Short Dietary Questionnaire Research Articles

Effects of an individualized nutritional educational program in pregnant women: A randomized controlled trial in Japan.

To evaluate the effectiveness of an individualized nutritional education program in promoting adequate nutrient intake in pregnant women. A stratified randomized controlled trial was conducted. Participants were stratified by factors affecting the primary outcome and randomly assigned to the intervention or control groups. Intervention group participants received an individualized 30-min booklet-based education program in their 2nd and 3rd trimesters; the control group received usual care. The primary outcome was protein intake after the intervention, which was compared between the intervention and control groups. Secondary outcomes included comparing the amount of increase of protein before and after the intervention. Nutrient intake was measured using a self-administered short dietary history questionnaire, and analyses of covariance and t tests were performed. Of the 130 participants, 66 were assigned to the intervention group and 64 to the control group. There was no difference in protein intake between the two groups after the intervention (p = .051, 95% CI [-0.021, 12.4]). Comparing the increase in protein intake before and after intervention, the intervention group was 7.4 g/day higher than that of the control group (p = .040; F = 4.31; effect size = 0.36). The primary outcome, a comparison of protein intake between the groups after the program, revealed no significant differences. However, on comparing the amount of protein increase before and after the intervention, the intervention group's increase was significantly higher than that of the control group. Results indicate the potential for individualized face-to-face interventions for pregnant women in Japan.

Development and validation of a short dietary questionnaire for assessing obesity-related dietary behaviours in young children.

There are few short, validated tools to assess young children's obesity-related dietary behaviours, limiting the rapid screening of dietary behaviours in research and practice-based early obesity prevention. This study aimed to develop and assess the reliability and validity of a caregiver-reported short dietary questionnaire to rapidly assess obesity-related dietary behaviours in children aged 6 months to 5 years. The Early Prevention of Obesity in Childhood Dietary Questionnaire (EPOCH-DQ) was developed using a rigorous process to determine content and structural validity. Three age-appropriate versions were developed for (1) infants, aged 6-12 months, (2) toddlers, aged 1-2.9 years and (3) pre-schoolers, aged 3-5 years. The questionnaire (7-15 items) measures dietary behaviours, including diet risk from non-core food and beverage intake, diet quality from vegetable frequency, bread type and infant feeding practices. Test-retest reliability was assessed from repeated administrations 1 week apart (n = 126). Internal consistency, concurrent validity (against a comparison questionnaire, the InFANT Food Frequency Questionnaire), construct validity and interpretability were assessed (n = 209). Most scores were highly correlated and significantly associated (p < 0.05) for validity (rs: 0.45-0.89, percentage agreement 68%-100%) and reliability (intraclass correlation coefficient: 0.61-0.99) for diet risk, diet quality and feeding practice items. The EPOCH-DQ shows acceptable validity and reliability for screening of obesity-related behaviours of children under 5 years of age. The short length and, thus, low participant burden of the EPOCH-DQ allows for potential applications in various settings. Future testing of the EPOCH-DQ should evaluate culturally and socio-economically diverse populations and establish the predictive validity and sensitivity to detect change.

Development and Validation of the Vietnamese Children's Short Dietary Questionnaire to Evaluate Food Groups Intakes and Dietary Practices among 9-11-Year-Olds Children in Urban Vietnam.

This study aims to develop and assess the reproducibility and validity of the Vietnamese Children’s Short Dietary Questionnaire (VCSDQ) in evaluating food groups intakes and dietary practices among school-aged children 9–11 years old in urban Vietnam. A 26-item questionnaire covering frequency intakes of five core food groups, five non-core food groups, five dietary practices over a week, and daily intakes of fruits, vegetables, and water was developed. Children (n = 144) from four primary schools in four areas of Ho Chi Minh City, Vietnam completed the VCSDQ twice, as well as three consecutive 24 h recalls over a week. Intra-class correlation, Spearman correlation, weighted kappa, cross-classification, and Bland–Altman plots were used to evaluate the reproducibility and validity. The direct validity of food groups from VCSDQ against the 24 h recalls was examined using Wilcoxon-test for trend. The VCSDQ had good reproducibility in 12 out of 15 group items; the ICC ranged from 0.33 (grains) to 0.84 (eating while watching screens). This VCSDQ had low relative validity, two items (instant noodles, eating while watching screens) had a moderate to good agreement (k = 0.43, k = 0.84). There was good direct validity in three core-food groups (fruits, vegetables, dairy) and three non-core food groups (sweetened beverages, instant noodles, processed meat). In addition, the VCSDQ can also be used to classify daily intakes of fruits and vegetables from low to high.

