Development and validation of a food frequency questionnaire for children aged 7 to 10 years
Keywords:
Diet surveys, Nutrients, Nutritional transitionAbstract
Objective
Food and nutritional evaluation of children can support public policies to combat early overweight and obesity. This study developed and validated a quantitative food frequency questionnaire for assessing the dietary intake of children.
Methods
This is a cross-sectional study of the development of a food frequency questionnaire for 130 children of both genders aged 7 to 10 years old. For the food frequency questionnaire list, 81 food items were selected. The validity of the food frequency questionnaire was evaluated by comparison with 24-hour recalls and reproducibility was performed by comparing two food frequency questionnaires.
Results
Most of the foods with 95% relative contribution were ultra-processed, such as packaged snacks and powdered juice. In validation, correlation coefficients were found between 0.45 (p<0.000) for lipids and 0.37 (p<0.000) for carbohydrates. An adjustment for energy reduced the correlations, but there was an increase in the correlation in calcium (r=0.75) and retinol (r=0.20). In terms of reproducibility, all macronutrients and calcium showed a satisfactory intraclass correlation coefficient (>0.400) and moderate correlations [proteins (0.54; p<0.000) and lipids (0.41; p<0.000)].
Conclusion
The food frequency questionnaire developed was valid and able to assess the local food consumption by children from northeastern Brazil.
References
Oddo VM, Mueller NT, Pollack KM, Surkan PJ, Bleich SN, Jones-Smith JC. Maternal employment and childhood overweight in low- and middle-income countries. Public Health Nutr. 2017;20(14):2523-36.
Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128•9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627-42.
Ferreira CM, Reis NDD, Castro AO, Höfelmann DA, Kodaira K, Silva MT, et al. Prevalence of childhood obesity in Brazil: systematic review and meta-analysis. J Pediatr (Rio J). 2021.
Oliveira T, Ribeiro I, Jurema-Santos G, Nobre I, Santos R, Rodrigues C, et al. Can the Consumption of Ultra-Processed Food Be Associated with Anthropometric Indicators of Obesity and Blood Pressure in Children 7 to 10 Years Old? 2020;9(11).
Leandro CG, da Fonseca E, de Lim CR, Tchamo ME, Ferreira ESWT. Barriers and enablers that influence overweight/ obesity/obesogenic behavior in adolescents from lower-middle Income countries: a systematic review. Food Nutr Bull. 2019:379572119853926.
Liberali R, Kupek E, Assis MAA. Dietary patterns and childhood obesity risk: a systematic review. Child Obes. 2020;16(2):70-85.
Golley RK, Bell LK, Hendrie GA, Rangan AM, Spence A, McNaughton SA, et al. Validity of short food questionnaire items to measure intake in children and adolescents: a systematic review. J Hum Nutr Diet. 2017;30(1):36-50.
Tugault-Lafleur CN, Black JL, Barr SI. A systematic review of methods to assess children’s diets in the school context. Adv Nutr. 2017;8(1):63-79.
Horiuchi Y, Kusama K, Sar K, Yoshiike N. Development and validation of a Food Frequency Questionnaire (FFQ) for assessing dietary macronutrients and calcium intake in Cambodian school-aged children. Nutr J. 2019;18(1):11.
Rodriguez CA, Smith ER, Villamor E, Zavaleta N, Respicio-Torres G, Contreras C, et al. Development and Validation of a Food Frequency Questionnaire to Estimate Intake among Children and Adolescents in Urban Peru. Nutrients. 2017;9(10).
Scagliusi FB, Garcia MT, Indiani ALC, Cardoso MA. Relative validity of a food-frequency questionnaire developed to assess food intake of schoolchildren living in the Brazilian Western Amazon. Cadernos de saude publica. 2011;27:2197-206.
Matos SM, Prado MS, Santos CA, D’Innocenzo S, Assis AM, Dourado LS, et al. Validation of a food frequency questionnaire for children and adolescents aged 4 to 11 years living in Salvador, Bahia. Nutr Hosp. 2012;27(4):1114-9.
Moura-Dos-Santos MA, De Almeida MB, Manhaes-De-Castro R, Katzmarzyk PT, Maia JA, Leandro CG. Birthweight, body composition, and motor performance in 7- to 10-year-old children. Dev Med Child Neurol. 2015;57(5):470-5.
Dos Santos FK, Moura Dos Santos MA, Almeida MB, Nobre IG, Nobre GG, Ferreira ESWT, et al. Biological and behavioral correlates of body weight status among rural Northeast Brazilian schoolchildren. Am J Hum Biol. 2018;30(3):e23096.
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(1):12.
World Health Organization. BMI-for-age (5-19 years). Geneva: Organization; 2007 [cited 2020 Sep 25]. Available from: https://www.who int/growthref/who2007_bmi_for_age/en/index html.
