Short Food Frequency Questionnaire Research Articles

960Dietary intakes of patients with first Acute Coronary Syndrome: the MENZACS study

Abstract Background In New Zealand (NZ) approximately 10,000 people experience an acute coronary syndrome (ACS) annually. Little is known about the diets of people who present with first ACS. Methods The Multi-Ethnic NZ study of Acute Coronary Syndromes (MENZACS) is a multi-centre, longitudinal cohort study of patients with first-time ACS. At baseline, patients complete a validated short food frequency questionnaire (FFQ) asking about dietary intakes in the 12 months preceding their event. Participants are followed up for rehospitalisation and mortality. Results Here we present the dietary intakes of the 2,015 participants enrolled into MENZACS. We excluded 90 participants who did not start the FFQ and 42 participants who had extreme energy intakes. For men (n = 1489), the median energy intake was 8637 kJ, and the median percentage of energy from carbohydrate, protein, fat, and saturated fat were 40.3%, 17.9%, 34.7% and 17.8%, respectively. For women (n = 394), the median energy intake was 7499 kJ, and the median percentage of energy from carbohydrate, protein, fat and saturated fat were 40.3%, 18.4%, 35.6%, and 18.0%, respectively. Conclusions Both men and women reported high saturated fat intakes in the year preceding their first ACS. Future work will examine dietary predictors of rehospitalisation and mortality, as well as analyse baseline blood samples for Lipoprotein(a) and lipidomics. Key messages Patients in hospital with first time ACS are able to complete a short food frequency questionnaire, with little missing data.

Dietary Habits and Lifestyle During Coronavirus Pandemic Lockdown: Experience From Lebanon.

This study aimed to examine the impact of quarantine on eating habits and lifestyle behaviors among the Lebanese adult population. A cross-sectional study was conducted using an online questionnaire designed on Google Forms between 3 June and 28 June 2020. The survey questions were adapted from the Short Food Frequency Questionnaire, the International Physical Activity Questionnaire Short Form, and the second version of the Copenhagen Psychosocial Questionnaire. A total of 2,507 adults completed the questionnaire. During the lockdown, 32.8% claimed weight gain, 44.7% did not eat fruits daily, 35.3% did not eat vegetables on daily basis, and 72.9% reported drinking less than eight cups of water per day. Moreover, there was a significant increase in the number of meals consumed per day, consumption of homemade meals, sedentary time, stress, and sleeping disturbances during the pandemic compared to before the pandemic (all p < 0.001). However, there was a significant decrease in physical activity engagement, sleep quality, and energy level during the lockdown compared to before the pandemic (all p < 0.001). The study highlights that the COVID-19 lockdown was associated with unfavorable changes in dietary habits and lifestyle behaviors in Lebanon. Sleep and mental health were also negatively impacted by the pandemic.

Determining Diet Quality through a Short Food Frequency Questionnaire, CKD SFFQ, for Adults with Chronic Kidney Disease

Determining Diet Quality through a Short Food Frequency Questionnaire, CKD SFFQ, for Adults with Chronic Kidney Disease

Development and Comparability of a Short Food-Frequency Questionnaire to Assess Diet in Prostate Cancer Patients: The Role of Androgen Deprivation Therapy in CArdiovascular Disease - A Longitudinal Prostate Cancer Study (RADICAL PC) Substudy.

ABSTRACTBackgroundThere are few concise tools to evaluate dietary habits in men with prostate cancer in Canada.ObjectiveThe aim was to develop a short food-frequency questionnaire (SFFQ) in a cohort of prostate cancer patients.MethodsA total of 130 men with prostate cancer completed the SFFQ and a validated comprehensive food-frequency questionnaire (CFFQ). Both questionnaires were administered at baseline and 6 mo later.ResultsWe found good correlation between the SFFQ and the CFFQ for seafood, dairy, egg, fruits, potatoes, grains, soft drinks, and processed meat (Spearman rank correlation >0.5). Moderate correlation was found for meat, sweets, vegetables, protein, and carbohydrates (Spearman rank correlation: 0.3–0.5). We found a weaker correlation for total fat measured by SFFQ and CFFQ (Spearman rank correlation <0.3). There was adequate reproducibility during the 6-mo follow-up among all food groups and nutrients, with the exception of meat.ConclusionsOur SFFQ can be considered an appropriate tool to be used for measuring the habitual dietary intake of prostate cancer patients. This trial was registered at www.clinicaltrials.gov as NCT03127631.