Prospective association of family members’ sugar-sweetened beverages intake with children’s sugar-sweetened beverages consumption in China

PurposeWe aimed to investigate whether parental and siblings’ sugar-sweetened beverage (SSB) intake had prospective impact on children’s SSB consumption, and the potential sex difference in these associations.MethodsThis study included a total of 904 children and their parents enrolled from 2004 to 2011 China Health and Nutrition Survey (CHNS) cohort study. SSB consumption information was estimated using a short dietary questionnaire and total energy intake was assessed with three-day 24-h dietary assessments at recruitment and follow-up surveys. Multivariate logistic or linear regression analyses were used to assess the association for SSB consumption between parents, siblings and children after adjusting for age, body mass index (BMI) z-score, household income and parental educational level.ResultsIn this study, a majority (87.6%) of children consumed SSB. Among them, the median consumption of SSB was 70.3 ml/day per capita and 205.4 ml/day per consumer. Parental SSB consumption was relevant to children’s SSB consumption, and this association was more pronounced in boys than in girls. Meanwhile, fathers seemed to have a stronger impact on whether children consume SSB than mothers which was reflected by lower P and higher OR. Additionally, children’s SSB intake was prospectively associated with their older siblings’ SSB consumption (Pfor trend < 0.03).ConclusionsParental and older siblings’ SSB consumption was relevant to children’s SSB intake. Particularly, boys were more susceptible to parental impact than girls, and fathers seemed to have a greater influence on children than mothers.

Meat consumption and risk of incident dementia: cohort study of 493,888 UK Biobank participants

ABSTRACTBackgroundWorldwide, the prevalence of dementia is increasing and diet as a modifiable factor could play a role. Meat consumption has been cross-sectionally associated with dementia risk, but specific amounts and types related to risk of incident dementia remain poorly understood.ObjectiveWe aimed to investigate associations between meat consumption and risk of incident dementia in the UK Biobank cohort.MethodsMeat consumption was estimated using a short dietary questionnaire at recruitment and repeated 24-h dietary assessments. Incident all-cause dementia comprising Alzheimer disease (AD) and vascular dementia (VD) was identified by electronic linkages to hospital and mortality records. HRs for each meat type in relation to each dementia outcome were estimated in Cox proportional hazard models. Interactions between meat consumption and the apolipoprotein E (APOE) ε4 allele were additionally explored.ResultsAmong 493,888 participants included, 2896 incident cases of all-cause dementia, 1006 cases of AD, and 490 cases of VD were identified, with mean ± SD follow-up of 8 ± 1.1 y. Each additional 25 g/day intake of processed meat was associated with increased risks of incident all-cause dementia (HR: 1.44; 95% CI: 1.24, 1.67; P-trend < 0.001) and AD (HR: 1.52; 95% CI: 1.18, 1.96; P-trend = 0.001). In contrast, a 50-g/d increment in unprocessed red meat intake was associated with reduced risks of all-cause dementia (HR: 0.81; 95% CI: 0.69, 0.95; P-trend = 0.011) and AD (HR: 0.70; 95% CI: 0.53, 0.92; P-trend = 0.009). The linear trend was not significant for unprocessed poultry and total meat. Regarding incident VD, there were no statistically significant linear trends identified, although for processed meat, higher consumption categories were associated with increased risks. The APOE ε4 allele increased dementia risk by 3 to 6 times but did not modify the associations with diet significantly.ConclusionThese findings highlight processed-meat consumption as a potential risk factor for incident dementia, independent of the APOE ε4 allele.

