Quality of food-frequency questionnaire validation studies in the dietary assessment of children aged 12 to 36 months: a systematic literature review.

Amy Lovell,Clare R Wall,Rhodi Bulloch,Cameron C Grant

doi:10.1017/jns.2017.12

Abstract

A child's diet is an important determinant of growth and development. Because of this, the accurate assessment of dietary intake in young children remains a challenge. A systematic search of studies validating FFQ methodologies in children 12 to 36 months of age was completed. English-language articles published until March 2016 were searched using three electronic databases (MEDLINE, EMBASE and CINAHL). Quality assessment of the identified studies was carried out using The Reduced Summary Score and EURopean micronutrient RECommendations Aligned (EURRECA) scoring system. Seventeen studies were included and categorised according to whether they reflected long-term (≥7d) or short-term (<7d) intake, or used a biomarker. A total score for each micronutrient was calculated from the mean of the correlation coefficients weighted by the study quality score. At least three validation studies per micronutrient were required for inclusion. Fifteen studies (83%) that considered validity of the FFQ in assessing nutrient intakes had quality scores from 2·5 to 6·0. Of those, ten (67%) studies found FFQ to have good correlations in assessing dietary intake (>0·4). Of the nutrients with three or more studies available, FFQ validated using a reference method reflecting short-term intake had a good weighted correlation for Ca (0·51), and acceptable weighted correlations for vitamin C (0·31) and Fe (0·33). Semi-quantitative FFQ were shown to be valid and reproducible when estimating dietary intakes at a group level, and are an acceptable instruments for estimating intakes of Ca, vitamin C and Fe in children 12 to 36 months of age.

Highlights

A child’s diet is an important determinant of growth and development
Food and nutrient intakes are estimated via dietary assessment methods that differ according to a study’s aims and objectives, skills of the study population, accuracy of the required dietary data, study resources and study design(3)
Studies that evaluated the validity of FFQ in the assessment of dietary intake, food(s), and dietary patterns with a reference dietary assessment tool (e.g. 24-h recalls (24-HR), diet records, diet histories, weighed food records (WFR) and biomarkers) in healthy children aged 12 to 36 months and met all the inclusion criteria (Fig. 1.) were included in the review

Summary

Introduction

A child’s diet is an important determinant of growth and development. Because of this, the accurate assessment of dietary intake in young children remains a challenge. Fifteen studies (83 %) that considered validity of the FFQ in assessing nutrient intakes had quality scores from 2·5 to 6·0. Ten (67 %) studies found FFQ to have good correlations in assessing dietary intake (>0·4). Of the nutrients with three or more studies available, FFQ validated using a reference method reflecting short-term intake had a good weighted correlation for Ca (0·51), and acceptable weighted correlations for vitamin C (0·31) and Fe (0·33). The accurate description and measurement of dietary intake is a necessary step in determining the nutritional adequacy of diets in individuals or a population(1). Food and nutrient intakes are estimated via dietary assessment methods that differ according to a study’s aims and objectives, skills of the study population, accuracy of the required dietary data, study resources and study design(3). Factors that may affect the validity of a diet questionnaire have been reviewed(5,8)

Methods

Results

Discussion

Conclusion