Early pregnancy plasma fatty acid profiles of women later diagnosed with gestational diabetes

IntroductionFatty acid (FA) concentrations have previously been associated with gestational diabetes mellitus (GDM). However, few studies on GDM have examined FA profiles in early pregnancy or before diagnosis. This study...

Resources in women's social networks for food shopping are more strongly associated with better dietary quality than people: A cross-sectional study

When healthy people are part of an individual's social network, those individuals will have better dietary quality. Little, however, is known about whether social networks for food shopping, including both people and resources (e.g. recipes, weight loss programmes and food advertisements) are associated with dietary quality. The aim of this study was to explore the relationship between social networks for food shopping and dietary quality, and whether this differs for people and resources, among women aged 18–45 years. A total of 129 participants completed a cross-sectional questionnaire including an ego-centric Social Network Exposure tool and short Food Frequency Questionnaire. Associations between dietary quality and type of network member, perceived healthiness and support for healthy shopping choices were explored using linear regression models. Analyses revealed that participants who nominated people in their food shopping social network that eat healthily or support healthy food shopping had better dietary quality (β = 0.16 SD per 1-point change on a 4-point scale, 95%CI -0.06, 0.39; β = 0.20, 95%CI -0.07, 0.46, respectively). Resources in participants' food shopping social networks which promote healthy eating or support healthy shopping were associated with better dietary quality. These associations remained robust after adjustment for confounding variables identified using a directed acyclic graph (β = 0.31 SD per 1-point change on a 4-point scale, 95%CI 0.03, 0.58; β = 0.44, 95%CI 0.09, 0.79 respectively). The results were strengthened when the outcome was multiplied by frequency of contact (β = 0.33, 95%CI 0.05, 0.61; β = 0.47, 95%CI 0.11, 0.83 respectively). This study suggests that resources which promote healthy eating and healthy food shopping have a stronger association with dietary quality than social support from people. Further research is required in a larger sample, including multiple time-points, to confirm these findings.

Development and validation of a short culture-specific food frequency questionnaire for Greek pregnant women and their adherence to the Mediterranean diet

ObjectivesThe aim of this study was to develop and evaluate the validity of a short, culture-specific, semiquantitative food frequency questionnaire (FFQ) for Greek dietary habits and among a population of pregnant women, and to assess the adherence of reported nutritional habits to the Mediterranean diet. MethodsThe validity of the FFQ was assessed by comparing FFQ-derived nutrient intakes against the average of two 24-h dietary recalls of 70 pregnant women. We used appropriate statistical methods to examine the nutrient correlation and level of agreement between the two figures (Pearson or Spearman correlation and Bland–Altman test, respectively). Calculation of the Mediterranean Diet Score was performed to evaluate participants’ adherence to the Mediterranean diet. ResultsStatistically significant positive correlations, of medium strength, were observed for almost all macronutrient groups (ρs ranging from 0.326 to 0.538). Dietary fiber intake was the only nutrient where a weak correlation was identified (ρ = −0.106; P > 0.05). Mean intakes, derived from the FFQ, agreed with results from the 24-h recalls based on Bland–Altman analysis, with the agreement ranging between 94.3% and 98.6% for the macronutrient groups under examination. The calculation of the Mediterranean Diet Score revealed that Greek pregnant women's habits are in accordance with the principles of the Mediterranean diet. ConclusionsThe developed FFQ is a valid tool that could provide reliable nutrient intake assessment in studies monitoring dietary habits of pregnant women, a group where nutritional monitoring is essential but to date remains limited.