Nutrition Module design in Maintain Your Brain: an internet-based randomised controlled trial to prevent cognitive decline and dementia.

The Maintain Your Brain (MYB) trial is one of the largest internet-delivered multidomain randomised controlled trial designed to target modifiable risk factors for dementia. It comprises four intervention modules: physical activity, nutrition, mental health and cognitive training. This paper explains the MYB Nutrition Module, which is a fully online intervention promoting the adoption of the 'traditional' Mediterranean Diet (MedDiet) pattern for those participants reporting dietary intake that does not indicate adherence to a Mediterranean-type cuisine or those who have chronic diseases/risk factors for dementia known to benefit from this type of diet. Participants who were eligible for the Nutrition Module were assigned to one of the three diet streams: Main, Malnutrition and Alcohol group, according to their medical history and adherence to the MedDiet at baseline. A short dietary questionnaire was administered weekly during the first 10 weeks and then monthly during the 3-year follow-up to monitor whether participants adopted or maintained the MedDiet pattern during the intervention. As the Nutrition Module is a fully online intervention, resources that promoted self-efficacy, self-management and process of change were important elements to be included in the module development. The Nutrition Module is unique in that it is able to individualise the dietary advice according to both the medical and dietary history of each participant; the results from this unique intervention will contribute substantively to the evidence that links the Mediterranean-type diet with cognitive function and the prevention of dementia and will increase our understanding of the benefits of a MedDiet in a Western country.

Validation of a Short Dietary Questionnaire to Evaluate Dietary Intake in School-Aged Children 9–11 Years in Ho Chi Minh City, Vietnam

ObjectivesRegular and timely assessment of children’s diet is crucial in the context of increased childhood overweight and obesity in countries undergoing the nutrition transition. Presently, there is no quick, simple, validated dietary assessment tool to evaluate children’s diet in Vietnam. Thus, this study will examine the reliability and validity of a newly developed short dietary questionnaire (SDQ) among school-aged children 9–11 years old in Ho Chi Minh City to assess whether they meet the Vietnamese dietary guidelines. MethodsA validation study is being conducted among fifth-grade students (9–11 years old) from four primary schools representative for four areas of Ho Chi Minh, Vietnam. 29-item questions including intakes in food groups (6 core food groups, and 5 non-core food groups) and five mealtime behaviors over the last week will be validated against 24-hour recalls on 3 days during one week (2 weekdays and one weekend). The SDQ will be administrated two times within one-week interval to examine its reliability. The difference between the frequency of food groups intakes and mealtime behaviors from the SDQ and 3-day 24 hour recalls will be examined using paired t-test. Bland-Altman analysis with 95% limit of agreement will be used to examine level agreement between two methods. Weighted Kappa will be applied to identify misclassification between quintiles of frequency of consumption in food groups per week. Strength of agreement will be defined by the Landis and Koch value. Also, the Children Dietary Score reflecting adherence to the Vietnamese dietary guidelines will be developed to examine agreement between scores from SDQ and from the 24 hour recalls. These Children Dietary scores will be used to test the validity and reliability of the tool using the above tests. The Wilcoxon rank-sum test will be used to examine whether an increase in the number of serves/cups from the SDQ correlates with increases in grams of fruits/vegetables or water volume consumed. ResultsN/A. ConclusionsThe SDQ is expected to be used as a screening tool to assess whether school-aged children meet the Vietnamese dietary guidelines. This could support governments to help improve children’s diet in a timely fashion. Funding SourcesPhD scholarship from QUT and the Commonwealth Government of Australia.

