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Validation of a Self-reported Food Frequency for Overweight and Obese Children, Using Parental 3-Day Food Records

The 4yourfamily Study

Varagiannis, Panagiotis MSc; Magriplis, Emmanuella PhD; Risvas, Grigoris PhD; Vamvouka, Katerina MSc; Nisianaki, Adamantia BSc; Papageorgiou, Anna PhD; Pervanidou, Panagiota MD, PhD; Chrousos, Georgios MD, PhD; Zampelas, Antonis PhD

doi: 10.1097/NT.0000000000000352
Nutrition Science
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Background Many studies derive dietary information from child self-reported Food Frequency Questionnaires (FFQs). This may be subjected to misreporting, especially among overweight and obese children.

Aim The aim of this study was to examine the validity of data acquired from child-reported dietary intake using a semiquantitative FFQ developed for assessing dietary habits of overweight and obese children in Greece, using parental 3-day food records of child intakes.

Methods Validation analysis was based on 106 (from total 115) children (41% boys and 59% girls). Children were asked to report the frequency of their dietary intake, using the FFQ provided. Parents were asked to keep a 3-day food record for their children’s intake. Correlations and significance between methods were assessed via Spearman correlation coefficient and Wilcoxon nonparametric pairwise comparisons, respectively. Agreement between the FFQ and the 3-day record was performed using Bland-Altman method.

Results Significant correlations, ranging from 0.32 to 1 (all P < .05), were observed between food consumption reported in the FFQ and recorded in the 3-day dietary record. High correlation was found for fruits (ρ = 0.988), vegetables (ρ = 0.985), dairy (ρ = 0.702), meat (ρ = 0.958), fish (ρ = 0.841), starchy foods (ρ = 0.793), sweets (ρ = 1), and beverages (ρ = 0.978). Medium correlation was observed only between the consumption of legumes (ρ = 0.329). No significant differences were found between reported FFQ and 3-day dietary record for most food groups and beverages examined. Mean intake agreement was ranged from 90.6% to 98.1% (Bland-Altman).

Conclusions The FFQ used appears to be a valid tool for investigating dietary intake of food among overweight and obese children.

Panagiotis Varagiannis, MSc, is a clinical dietitian/epidemiologist and a PhD candidate at the Department of Food Science and Human Nutrition, Agricultural University of Athens, Greece.

Emmanuella Magriplis, PhD, is clinical dietitian/epidemiologist–research fellow, Department of Food Science and Human Nutrition, Agricultural University of Athens, Greece.

Grigoris Risvas, PhD, is dietitian–research fellow, Department of Food Science and Human Nutrition, Agricultural University of Athens, Greece.

Katerina Vamvouka, MSc, is clinical dietitian/nutritionist, Department of Food Science and Human Nutrition, Agricultural University of Athens, Greece.

Adamantia Nisianaki, BSc, is dietitian, Department of Food Science and Human Nutrition, Agricultural University of Athens, Greece.

Anna Papageorgiou, PhD, is clinical dietitian/nutritionist–research fellow, Department of Food Science and Human Nutrition, Agricultural University of Athens, Greece.

Panagiota Pervanidou MD, PhD, is Associate Professor of Developmental and Behavioral Paediatrics, First Department of Paediatrics, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, Athens.

Georgios Chrousos, MD, PhD, is professor of Pediatrics and Endocrinology Emeritus and former chairman of the Department of Pediatrics at the Athens University Medical School, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, Greece.

Antonis Zampelas, PhD, is professor of Human Nutrition, Department of Food Science and Human Nutrition, Agricultural University of Athens, Greece.

Correspondence: Antonis Zampelas, PhD, Department of Food Science and Human Nutrition, Agricultural University of Athens, 75 Iera Odos str., 11855, Athens, Greece (azampelas@aua.gr).

A.Z., G.H., G.R., and P.V. were responsible for the study design and the supervision of the field study. E.M. and P.V. were responsible for the statistical analysis. K.V., A.P., and A.N. were responsible for the interpretation of the data. P.P. and E.M. corrected manuscript drafts. All authors have read and approved the final manuscript.

Funding for the study was provided by the Coca Cola Foundation.

The authors have no conflicts of interest to disclose.

The study followed the ethical considerations provided by the Ethics Committee of the Department of Food Science and Human Nutrition of Agricultural University of Athens (approval no. 87/06-02-2014).

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