Orthorexia Nervosa: Examining Two Self-Report Measures and the Predictors of Orthorexic Symptoms in Elite and Recreational Athletes

ObjectivesOrthorexia nervosa (ON) is characterised by a pathological fixation on healthy eating. Athletes strive for athletic performance through restricted dietary habits which may lead to the presence of ON symptoms. The aim of the present study was to investigate the underlying structures of two self-report measures of ON, assess differences in ON symptoms between elite and recreational athletes, and determine potential predictors of ON symptomatology. MethodsCross-sectional study of 215 elite (n = 59; mean age 26.71 ± 6.83 years) and recreational athletes (n = 156; mean age 36.13 ± 14.33 years) completed the Teruel Orthorexia Scale (TOS), Eating Habits Questionnaire (EHQ), Short Form Food Frequency Questionnaire (SFFFQ), Eating Attitudes Test-26 (EAT-26), and the Hewitt-Flett Multidimensional Perfectionism Scale Short Form (HF-MPS-SF). ResultsFactor analysis revealed two-factor structures for both the TOS and the EHQ. Elite athletes exhibited higher scores for ‘healthy orthorexia’ (HeOr) (P = .016), ‘knowledge of healthy eating’ (P = .038) (EHQ-Knowledge), diet quality score (DQS) (P = .013) and self-orientated perfectionism scores (P = .032) compared to recreational athletes. Multiple linear regression analysis revealed DQS to be a consistent and significant predictor of all ON symptoms (both TOS and EHQ). BMI was negatively associated with HeOr (β = –.21, P < .001). EAT-26 dieting, bulimia and oral subscales predicted ‘orthorexia nervosa’ (OrNe; smallest P = .015) and ‘problems associated with healthy eating’ (EHQ-Problems; smallest P = .012). Other-orientated perfectionism (OOP) was the only perfectionism construct to predict HeOr (β = .23, P < .01), EHQ-Knowledge (β = .34, P < .001), EHQ-Problems (β = .18, P < .01) and EHQ-Total (β = .27, P < .001). ConclusionsFindings suggest TOS is a reliable measure of ON symptomatology in athletes and further refinement of the EHQ is required. Improvements in assessment tools, study methodology and classification of athlete characteristics are required to advance our understanding of ON in athlete populations. Funding SourcesNone.

The Perceived Effectiveness of Cannabidiol on Adult Women With Inflammatory Bowel Disease

ObjectivesTo analyze the perceived effectiveness of cannabidiol in women over 18 years old with Inflammatory Bowel Disease. MethodsThis was a cross-sectional survey. The population included women diagnosed with either Crohn’s Disease or Ulcerative Colitis, who were not currently pregnant or nursing. The main outcome measures were descriptive characteristics, Harvey Bradshaw Index (disease severity), Partial Mayo Score (disease severity), Short Inflammatory Bowel Disease Questionnaire (quality of life), Prime Screen Short Food Frequency Questionnaire, Bristol Stool Scale, CBD use, administration and dosage, reasons for not using CBD, and the effect of legalization on medical use of CBD. Pearson and Spearman’s correlations and Chi Square analyses were performed using SPSS Version 24.0. ResultsSeventy one patients, twenty five of which are current CBD users and forty six of which are past/never users, completed the study. Correlations showed no association between CBD use and disease severity, quality of life (QOL), food intake, or fecal consistency. However, disease severity and quality of life were inversely correlated (past/never users: p = 0.000, r = –0.544; current users: p = 0.042, r = –0.427) and CBD users reported decreases in IBD-related pain and nausea (76% and 64% respectively), and improvement in appetite (60%). ConclusionsThere is no significant relationship between disease severity, QOL, and food intake with CBD use. Results showed that, overall, disease severity and QOL are inversely associated. Although no significant clinical associations were found, this study indicates the need for future research of CBD use on IBD-related symptoms as medical utilization grows in popularity. Funding SourcesSimmons University.

Children’s Willingness to Try New Foods: Associations With Diet Quality and Body Mass Index