Validation and reproducibility of a short food frequency questionnaire for cardiovascular prevention

Diet strongly influences cardiovascular risk. Dietary evaluation is a major issue in cardiovascular prevention, but few simple tools are available. Our team previously validated a short food frequency questionnaire; a new version of this questionnaire (Cardiovascular Dietary Questionnaire 2 [CDQ-2]) is easier to complete and more reliable. To validate CDQ-2 in comparison with the original version, and to test its reproducibility. CDQ-2 has 17 closed-ended questions; it provides a global dietary score that is a combination of specific scores for saturated, monounsaturated and omega-3 fatty acids, and fruit and vegetables. CDQ-2 was validated against the original version in two groups, who completed both questionnaires: 99 patients with cardiovascular risk factors and 50 healthy subjects. Reproducibility was assessed with 27 health professionals who completed the questionnaire twice, with a 1-month interval. The correlation coefficients of the scores between the two questionnaires ranged from 0.65 (monounsaturated fatty acids) to 0.93 (fruit and vegetables) (all P<0.001). The percentage of subjects classified in the same quartile by both questionnaires ranged from 56% (omega-3 fatty acids) to 78% (fruit and vegetables). The percentage of subjects classified in the same or adjacent quartile ranged from 91% to 99%. The intraclass correlation coefficients, which assessed reproducibility, ranged from 0.61 (fruit and vegetables) to 0.88 (saturated fatty acids) (P<0.001). This new version of the short dietary questionnaire shows good reproducibility and correlations with the original version; use and reliability are improved, which makes CDQ-2 a valuable tool for cardiovascular prevention.

Telephone-Delivered Dietary Intervention in Patients with Age-Related Macular Degeneration: 3-Month Post-Intervention Findings of a Randomised Controlled Trial.

There is an evidence–practice gap between the dietary recommendations for age-related macular degeneration (AMD) presented in the literature and those practiced by patients. This study reports on the 3-month post-intervention results of a randomised controlled trial (RCT) evaluating telephone-delivered counselling to improve dietary behaviours among AMD patients. A total of 155 AMD patients (57% female, aged 78 ± 8 years; control: 78, intervention: 77), primarily residing in New South Wales, Australia, were recruited. Participants completed a baseline questionnaire and a short dietary questionnaire (SDQ-AMD). The intervention included an evidence-based nutrition resource and four monthly calls with a dietitian. Immediately post-intervention, intervention participants repeated the SDQ-AMD and completed a feedback form. At 3 months post-intervention, both study arms repeated the SDQ-AMD. Statistical analyses included t-tests and McNemar’s test. Intervention participants reported satisfaction with the tailored phone calls, nutrition resource and nutrition education provided. At 3 months post-intervention, there was no statistically significant difference between study arms in the proportion of participants meeting the dietary goals nor in intake (mean servings ± SE) of total vegetables (primary outcome) and other key food groups; however, there was a significantly higher intake of nuts (secondary outcome) (3.96 ± 0.51 vs. 2.71 ± 0.32; p = 0.04) among participants in the intervention versus control group. Within the intervention arm, there were also significant improvements in intakes of the following secondary outcomes: dark green leafy vegetables (0.99 ± 0.17 vs. 1.71 ± 0.22; p = 0.003) and legumes (0.69 ± 0.10 vs. 1.12 ± 0.16; p = 0.02) and intake of sweets and processed/prepared foods (8.31 ± 0.76 vs. 6.54 ± 0.58, p = 0.01). In summary, although there were few dietary differences between study arms at 3 months post-intervention, the intervention involving four monthly calls was acceptable and helpful to the participants. This type of intervention therefore has the potential to provide people with AMD the needed support for improving their nutrition knowledge and dietary practices, especially if continued over a longer period.

Adequacy of dairy product intake among children in Kuwait using a short dietary assessment questionnaire

PurposeThis paper aims to assess the consumption of dairy products in Kuwaiti children, and develop and validate a semi-quantitative food frequency questionnaire to measure dairy product consumption.Design/methodology/approachThis cross-sectional study was based on a sample of child–parent dyads (n= 150). A dietary assessment questionnaire on local dairy products consumed by preschool and preadolescent children was developed. Serving and portion sizes were evaluated on the basis of the guidelines of the United States Department of Agriculture and the American Academy of Pediatrics to calculate median intake levels of three age groups (3-5, 6-8 and 9-11 years).FindingsAll children met or exceeded the recommended daily servings of dairy products for their age and sex. Dairy product intake was often from processed dairy including milk-based desserts, flavored milk and cheese. Compared to boys, girls consumed more yogurt (15.5 per cent vs 14.2 per cent,p= 0.001) and milk-based desserts (15.5 vs 14.3,p= 0.001). In boys, flavored milk contributed more to the total dairy intake than in girls, especially in 6-8-year-olds (21.8 per cent vs 18.9 per cent,p= 0.021). Weight status was not associated with dairy product intake in either sex.Originality/valueThis is the first study that quantifies dairy product consumption in Kuwaiti children and provides insight into sex-specific trends in dairy product selection. The findings of this study may help in investigating relationships between dairy product consumption in children and disease risk factors, and are important for the development of local dietary guidelines for children.

