens food intake in a longitudinal context. The aim of the present study was to compare the FFQ of the longitudinal Family Influences on Food Intake study, assessing childrens food intake in the previous 3 months, with a 3 d online food record when children were 3 and 7 years old, as well as to investigate the relative validity of changes in food group intake over a 4-year period. Parents (n 89) completed the FFQ and an online food record over three non-consecutive days on two separate occasions (January-April 2008 and 2012). Wilcoxon signed-rank tests and Spearmans correlations were used to compare food group intake and changes in intake assessed using both methods. In 2008, the intake of eleven of the twenty-two food groups was overestimated and that of four food groups underestimated in the FFQ in comparison with the online tool; in 2012, the intake of four food groups was overestimated and that of seven food groups underestimated. Nevertheless, changes in intake did not differ significantly between the two methods for eighteen food groups. Correlations in 2008 and 2012 were, on average, 0.47; correlations between the changes in dietary intake were, on average, 0.26. The results suggest that despite the significant differences between the two methods for a number of food groups at both baseline and/or follow-up, the FFQ can be used to monitor changes in dietary intake for groups of young children.