Abstract Objectives To examine how children's willingness to try new foods (WTNF) is related to diet quality and body mass index. Methods Participants included children (n = 402), ages 3–5 y, recruited from childcare centers participating in baseline assessment of a randomized controlled trial to evaluate strategies to promote the development of healthy eating behaviors. Children's intake of fruit, vegetables, sweets, and salty snacks was measured through a short food frequency questionnaire administered to parents and a diet quality score (DQS) was generated. Children's height and weight were measured, and body mass index z-scores (BMIz) was calculate using CDC criteria. Children's WTNF was assessed by offering 6 novel and 3 familiar foods during a food tasting activity administered in the childcare center. Poisson regressions were used to examine the association between children's WTNF (dichotomized as high: tried ≥ 3 novel foods vs. low: tried &amp;lt; 3 novel foods) and children's weekly intake of each food group. An ordinal regression was used to examine the association between children's WTNF and DQS. Linear regressions were used to examine the association between children's WTNF and BMIz. All analyses were adjusted for child sex, age, race, and household income, parent BMI was also adjusted in models including child BMI. In all models, standard errors were adjusted for clustering within childcare centers, the unit of randomization. Results Children who demonstrated high WTNF consumed 1.24 (95% CI: 1.11–1.38) times more servings of vegetables per week, and had a 1.53 (95% CI: 1.03–2.26) greater odds of having a higher diet quality score compared to children who demonstrated low WTNF. Children's WTNF was not significantly associated with children's intake of fruits, salty snacks, or sweets, or related to their BMIz. Conclusions Diet quality is compromised by children's lower WTNF. Future studies are needed to investigate strategies that promote children's WTNF such as vegetables, and examine whether the relation between low willingness to try new foods and poor diet quality influences child weight outcomes prospectively across childhood. Funding Sources National Institute of Diabetes and Digestive and Kidney Diseases.

Adherence to Healthy Diet and Risk and Severity of SARS-CoV-2 Infections: A Community Survey Study Within the COVID Symptom Study Application

ObjectivesTo examine the association of adherence to a healthy diet with risk and severity of SARS-CoV-2 infections.MethodsWe included participants from the COVID Symptom Study smartphone application enrolled in March 2020 from the UK and the US who provided information about their sociodemographic characteristics and risk factors for COVID-19 at baseline, and subsequently reported any symptoms they were experiencing over follow-up. We administered a supplementary diet and lifestyle survey between August and September 2020 to ascertain diet quality before the pandemic using a validated 35-item short food frequency questionnaire. We defined incident predicted cases of COVID-19 over follow-up using a validated symptom-based model and a severe case of COVID-19 asa report of hospitalization with requirement of oxygen support. We used Cox models to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) for predicted COVID-19 and severe COVID-19 after adjusting for potential sociodemographic and behavioral confounders.ResultsOver 4,044,344 person-months of follow-up, we recorded 33,360 incident COVID-19 cases. Compared with individuals in the lowest quartile of the diet quality score, high diet quality was associated with a reduced risk of predicted COVID-19 (adjusted HR 0.94, 95% CI 0.91 to 0.97) and reduced risk of severe COVID-19 (adjusted HR 0.80, 95% CI 0.65 to 0.99). We found evidence of significant interactions between diet quality and socioeconomic status on COVID-19 risk, in which the attributable risk proportion of the joint effect due to the interaction was 30% (95% CI 2.8 to 57.2). Among participants with higher levels of socioeconomic deprivation, COVID-19 incidence rate per 1,000 person-months was 7.5% for those with low diet quality (95% CI 7.1 to 7.8) compared with 5.5% for those with a high diet quality (95% CI 5.2 to 5.9).ConclusionsThese findings suggest that adherence to a healthy diet is associated with lower risk of COVID-19 infection and severity. The apparent beneficial association of a high-quality diet may be particularly evident among individuals with a higher levels of socioeconomic deprivation.Funding SourcesZoe Global, UK Government Department of Health and Social Care, Wellcome Trust, Massachusetts Consortium on Pathogen Readiness

P520 ‘Eetscore’ in patients with Inflammatory Bowel Disease: an online tool to assess diet quality and provide personalised dietary advice