Development of a dietary screening questionnaire to predict excessive weight gain in pregnancy.

Excessive gestational weight gain (GWG) is a risk factor for several adverse pregnancy outcomes, including macrosomia. Diet is one of the few modifiable risk factors identified. However, most dietary assessment methods are impractical for use in maternal care. This study evaluated whether a short dietary screening questionnaire could be used as a predictor of excessive GWG in a cohort of Icelandic women. The dietary data were collected in gestational weeks 11–14, using a 40‐item food frequency screening questionnaire. The dietary data were transformed into 13 predefined dietary risk factors for an inadequate diet. Stepwise backward elimination was used to identify a reduced set of factors that best predicted excessive GWG. This set of variables was then used to calculate a combined dietary risk score (range 0–5). Information regarding outcomes, GWG (n = 1,326) and birth weight (n = 1,651), was extracted from maternal hospital records. In total, 36% had excessive GWG (Icelandic criteria), and 5% of infants were macrosomic (≥4,500 g). A high dietary risk score (characterized by a nonvaried diet, nonadequate frequency of consumption of fruits/vegetables, dairy, and whole grain intake, and excessive intake of sugar/artificially sweetened beverages and dairy) was associated with a higher risk of excessive GWG. Women with a high (≥4) versus low (≤2) risk score had higher risk of excessive GWG (relative risk = 1.23, 95% confidence interval, CI [1.002, 1.50]) and higher odds of delivering a macrosomic offspring (odds ratio = 2.20, 95% CI [1.14, 4.25]). The results indicate that asking simple questions about women's dietary intake early in pregnancy could identify women who should be prioritized for further dietary counselling and support.

Abstract C48: Colorectal cancer among African-Americans: Examining the relationship between dietary habits, physical activity, and colorectal cancer screening to reduce cancer risk and health disparities

Abstract Colorectal cancer (CRC) is the second leading cancer killer in the United States affecting both men and women. It is found that African-American men and women have the highest rates of CRC as well as suffer the highest rates of mortality from CRC than any other racial or ethnic group. Research shows that unhealthy dietary habits such as a diet low in fruits and vegetables, a low-fiber and high-fat diet all contribute to an increased risk of CRC. Low levels of physical activity and being overweight or obese also contribute to an increased risk of developing CRC, and the African-American community has the highest rates of obesity (48.1%) compared to other racial and ethnic groups. CRC can be prevented through lifestyle behaviors, such as diet, physical activity, smoking, weight, and appropriate CRC screening. A majority of the literature does not specifically focus on examining how these lifestyle behaviors influence CRC screening within the African-American community. In the past few years, diabetes has emerged as a potential link with CRC. Obesity is a risk factor for comorbidities such as diabetes and hypertension and CRC. The aim of this study is to examine the relationship between dietary habits, physical activity, comorbidities, and CRC screening in the African-American community. Methods: This study is a secondary data analysis of a longitudinal study, assessing a family health history intervention on the prevention of cancer and chronic diseases. A total of 164 participants were recruited from barbershops/salons, located in low-income urban neighborhoods in the Washington, D.C. metropolitan area. Baseline survey measures include participants' demographics, CRC screening status, family history of cancer, body mass index (BMI), diagnosed chronic diseases, dietary habits, levels of physical activity, and stress, among others. Diet was assessed at baseline with use of PrimeScreen inventory, a short dietary assessment questionnaire, the results of which compare well with extended food frequency questionnaires and biomarkers. PrimeScreen assessed self-reported intake of various foods, specifically fruits, vegetables, whole grains, fish, and red meat as well as other foods with saturated and trans fats. The survey also included the number of meals prepared away from the home and meals from fast-food establishments. Body mass index was calculated with participant self-reported height and weight. According to the Centers for Disease Control, an overweight BMI is 25-29.99 and obese BMI is ≥30. Physical activity was measured through self-reported activity level, opportunities to engage in activity, and the number of days the participant was physically active in the past 7 days. Results: Preliminary analysis shows participants were primarily African-American (89%), female (54%), and aged ≥50 (53%). According to BMI, 52% were obese and 30% were overweight. Only 18% of participants were familiar with “MyPlate.” Participants unaware of “MyPlate” reported greater unhealthy dietary habits (p=.007). In regards to comorbidities, participants were diagnosed with high blood pressure (44.5%) and diabetes (15.2%). Only 29.9% of participants had an up-to-date CRC screening at baseline. Multivariate analysis will be presented to identify predictors of CRC screening, comorbidities, BMI, physical activity, and dietary habits. Conclusion: A better understanding of the role that diet, physical activity, and comorbidities play among African-Americans is integral to promote healthy dietary habits to reduce obesity and cancer risk. This information can be used to inform public health interventions that specifically target dietary habits and physical activity to reduce cancer risk and ultimately reduce cancer health disparities. Citation Format: Noora S. Kanfash, Mary A. Garza, Luciana Assini-Meytin. Colorectal cancer among African-Americans: Examining the relationship between dietary habits, physical activity, and colorectal cancer screening to reduce cancer risk and health disparities [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C48.

