Objective: To investigate the reproducibility of food consumption frequencies derived from the food frequency section of the Children's Eating Habits Questionnaire (CEHQ-FFQ) that was developed and used in the IDEFICS (Identification and prevention of dietary-and lifestyle-induced health effects in children and infants) project to assess food habits in 2-to 9-year-old European children. Design and methods: From a subsample of 258 children who participated in the IDEFICS baseline examination, parental questionnaires of the CEHQ were collected twice to assess reproducibility of questionnaire results from 0 to 354 days after the first examination. Weighted Cohen's kappa coefficients (k) and Spearman's correlation coefficients (r) were calculated to assess agreement between the first and second questionnaires for each food item of the CEHQ-FFQ. Stratification was performed for sex, age group, geographical region and length of period between the first and second administrations. Fisher's Z transformation was applied to test correlation coefficients for significant differences between strata. Results: For all food items analysed, weighted Cohen's kappa coefficients (k) and Spearman's correlation coefficients (r) were significant and positive (Po0.001). Reproducibility was lowest for diet soft drinks (k ¼ 0.23, r ¼ 0.32) and highest for sweetened milk (k ¼ 0.68, r ¼ 0.76). Correlation coefficients were comparable to those of previous studies on FFQ reproducibility in children and adults. Stratification did not reveal systematic differences in reproducibility by sex and age group. Spearman's correlation coefficients differed significantly between northern and southern European countries for 10 food items. In nine of them, the lower respective coefficient was still high enough to conclude acceptable reproducibility. As expected, longer time (4128 days) between the first and second administrations resulted in a generally lower, yet still acceptable, reproducibility. Conclusion: Results indicate that the CEHQ-FFQ gives reproducible estimates of the consumption frequency of 43 food items from 14 food groups in European children.
Dietary assessment is strongly affected by misreporting (both under-and over-reporting), which results in measurement error. Knowledge about misreporting is essential to correctly interpret potentially biased associations between diet and health outcomes. In young children, dietary data mainly rely on proxy respondents but little is known about determinants of misreporting here. The present analysis was conducted within the framework of the multi-centre IDEFICS (Identification and prevention of dietary-and lifestyle-induced health effects in children and infants) study and is based on 6101 children aged 2 -9 years with 24 h dietary recall (24-HDR) and complete covariate information. Adapted Goldberg cut-offs were applied to classify the 24-HDR as 'over-report', 'plausible report' or 'under-report'. Backward elimination in the course of multi-level logistic regression analyses was conducted to identify factors significantly related to under-and over-reporting. Next to characteristics of the children and parents, social factors and parental concerns/perceptions concerning their child's weight status were considered. Further selective misreporting was addressed, investigating food group intakes commonly perceived as more or less socially desirable. Proportions of under-, plausible and over-reports were 8·0, 88·6 and 3·4 %, respectively. The risk of under-reporting increased with age (OR 1·19, 95 % CI 1·05, 1·83), BMI z-score of the child (OR 1·23, 95 % CI 1·10, 1·37) and household size (OR 1·12, 95 % CI 1·01, 1·25), and was higher in low/medium income groups (OR 1·45, 95 % CI 1·13, 1·86). Over-reporting was negatively associated with BMI z-scores of the child (OR 0·78, 95 % CI 0·69, 0·88) and higher in girls (OR 1·70, 95 % CI 1·27, 2·28). Further social desirability and parental concerns/perceptions seemed to influence the reporting behaviour. Future studies should involve these determinants of misreporting when investigating diet-disease relationships in children to correct for the differential reporting bias.
Background/purposeThe number of dietary exposure assessment studies focussing on children is very limited. Children are however a vulnerable group due to their higher food consumption level per kg body weight. Therefore, the EXPOCHI project aims [1] to create a relational network of individual food consumption databases in children, covering different geographical areas within Europe, and [2] to use these data to assess the usual intake of lead, chromium, selenium and food colours.MethodsEXPOCHI includes 14 food consumption databases focussed on children (1-14 y old). The data are considered representative at national/regional level: 14 regions covering 13 countries. Since the aim of the study is to perform long-term exposure assessments, only data derived from 24 hr dietary recalls and dietary records recorded on at least two non-consecutive days per individual were included in the dietary exposure assessments. To link consumption data and concentration data of lead, chromium and selenium in a standardised way, categorisation of the food consumption data was based on the food categorisation system described within the SCOOP Task report 3.2.11. For food colours, the food categorisation system specified in the Council Directive 94/36/EC was used.ConclusionThe EXPOCHI project includes a pan-European long-term exposure assessment of lead, chromium, selenium and food colours among children living in 13 different EU countries. However, the different study methods and designs used to collect the data in the different countries necessitate an in-depth description of these different methods and a discussion about the resulting limitations.
Background: Increased preference for fat and sugar may have a role in overweight and obesity development. However, this effect is likely to vary across different food cultures. To date, few studies on this topic have been conducted in children and none have employed an international, multi-centre design. Objective: To document taste preferences for fat and sweet in children from eight European countries and to investigate their association with weight status and dietary habits. Design: A total of 1696 children aged 6-9 years from survey centres in Italy, Estonia, Cyprus, Belgium, Sweden, Germany, Hungary and Spain tasted and subsequently chose between a high-versus a low-fat cracker and a natural versus a sugarsweetened apple juice. Children's consumption frequency of fatty and sweet foods and demographic variables were obtained from parental-reported questionnaires. Weight and height of the children were measured. Results: Fat and sweet taste preferences varied substantially across survey centres. Independent of survey centre, age, sex, parental education and parental BMI, overweight including obesity was positively associated with fat preference and sweet preference. Fat preference associations were stronger in girls. GirlsFbut not boysFwith a combined preference for fat and sweet had an especially high probability of being overweight or obese. Adjusted models with BMI z-score as the dependent variable were consistent with results of the analyses with BMI categories, but with significant results only for fat preference in girls. Frequent consumption of fatty foods was related to fat preference in bivariate analyses; however, adjusting for survey centre attenuated the association. Sweet preference was not related to consumption of sweet foods, either in crude or in adjusted analyses. Conclusions: Fat and sweet taste preferences are related to weight status in European children across regions with varying food cultures.
This study investigated associations between timing
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