Abstract Background Many patients with IBD believe diet affects the course of disease and is at least as important as medication in their IBD treatment. However, easy assessment of patients’ food intake and structured support of a healthy diet are lacking. The Eetscore is an online tool which assesses diet quality and subsequently gives personal dietary advice. We used the Eetscore to assess diet quality of IBD patients, evaluated if diet quality improved over time and studied correlations with quality of life (QoL) and clinical disease activity. Methods A prospective cohort study with adult IBD patients was performed. Participants completed the Eetscore, the short IBDQ and a clinical disease activity questionnaire (P-HBI or P-SCCAI) at baseline and after 1 month. The Eetscore is a validated web-based screening tool to assess diet quality based on 16 food components (e.g. meat, vegetables, fruit and fish). It consists of a short Food Frequency Questionnaire and is scored with the Dutch Healthy Diet 2015-index based on the Dutch dietary guidelines. The score of each component ranges from 0 to 10, resulting in a total score between 0 and 160. Higher scores indicate better adherence to Dutch dietary guidelines. The Eetscore subsequently provides personalised dietary advice based on the assessment. We assessed changes over time using paired samples t-tests or McNemar’s test and correlations using Pearson’s or Spearman’s correlation. Results We included 212 participants. At time of this preliminary analysis, 175 participants (60% female, 49% Crohn’s disease) completed baseline and 1-month assessments. Their median age was 49 years [IQR 32–58], BMI 25 kg/m2 [IQR 22–28] and disease duration 10 years [IQR 4–18]. At baseline, mean Eetscore was 98 ± 19, with highest median scores (≥8.5) on red meat, fat and oils, sweetened beverages, alcohol and salt intake, and lowest median scores (≤5) on nuts, legumes, processed meat and unhealthy choices (Figure 1). Diet quality increased with 5.6 points (95%CI 3.7–7.5) to a mean Eetscore of 103 ± 21 (p&amp;lt;0.001) after 1 month. QoL improved from 53 ± 10 to 55 ± 9 (∆2.0 (95%CI 1.2–2.8); p&amp;lt;0.001). The proportion of participants with clinically quiescent disease was comparable at both time points (71% vs 74%, p=0.29). Diet quality was not correlated with QoL or clinical disease activity. Conclusion This study suggests the Eetscore is a useful tool to monitor and support a healthy diet in IBD patients. Diet quality improved significantly following personalised dietary advice of the Eetscore. Short term results did not indicate a correlation between diet quality and QoL or clinical disease activity.

Dietary Data in the Malmö Offspring Study-Reproducibility, Method Comparison and Validation against Objective Biomarkers.

Irregular dietary intakes impairs estimations from food records. Biomarkers and method combinations can be used to improve estimates. Our aim was to examine reproducibility from two assessment methods, compare them, and validate intakes against objective biomarkers. We used the Malmö Offspring Study (55% women, 18–71 y) with data from a 4-day food record (4DFR) and a short food frequency questionnaire (SFFQ) to compare (1) repeated intakes (n = 180), (2) intakes from 4DFR and SFFQ (n = 1601), and (3) intakes of fatty fish, fruits and vegetables, and citrus with plasma biomarkers (n = 1433) (3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid [CMPF], β-carotene and proline betaine). We also combined 4DFR and SFFQ estimates using principal component analysis (PCA). Moderate correlations were seen between repeated intakes (4DFR median ρ = 0.41, SFFQ median ρ = 0.59) although lower for specific 4DFR-items, especially fatty/lean fish (ρ ≤ 0.08). Between-method correlations (median ρ = 0.33) were higher for intakes of overall food groups compared to specific foods. PCA scores for citrus (proline betaine ρ = 0.53) and fruits and vegetables (β-carotene: ρ = 0.39) showed the highest biomarker correlations, whereas fatty fish intake from the SFFQ per se showed the highest correlation with CMPF (ρ = 0.46). To conclude, the reproducibility of SFFQ data was superior to 4DFR data regarding irregularly consumed foods. Method combination could slightly improve fruit and vegetable estimates, whereas SFFQ data gave most valid fatty fish intake.

Associations between health behaviors and mental health in Australian nursing students

Aim: Nursing students experience high levels of stress, anxiety and depression. This study examined associations between health behaviors and stress, anxiety and depression in Australian nursing students. Design: this was a cross-sectional study. Methods: Participants completed an online survey providing demographic information and responses to the 21-item Depression Anxiety Stress Scale, Fagerström Test for Nicotine Dependence, short Food Frequency Questionnaire, Alcohol Use Disorders Identification Test, International Physical Activity Questionnaire and Workforce Sitting Questionnaire. Associations were evaluated using multivariate linear regression. Results: Mild to extremely severe stress (46.6%), anxiety (52.8%) and depression (42.2%) were prevalent. Intake of snack-foods was associated with higher depression (β = 8.66, p < 0.05) and stress (β = 3.92, p = 0.055) scores. More time spent sitting was associated with higher depression (β = 0.48, p < 0.001) and stress (β = 0.28, p < 0.05) scores. Skipping meals correlated with higher stress, anxiety and depression scores. Conclusion: More support must be provided to nursing students to manage psychological distress and mental health during university study.