Usefulness of a Short Dietary Propensity Questionnaire in Japan.

Aim: There is a growing need for nutritional education for prevention and non-pharmacological treatment of risk factors for cardiovascular diseases (CVD). We compared the results of a short dietary propensity questionnaire (SDPQ) with those from the food frequency and quantity survey (FF Quantity), which had been previously quantitatively assessed by comparison with the 24-hr dietary recall (24hr-DR), to examine the usefulness of the SDPQ. The SDPQ was designed to assess dietary propensities of 12 food/nutrients relevant to CVD risk factors.Methods: We conducted a dietary survey using the SDPQ on Japanese men and women. After 2–3 weeks, we conducted the FF Quantity survey with the same participants. For each of the 12 food/nutrient categories, the relationships between quintiles of results from the SDPQ and FF Quantity were examined. Results from 79 participants who completed both surveys were used.Results: Spearman's correlation coefficients (r) were significant for all food/nutrient categories. Good correlations were found with alcohol (r = 0.792), starchy foods (r = 0.566), and milk and dairy products (r = 0.687), for which good correlations between the FF Quantity and 24hr-DR had been observed previously. Moderate correlations were found for vegetables (r = 0.386) and high-salt foods (r = 0.505), although the FF Quantity survey poorly correlated with the 24hr-DR.Conclusion: The SDPQ may be useful for assessment of dietary propensities for alcohol, starchy foods, and milk and dairy products in Japan.

Assessment of dietary compliance in celiac children using a standardized dietary interview

Compliance to a gluten free diet (GFD) in celiac disease (CD) is ideally assessed by dietary interviews, albeit time-consuming. Short dietary questionnaires have been developed for adults but not for children. Primary aim was to compare GFD compliance in celiac children, measured by a short dietary questionnaire against a dietary interview. Secondary aims were correlation between both questionnaires and celiac antibodies and identifying variables predicting noncompliance. Between 2012 and 2014, participants in the E-health CoelKids study, completed a short dietary questionnaire and standardized dietary interview together with measurement of anti-tissue transglutaminase antibodies (TG2A). Results of the questionnaires were assigned under similar categories. Factors possibly influencing dietary compliance were recorded. Where appropriate, Pearson's Chi-square test for trend, unpaired t-test, Cohen's kappa and one-way ANOVA were used. 151 of 165 participating patients were studied, 66% were female. Mean age was 11.3 years (2-26, SD 5.4), mean age at CD diagnosis was 4.9 years (1-23, SD 4.0). The short questionnaire and dietary interview correlated poorly, detecting problems in dietary adherence in 14% and 52% of the patients, respectively (Cohen's kappa 0.034). Only the short questionnaire correlated with TG2A (p=0.003). Only older age was associated with noncompliance, the mean age of completely nonadherent, adherent but committing errors, and strictly adherent patients were 15.5, 11.5 and 10.1 years, respectively (p<0.001). Compared to the dietary interview, short dietary questionnaires and TG2A serology failed to detect dietary transgressions in CD children, wherein adolescents were shown to be at highest risk.

