Silvia Bel-Serrat1, Theodora Mouratidou1, Valeria Pala2, Inge Huybrechts3, Claudia Börnhorst4, Juan Miguel Fernández-Alvira1, Charalampos Hadjigeorgiou5, Gabriele Eiben6, Antje Hebestreit4, Lauren Lissner6, Dénes Molnár7, Alfonso Siani8, Toomas Veidebaum9, Vittorio Krogh2, Luis A Moreno1. 1. 1 Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, Corona de Aragón 42, 2nd floor, 50009 Zaragoza, Spain. 2. 2 Department of Preventive and Predictive Medicine, Nutritional Epidemiology Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy. 3. 3 Department of Public Health, Ghent University, Ghent, Belgium. 4. 4 BIPS - Institute for Epidemiology and Prevention Research, University of Bremen, Bremen, Germany. 5. 5 Research and Education Institute for Child Health, Strovolos, Cyprus. 6. 6 Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden. 7. 7 Department of Pediatrics, Medical Faculty, University of Pécs, Pécs, Hungary. 8. 8 Unit of Epidemiology and Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy. 9. 9 National Institute for Health Development, Center of Health and Behavioral Science, Tallinn, Estonia.
Abstract
OBJECTIVE: To compare, specifically by age group, proxy-reported food group estimates obtained from the food frequency section of the Children's Eating Habits questionnaire (CEHQ-FFQ) against the estimates of two non-consecutive 24 h dietary recalls (24-HDR). DESIGN: Estimates of food group intakes assessed via the forty-three-food-group CEHQ-FFQ were compared with those obtained by a computerized 24-HDR. Agreement on frequencies of intakes (equal to the number of portions per recall period) between the two instruments was examined using crude and de-attenuated Pearson's correlation coefficients, cross-classification analyses, weighted kappa statistics (κ w) and Bland-Altman analysis. SETTING: Kindergartens/schools from eight European countries participating in the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) Study cross-sectional survey (2007-2008). SUBJECTS: Children aged 2-9 years (n 2508, 50·4% boys). RESULTS: The CEHQ-FFQ provided higher intake estimates for most of the food groups than the 24-HDR. De-attenuated Pearson correlation coefficients ranged from 0·01 (sweetened fruit) to 0·48 (sweetened milk) in children aged 2-<6 years (mean = 0·25) and from 0·01 (milled cereal) to 0·44 (water) in children aged 6-9 years (mean = 0·23). An average of 32% and 31% of food group intakes were assigned to the same quartile in younger and older children, respectively, and classification into extreme opposite quartiles was ≤12% for all food groups in both age groups. Mean κ w was 0·20 for 2-<6-year-olds and 0·17 for 6-9-year-olds. CONCLUSIONS: The strength of association estimates assessed by the CEHQ-FFQ and the 24-HDR varied by food group and by age group. Observed level of agreement and CEHQ-FFQ ability to rank children according to intakes of food groups were considered to be low.
OBJECTIVE: To compare, specifically by age group, proxy-reported food group estimates obtained from the food frequency section of the Children's Eating Habits questionnaire (CEHQ-FFQ) against the estimates of two non-consecutive 24 h dietary recalls (24-HDR). DESIGN: Estimates of food group intakes assessed via the forty-three-food-group CEHQ-FFQ were compared with those obtained by a computerized 24-HDR. Agreement on frequencies of intakes (equal to the number of portions per recall period) between the two instruments was examined using crude and de-attenuated Pearson's correlation coefficients, cross-classification analyses, weighted kappa statistics (κ w) and Bland-Altman analysis. SETTING: Kindergartens/schools from eight European countries participating in the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) Study cross-sectional survey (2007-2008). SUBJECTS:Children aged 2-9 years (n 2508, 50·4% boys). RESULTS: The CEHQ-FFQ provided higher intake estimates for most of the food groups than the 24-HDR. De-attenuated Pearson correlation coefficients ranged from 0·01 (sweetened fruit) to 0·48 (sweetened milk) in children aged 2-<6 years (mean = 0·25) and from 0·01 (milled cereal) to 0·44 (water) in children aged 6-9 years (mean = 0·23). An average of 32% and 31% of food group intakes were assigned to the same quartile in younger and older children, respectively, and classification into extreme opposite quartiles was ≤12% for all food groups in both age groups. Mean κ w was 0·20 for 2-<6-year-olds and 0·17 for 6-9-year-olds. CONCLUSIONS: The strength of association estimates assessed by the CEHQ-FFQ and the 24-HDR varied by food group and by age group. Observed level of agreement and CEHQ-FFQ ability to rank children according to intakes of food groups were considered to be low.
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