Gastrointestinal symptom burden and dietary intake in patients with chronic kidney disease.

Gastrointestinal (GI) symptoms can present a significant burden to patients with chronic kidney disease (CKD) but the reported prevalence is inconsistent. To examine the GI burden and dietary intake in patients with CKD with or without dialysis. This was a cross-sectional study of 216 adults, recruited from outpatient and dialysis clinics, with CKD stage 4 or 5 not receiving dialysis (CKD-ND), or receiving haemodialysis (HD) or peritoneal dialysis (PD). Three questionnaires were administered: the Bristol Stool Form Scale (BSFS); a modified Gastrointestinal Symptom Rating Scale and a short Food Frequency Questionnaire. Outcomes were stool frequency and consistency, GI symptoms and dietary intake. Data were collected from 216 patients (mean age, 63 years [95% CI: 61, 65]; 63% males; CKD-ND: n = 134; HD: n = 67; PD: n = 15). Mean stool frequency for all groups was one bowel action per day (p = .45) and consistency was normal (BSFS type 4, p = .95). Overall GI symptom burden was low but several symptoms occurred at least "most of the time" including "tiredness/lethargy" (54% of participants), "reduced appetite" (29%), "early satiety" (25%) and "change in taste" (15%). Low intakes of fresh fruit, vegetables, whole-grains and legumes were found. No associations were observed between diet and GI symptoms. The overall GI symptom burden was low, but >15% of participants reported several symptoms as occurring most to all of the time. Low intakes of fresh fruit, vegetables, whole-grains and legumes were observed in all CKD patients.

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.

Twenty-Four-Year Trends in Family and Regional Disparities in Fruit, Vegetable and Sugar-Sweetened Beverage Consumption among Adolescents in Belgium.

Dietary habits are influenced by various determinants that may evolve over time. This study aimed to examine, among adolescents in Belgium, trends in the dietary habits between 1990 and 2014 and to determine changes in family and regional disparities related to diet during this time period. In the 1990, 2002 and 2014 cross-sectional “Health Behaviour in School-aged Children” (HBSC) surveys, food consumption was estimated using a short Food Frequency Questionnaire. The Relative Index of Inequality (RII) enabled quantification of the gradients of inequality related to the family structure and to the region for non-daily fruit and vegetable and daily sugar-sweetened beverage (SSB) consumption. Between 1990 and 2014, the prevalence of non-daily fruit consumption increased from 27.7% to 60.6%, whereas the daily SSB consumption decreased from 58.9% to 34.8%. Over time, a downward trend in family disparities (p = 0.007) was observed for daily fruit consumption (RII: 1.58 (1.33–1.88) to 1.18 (1.13–1.23)). An upward trend in region-related disparities (p < 0.001) for SSB was found (RII: 1.15 (1.07–1.23) to 1.37 (1.28–1.47)). The overall trend of increasing disparities when dietary habits improved and decreasing disparities when dietary habits worsened highlights the need to implement actions that improve overall dietary habits while ensuring that disparities do not increase.

Sex differences in dietary consumption and its association with frailty among middle-aged and older Australians: a 10-year longitudinal survey

BackgroundNutritional status has been considered as a key factor in preventing the development of the frailty syndrome. However, sex-specific dietary consumption transition over time and how it impacts of frailty status are unclear.MethodWe assessed 113,039 adults (aged 50 years and over) from the 45 and Up Study who had completed both baseline (2006–2009) and follow-up (2012–2015) surveys. Dietary consumption was assessed by a short food frequency questionnaire. Frailty was identified by the FRAIL scale. Multinomial regression models were used to examine the association between a long-term dietary consumption and frailty, stratified by sex.ResultsOf a total of 113,039 participants, females had a higher percentage of pre-frailty and frailty than males (pre-frailty: 35.5% for female and 30.1% for male; frailty: 4.86% for female and 3.56% for male). As age increased, males had significant decreases in overall dietary risk scores, while females had significant increases in overall dietary risk scores. Males and females with a long-term consumption of adequate fruits, high grains or had a variety of foods were related to a low risk of frailty. Females with a long-term consumption of adequate vegetables or high lean meats and poultry were related to a low risk of frailty. Females with an unhealthy diet at both surveys [Relative Risk Ratio (RRR) = 1.32, 95% CI: 1.18; 1.49], and those with unhealthy diet at either surveys (RRR = 1.28, 95% CI: 1.12; 1.47, RRR = 1.19, 95% CI: 1.04; 1.37) had a higher risk of frailty compared to those had a long-term healthy diet. No association were found between overall dietary risk and frailty for males.ConclusionMales and females changed their dietary consumption as they age. These changes affect its association with frailty, particularly for females. Sex-specific dietary advice in prevention of frailty needs to be further developed.