Dalwood P, Marshall S. Diet quality indices and their associations with health-related outcomes in children and adolescents: an updated systematic review. Nutr J. 2020;19(1):118.
Burrows T, Goldman S, Rollo M. A systematic review of the validity of dietary assessment methods in children when compared with the method of doubly labelled water. Eur J Clin Nutr. 2019;74(5):669-81.
Block G, Hartman AM, Dresser CM, Carroll MD, Gannon J, Gardner L. A data-based approach to diet questionnaire design and testing. Am J Epidemiol. 1986;124(3):453-69.
Núcleo de Estudos e Pesquisas em Alimentaçãod. Tabela brasileira de composição de alimentos (TACO). Campinas: Unicamp; 2011.
Philippi ST. Tabela de composição de alimentos: suporte para decisão nutricional. Barueri: Manole; 2013. 164 p.
Santos GCJN, Isabele G, Ribeiro IC, Oliveira TLPS, Santos RM, Canuto R. et al. Álbum fotográfico de quantificação alimentar para crianças. Recife: Editora UFPE; 2019. p 68.
Willett W. Nutritional epidemiology: Oxford University Press; 2012.
Perez Rodrigo C, Aranceta J, Salvador G, Varela-Moreiras G. Food frequency questionnaires. Nutr Hosp. 2015;31(Suppl 3):49-56.
Saravia L, Gonzalez-Zapata LI, Rendo-Urteaga T, Ramos J, Collese TS, Bove I, et al. Development of a Food Frequency Questionnaire for Assessing Dietary Intake in Children and Adolescents in South America. Obesity (Silver Spring). 2018;26(Suppl 1):S31-S40.
Shaikh NI, Frediani JK, Ramakrishnan U, Patil SS, Yount KM, Martorell R, et al. Development and evaluation of a Nutrition Transition-FFQ for adolescents in South India. Public Health Nutr. 2017;20(7):1162-72.
Mikkila V, Vepsalainen H, Saloheimo T, Gonzalez SA, Meisel JD, Hu G, et al. An international comparison of dietary patterns in 9-11-year-old children. Int J Obes Suppl. 2015;5(Suppl 2):S17-21.
Fatihah F, Ng BK, Hazwanie H, Norimah AK, Shanita SN, Ruzita AT, et al. Development and validation of a food frequency questionnaire for dietary intake assessment among multi-ethnic primary school-aged children. Singapore Med J. 2015;56(12):687-94.
Liu D, Ju H, Yang ZY, Zhang Q, Gao JF, Gong DP, et al. Food Frequency Questionnaire for Chinese Children Aged 12-17 Years: Validity and Reliability. Biomed Environ Sci. 2019;32(7):486-95.
Mascarenhas JMO, Silva RDCR, Machado MEPC, Santos CADST, Marchioni DML, Barreto ML. Validation of a food frequency questionnaire designed for adolescents in Salvador, Bahia, Brazil. Rev Nutr. 2016;29(2):163-71.
Yanagisawa A, Sudo N, Amitani Y, Caballero Y, Sekiyama M, Mukamugema C, et al. Development and Validation of a Data-Based Food Frequency Questionnaire for Adults in Eastern Rural Area of Rwanda. Nutr Metab Insights. 2016;9:31-42.
van Dongen MC, Wijckmans-Duysens NE, den Biggelaar LJ, Ocké MC, Meijboom S, Brants HA, et al. The Maastricht FFQ: development and validation of a comprehensive food frequency questionnaire for the Maastricht study. Nutrition. 2019;62:39-46.
Moghames P, Hammami N, Hwalla N, Yazbeck N, Shoaib H, Nasreddine L, et al. Validity and reliability of a food frequency questionnaire to estimate dietary intake among Lebanese children. Nutr J. 2016;15:4.
Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res. 1999;8(2):135-60.
Herter-Aeberli I, Graf C, Vollenweider A, Haberling I, Srikanthan P, Hersberger M, et al. Validation of a Food Frequency Questionnaire to Assess Intake of n-3 Polyunsaturated Fatty Acids in Switzerland. Nutrients. 2019;11(8):1863.
Fangupo LJ, Haszard JJ, Leong C, Heath AM, Fleming EA, Taylor RW. Relative Validity and Reproducibility of a Food Frequency Questionnaire to Assess Energy Intake from Minimally Processed and Ultra-Processed Foods in Young Children. Nutrients. 2019;11(6):1290.
Selem SS, Carvalho AM, Verly-Junior E, Carlos JV, Teixeira JA, Marchioni DM, et al. Validity and reproducibility of a food frequency questionnaire for adults of Sao Paulo, Brazil. Rev Bras Epidemiol. 2014;17(4):852-9.