A Semi-Quantitative Food Frequency Questionnaire Validated in Hispanic Infants and Toddlers Aged 0 to 24 Months

Abstract

Background There are limited validated FFQs for infants and toddlers, most of which were evaluated in Europe or Oceania and the available ones for use in the US have important limitations. Objective To assess the validity of a food frequency questionnaire (FFQ) developed for infants and toddlers. Design A semi-quantitative FFQ was developed including 52 food items, their source and portion sizes. It enquired about diets over the previous 7 days. Its validity was assessed in a cross-sectional study. Participants completed the FFQ followed by a 24-hour recall on two occasions with one week between data collection. Participants/setting A total of 296 caregivers of infants and toddlers aged 0–24 months enrolled in WIC-Puerto Rico. Main outcome measures Intake of nutrients and food groups were averaged for the two FFQs and the two 24-h food recalls and adjusted for energy intake. Statistical analyses performed Spearman correlations were performed for intakes of energy, nutrients, and foods between administrations and between instruments. Correlation coefficients were de-attenuated to account for variation in the 24 hour recalls. Results A total of 241 participants completed the study. Intake of all nutrients and foods were significantly correlated between FFQs, 24-h recalls and between the average of FFQs and 24-h food recalls. The de-attenuated correlation for nutrients between the FFQs and 24-h recalls ranged from 0.26 (folate) to 0.77 (energy), with an average correlation of 0.53. The de-attenuated correlation for food groups between the FFQs and 24-h recalls ranged from 0.28 (sweets) to 0.80 (breast-milk) with an average correlation of 0.55. When analyses were restricted to those consuming foods other than breast milk or formula (N=186), results were similar. Conclusions This semi-quantitative FFQ is a tool that offers reasonably valid rankings for intake of energy, nutrients, foods and food groups in this sample of infants and toddlers.

Multi-site trial using short mobile messages (SMS) to improve infant weight in low-income minorities: Development, implementation, lessons learned and future applications

“…31 Subsequently, it was validated against 2 non-consecutive 24-hour recalls among 296 participants from WIC Puerto Rico. 32 Reliability was assessed by examining the correlation between responses on the FFQ on the first and second administration performed 2 weeks apart. For the purposes of this study, the pediatrician collaborator in HI, who had experience performing research on chronic disease prevention in underserved populations and worked predominantly with Native Hawaiian populations, reviewed the tool for cultural relevance.…”

Validation of a Complementary Food Frequency Questionnaire to assess infant nutrient intake

“…Although the CFFQ overestimated intake of fat, overall, there was a tendency to underestimate nutrient intake, including for carbohydrate, fibre, folate, potassium, thiamin, riboflavin, niacin, and vitamin C. In contrast, other studies in preschool children have generally shown that FFQs overestimate nutrient intake (Andersen et al, ; Bell, Golley, & Magarey, ; Gondolf et al, ; Livingstone & Robson, ; Marriott et al, ; Marriott et al, ; Palacios et al, ; Watson et al, ). These studies varied in methodology, nutrients assessed, reference methods, and timeframes.…”

“…Milk intake is a major contributor to an infant's energy and nutrient intake, typically accounting for a third or more of nutrient intake in infants less than 12 months of age. Breast milk intake has been handled differently in validation studies in young children (0–24 months): Either included in analysis (using estimates of volume; Andersen et al, ; Marriott et al, ; Marriott et al, ) or excluded from analysis (Gondolf et al, ; Watson et al, ), to our knowledge, only the study by Palacios et al () has compared the validity of FFQs with and without milk intake. Similar to this study, we found poorer agreement between methods when milk intake was excluded, which was not unexpected considering the large contribution of milk to an infant's diet.…”

“…Newly developed or modified tools must be validated to ensure they are measuring what they claim to measure. There are very few FFQs that have been validated for assessment of nutrient intake in infants less than 12 months of age (Andersen, Lande, Arsky, & Trygg, ; Gondolf, Tetens, Hills, Michaelsen, & Trolle, ; Marriott et al, ; Marriott et al, ; Palacios et al, ) and none specific to NZ infants. Therefore, the purpose of this study was to determine the relative validity and reproducibility of a Complementary Food Frequency Questionnaire (CFFQ) to assess nutrient intake in NZ infants aged 9–12 months.…”

Development of a Diet Quality Score for Infants and Toddlers and its Association with Weight

“…This FFQ includes 52 items with portion sizes and has been previously validated in a similar population 17 . A picture guide was created to aid caregivers estimate portion sizes of fruits, vegetables, milk, cereals, cookies, salted snacks, protein foods and beverages.…”