Mediterranean diet based intervention in pregnancy to improve maternal and fetal outcomes: Methodological challenges and lessons learned from the multicentre ESTEEM study.

IntroductionEvaluating complex dietary interventions such as Mediterranean diet in pregnancy presents unique methodological challenges. We present the challenges and the lessons learned from a multicentre randomised trial (ESTEEM) on Mediterranean-based dietary intervention in pregnancy.MethodsWe recruited pregnant women who met our predefined inclusion criteria and randomised those with metabolic risk factors to the Mediterranean-based dietary intervention or routine antenatal care. We evaluated the effect of the ESTEEM intervention on composite maternal and fetal outcomes.Challenges and solutionsThe main challenges were encountered in recruiting to ESTEEM, delivering the intervention, engaging clinical staff, assessing adherence and choosing the outcome measures. The large sample size coupled with the slow recruitment rate forced us to extend the recruitment period by 4 months. The limitation in available resources was overcome by opening sites in a step-wise approach. Engaging healthcare providers was promoted by embedding the recruitment and the follow-up activities into current clinical practice, and promoting research skills training. We delivered the intervention early on in the pregnancy to promote the dietary effect on healthy placentation and reduce metabolic risk factors. Participants and their families were actively involved in the dietary intervention to improve adherence through a series of group teaching sessions. A user-friendly short dietary questionnaire was developed and validated to assess adherence to the intervention. The trial composite primary outcome was chosen in consensus based on input from a panel of experts.ConclusionThe ESTEEM experience offers an insight into future pragmatic nutritional studies in pregnancy.Trial registration numberNCT02218931.

Development and Validation of a Semi-Quantitative Food Frequency Questionnaire to Assess Dietary Intake of Turkish School-Aged Children

1. Adequacy of dairy product intake among children in Kuwait using a short dietary assessment questionnaire Dalal Alkazemi, Asma Saleh Nutrition & Food Science CrossRef

Synthetic folic acid intakes and status in children living in Ireland exposed to voluntary fortification

In the context of mandatory and voluntary folic acid fortification, the exposure of children to folic acid has been a focus of concern, particularly regarding the possibility of whether any potentially adverse effects will emerge in the future. We explored concentrations of fasting unmetabolized folic acid (UFA) in the circulation of children living in Ireland who were exposed to the voluntary folic acid-fortification regimen in place in Ireland. Healthy children who were attending Our Lady's Children's Hospital, Crumlin, for routine minor surgery were recruited to provide a fasting 3-mL blood sample that was taken while a general anesthetic was administered. The samples were analyzed for plasma folate, red blood cell folate, and UFA concentrations. A short dietary questionnaire that captured recent and habitual intakes of folic acid, both as supplements and as fortified foods, was completed face to face with parents. We collected fasting samples (n = 68) and completed questionnaires that captured recent and habitual daily folic acid intakes of children grouped as follows: 0-5 y of age: 6 girls and 21 boys (27 children total); 6-10 y of age: 10 girls and 10 boys (20 children total); and 11-16 y of age: 10 girls and 11 boys (21 children total). UFA was detected in 10.3% of the samples tested (range: 0.5-1.3 nmol/L). Mean plasma folate and red blood cell folate concentrations were 35.1 nmol/L (range: 21-47 nmol/L) and 956 nmol/L (range: 305-2319 nmol/L), respectively. Mean daily intake of folic acid from fortified foods and supplements was 109 μg (range: 0-767 μg). We showed that there was UFA in the plasma of just >10% of the children sampled after an overnight fast. These findings should be considered by policy makers who are responsible for folic acid fortification. This trial was registered at www.isrctn.com as ISRCTN90038765.

