Abstract
Despite that fruits and vegetables are key elements for health promotion, there are limited studies validating their intake in children. We aimed to validate the SAYCARE (South American Youth/Child Cardiovascular and Environmental) Study Food Frequency Questionnaire (FFQ) and the combination of the FFQ frequency of intake with the 24 h-dietary-recall (24 h-DR) (mean of 3 days), for children’s fruit and vegetable intake. The reference methods were plasma dosages of β-carotene, retinol, ascorbic acid, and α-tocopherol, which were collected in the school environment. It is a validity study in a subsample of 45 children aged 6–10 years participating in the SAYCARE Study, from São Paulo (Brazil). The FFQ was answered by the parents/guardians over the previous 3 months; the 24 h-DR was answered three times (two weekdays by nutritionists, one weekend day by parents/guardians). The mean fruit and vegetable intake (combined with frequency of intake) was calculated using the multiple source method (MSM). Multiple linear regression showed pooled correlation coefficients of 0.29 to 0.35 for the reported fruit and vegetable intake estimated by the FFQ and the MSM, respectively. The SAYCARE FFQ is an accurate and useful tool for ranking fruit and vegetable intake in children between 6–10 years from the SAYCARE Study.
Highlights
Fruits and vegetables are key elements for the promotion of lifelong health [1]
Of the 60 children (6 to 10 years) who were identified at schools, 57 of them were interested in participating in the study and signed the parental consent form, 55 completed the blood examination, but four of these children did not have enough plasma samples for vitamin analysis
We excluded two children with physiologically implausible energy intake according to the Food Frequency Questionnaire (FFQ), and four children were excluded because they showed blood concentrations of c-reactive protein over 10.0 mg/dL(these levels are suggestive of active inflammation/infection that could affect the bioavailability of the vitamins in plasma) [28]
Summary
There are limited studies validating questionnaires for children’s fruit and vegetable intake [2]. Assessing dietary intake in children is a complex and challenging task [3], because it often relays on the parental report, mainly when children are younger than 10 years of age [4]. As the custom of families eating together is constantly decreasing [5], parental knowledge about their children’s dietary intake is difficult to assess with accuracy [6]. Accuracy is the precision of a measurement or the degree to which a tool measures the aspect it was designed to measure, usually assessed to validate a tool [7]. In the usual fruit and vegetable intake, for example, the validity of a food frequency questionnaire (FFQ) newly developed might be assessed by comparing
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