Reproducibility and validity of food group intake in a short food frequency questionnaire for the middle-aged Japanese population

PurposeThe purpose of this study was to evaluate the reproducibility and validity of a short food frequency questionnaire (FFQ) for food group intake in Japan, the reproducibility and partial validity of which were previously confirmed for nutrients.MethodsA total of 288 middle-aged healthy volunteers from 11 different areas of Japan provided nonconsecutive 3-day weighed dietary records (DRs) at 3-month intervals over four seasons. We evaluated reproducibility based on the first (FFQ1) and second (FFQ2) questionnaires and their validity against the DRs by comparing the intake of 20 food groups. Spearman’s rank correlation coefficients (SRs) were calculated between energy-adjusted intake from the FFQs and that from the DRs.ResultsThe intake of 20 food groups estimated from the two FFQs was mostly equivalent. The median energy-adjusted SRs between the FFQ1 and FFQ2 were 0.61 (range 0.38–0.86) for men and 0.66 (0.45–0.84) for women. For validity, the median de-attenuated SRs between DRs and the FFQ1 were 0.51 (0.17–0.76) for men and 0.47 (0.23–0.77) for women. Compared with the DRs, the proportion of cross-classification into exact plus adjacent quintiles with the FFQ1 ranged from 58 to 86% in men and from 57 to 86% in women. According to the robust Z scores and the Bland–Altman plot graphs, the underestimation errors in the FFQ1 tended to be greater in individuals with high mean levels of consumption for meat for men and for other vegetables for both men and women.ConclusionThe FFQ demonstrated high reproducibility and reasonable validity for food group intake. This questionnaire is short and remains appropriate for identifying associations between diet and health/disease among adults in Japan.

Development of a short food frequency questionnaire to assess diet quality in UK adolescents using the National Diet and Nutrition Survey

BackgroundUK adolescents consume fewer fruits and vegetables and more free sugars than any other age group. Established techniques to understand diet quality can be difficult to use with adolescents because of high participant burden. This study aimed to identify key foods that indicate variation in diet quality in UK adolescents for inclusion in a short food frequency questionnaire (FFQ) and to investigate the associations between adolescent diet quality, nutritional biomarkers and socio-demographic factors.MethodsDietary, demographic and biomarker data from waves 1–8 of the National Diet and Nutrition Survey rolling programme were used (n=2587; aged 11–18 years; 50% boys; n=≤997 biomarker data). Principal component analysis (PCA) was applied to 139 food groups to identify the key patterns within the data. Two diet quality scores, a 139-group and 20-group, were calculated using the PCA coefficients for each food group and multiplying by their standardised reported frequency of consumption and then summing across foods. The foods with the 10 strongest positive and 10 strongest negative coefficients from the PCA results were used for the 20-group score. Scores were standardised to have a zero mean and standard deviation of one.ResultsThe first PCA component explained 3.0% of variance in the dietary data and described a dietary pattern broadly aligned with UK dietary recommendations. A correlation of 0.87 was observed between the 139-group and 20-group scores. Bland-Altman mean difference was 0.00 and 95% limits of agreement were − 0.98 to 0.98 SDs. Correlations, in the expected direction, were seen between each nutritional biomarker and both scores; results attenuated slightly for the 20-group score compared to the 139-group score. Better diet quality was observed among girls, non-white populations and in those from higher socio-economic backgrounds for both scores.ConclusionsThe diet quality score based on 20 food groups showed reasonable agreement with the 139-group score. Both scores were correlated with nutritional biomarkers. A short 20-item FFQ can provide a meaningful and easy-to-implement tool to assess diet quality in large scale observational and intervention studies with adolescents.