Dietary intake assessment in women with different weight and pregnancy status using a short questionnaire.

First, to evaluate the ability of a short dietary questionnaire (SDQ) to estimate energy intake (EI) on group and individual levels compared with total energy expenditure (TEE) measured by the doubly labelled water method. Second, to compare the SDQ's performance in estimating energy, nutrient and food intakes with a sixty-six-item FFQ used in large-scale Swedish epidemiological research. Cross-sectional. Umeå, Sweden. In total, sixty-five non-pregnant women, of whom thirty-one were overweight or obese, and twenty-five pregnant, normal-weight women completed the protocol. On average, the SDQ captured 78 % and 79 % of absolute TEE in the non-pregnant and pregnant normal-weight women, respectively. Furthermore, the SDQ captured an average of 57 % of TEE in the overweight/obese non-pregnant women. The Spearman correlation of EI and TEE was significant in the overweight and obese women only (ρ = 0·37, 95 % CI 0·02, 0·64). There was no significant difference between the SDQ and the more extensive FFQ in the ability to assess EI when compared with TEE. Intakes of most nutrients and foods were significantly higher when assessed with the SDQ compared with the FFQ. A new short dietary questionnaire with an alternative design underestimated EI of non-pregnant and pregnant, overweight and obese women on a group level but was able to rank the overweight/obese women according to EI. Furthermore, the short questionnaire captured as much or more of the energy, nutrient and food intakes of non-pregnant normal-weight and overweight/obese women on the group level as a traditional, more extensive FFQ.

Validity and test–retest reliability of a short dietary questionnaire to assess intake of saturated fat and free sugars: a preliminary study

The present study aimed to conduct a preliminary investigation of the validity and reliability of a short dietary questionnaire designed to assess dietary intake of saturated fat and free sugars. Forty students at Macquarie University, aged 17-46years, completed the Dietary Fat and free Sugar-Short Questionnaire (DFS), a full-length food frequency questionnaire (C-FFQ) and a 4-day diet diary (DD). After a mean (SD) follow-up time of 158 (10)days, 29 participants completed a second administration of the DFS. Correlation coefficients comparing DFS scores with the percentage energy from saturated fat and free sugar assessed by the C-FFQ and DD ranged from 0.35 to 0.71. The intraclass correlation (0.83) was high, indicating good reliability. These results suggest that the DFS is a valid and reliable measure of saturated fat and free sugar intake. Because it is quick to administer and score, in the public domain, and easy to interpret, it maybe useful as a screener, simple self-check tool or for large-scale epidemiological studies.

Performance of a short dietary questionnaire to assess nutrient intake using regression-based weights

To evaluate the performance of a short dietary questionnaire, using weights to estimate nutrient intake. Using dietary data collected in 1993-1995 from a large cohort of French women, stepwise regression analysis was used to identify the food groups that best predicted nutrient intakes, resulting in a short list of twenty-three foods. This list was used to design a twenty-three-item dietary questionnaire. Nutrient intake was estimated from the answers to the twenty-three questions, applying weights to each response. Weights were calculated from the large database as regression coefficients of the nutrient intake against the twenty-three food groups. In 2005-2006, 103 women responded (at a 1-year interval) to both the short questionnaire and a previously validated dietary history questionnaire. Intakes of twenty nutrients and energy estimated from these two questionnaires were compared. French adult female population. For developing the instrument, 73 034 women aged 41-72 years; for testing, 103 women aged 55-80 years in 2005. Mean nutrient intakes generally differed by less than 10 % between the two methods. Correlation coefficients of nutrient intakes ranged from 0.23 for vitamin D to >0.65 for Mg, vitamin B3 and alcohol. For most nutrients, at least 70 % of subjects fell into the same or an adjacent quintile when classified by either of the two questionnaires. In light of both its strengths and limitations, this short questionnaire could be used in French adult women to obtain some general nutritional information, notably for adjustment purposes when response to an extensive questionnaire cannot be obtained.