A Diet Score Assessing Norwegian Adolescents’ Adherence to Dietary Recommendations—Development and Test-Retest Reproducibility of the Score

Abstract

Assessment of adolescents’ dietary habits is challenging. Reliable instruments to monitor dietary trends are required to promote healthier behaviours in this group. The purpose of this cross-sectional study was to assess adolescents’ adherence to Norwegian dietary recommendations with a diet score and to report results from, and test-retest reliability of, the score. The diet score involved seven food groups and one physical activity indicator, and was applied to answers from a semi-quantitative food frequency questionnaire (FFQ) administered twice. Reproducibility of the score was assessed with Cohen’s Kappa (κ statistics) at an interval of three months. The setting was eight lower-secondary schools in Hordaland County, Norway, and subjects were adolescents (n = 472) aged 14–15 years and their caregivers. Results showed that the proportion of adolescents consistently classified by the diet score was 87.6% (κ = 0.465). For food groups, proportions ranged from 74.0% to 91.6% (κ = 0.249 to κ = 0.573). Less than 40% of the participants were found to adhere to recommendations for frequencies of eating fruits, vegetables, added sugar, and fish. Highest compliance to recommendations was seen for choosing water as beverage and limit the intake of red meat. The score was associated with parental socioeconomic status. The diet score was found to be reproducible at an acceptable level. Health promoting work targeting adolescents should emphasize to increase the intake of recommended foods to approach nutritional guidelines.

The effect of school meals with fatty fish on adolescents’ self-reported symptoms for mental health: FINS-TEENS - a randomized controlled intervention trial

“…As the dietary compliance in the fish group was low compared to the meat group [25], a possible explanation is therefore that a higher consumption of lunch meals with better nutritional composition than their habitual packed lunch was beneficial for the adolescents with emotional problems. As already reported, the participants’ habitual diet was below the recommendations for fish, fruits and vegetables [31], which support this interpretation. In addition, a recent systematic review found evidence for a consistent trend between good quality diet and lower levels of internalizing problems (low mood and anxiety) in children and adolescents, and some evidence for the reverse [8].…”

“…In addition, the FFQ included questions related to physical activity and characteristics, such as age, gender, weight, height and ethnicity. A more detailed description of the FFQ used in the present study is given in Handeland et al [31]. However, as previously shown, there were no changes in the participants’ habitual diet during the intervention period [32].…”

“…In addition, Cole’s age and sex-specific BMI cut-off points for underweight [33] and overweight [34] according to adolescents (14.5 years) were used to define the proportions that where underweight, normal and overweight/obese. At post-intervention the adolescents were instructed to not include the meals/supplements served in the study [31]. In addition, one of the parents/caregivers received an email with a link to an online questionnaire at the same time points, measuring demographic factors, such as education, household income and marital status and the adolescents’ mental health status (SDQ-P).…”

Test-Retest Reliability of a Food Frequency Questionnaire to Assess Seafood Intake Dynamics for High-End Consumers in Coastal Gulf of Mexico Communities

“…Amongst all participants, yearly consumption rate items were slightly more reliable than seasonal consumption rate items with mean weighted kappa coefficient of 0.94 and 0.93, respectively. In other test-retest studies of FFQs examining consumption of fish and shellfish, kappa coefficients range from 0.45 to 0.75 [18][19][20]. is FFQ showed relatively higher kappa coefficients, indicating good reproducibility and reliability.…”

“…Studies with an interval between repeated FFQ administrations less than one month gave higher reliability coefficients than those further apart [21]. Other test-retest studies using a 3-month interval between the two administrations generally had lower kappa values for fish and shellfish consumption (0.45-0.62) suggesting moderate to substantial agreement [18,19]. e reproducibility study on the dietary habits of Polish adolescents and adults used a test-retest interval of 14 days, which is similar to the current study test-retest interval of 21 days.…”