Assessing dietary intake in children and adolescents: Considerations and recommendations for obesity research

Abstract

Dietary intake and food habits are important contributors to the obesity epidemic. They are highly modifiable components of energy balance and are usually targeted in both obesity prevention and treatment programs. However, measurement of total diet creates challenges and can convey a large burden in terms of cost, technical expertise, impact on respondents and time. It is not surprising therefore that comprehensive reports of dietary intake in children are uncommon and, when reported, have limitations. The aim of this paper is to guide researchers and practitioners in selecting the most appropriate dietary assessment method for situations involving children and adolescents. This paper presents a summary of the issues to consider when choosing a method, a description of some of the more commonly used dietary assessment methods for young people and a series of case-studies to illustrate the range of circumstances faced when measuring dietary intake. We recommend that researchers consider the specific components of dietary intake addressed in their research and practice, and whether diet should be reported comprehensively or as targeted components. Other considerations include age, cognitive ability, weight status, physical activity level, respondent burden, and reliability and validity in the context of program goals and research questions. A checklist for selecting the appropriate dietary methodology is provided. This guide aims to facilitate the reporting of dietary intake and food habits in the context of obesity using valid and reliable measures, thus contributing to the evidence-base for nutrition policies and programs relating to obesity.

Reliability and Validity of a Modified MEDFICTS Dietary Fat Screener in South African Schoolchildren Are Determined by Use and Outcome Measures

“…Finally, the BMI-for-age z scores suggested that the children were, on average, heavier than the American reference population, one of the many variables known to be associated with underreporting. [34][35][36][37] Against the backdrop of limited testeretest reliability of the modified MEDFICTS in the group as a whole and specifically among boys the lack of significant correlations between the final score in the modified MEDFICTS and the PFE, PSFE, and cholesterol in the food records was not surprising. Thus, only for girls could a meaningful relative validity be reasonably expected.…”

“…28,35 Dietary assessment is critical yet remains challenging, particularly amongst children, where cognitive factorsspecifically to record, remember, or generalize intake-as well as restricted knowledge of food and food preparation, limited motivation, and attention span are well-documented child-specific respondent factors that can contribute to error. 27,28,37 True inter-and intraindividual variability are also important. In 5-to 17-year-old children the ratio of intra-to intersubject variances in intake was about twice that observed in adults.…”

Relative validity and reproducibility of a parent-administered semi-quantitative FFQ for assessing food intake in Danish children aged 3–9 years

“…Therefore, the measurement errors of FR and FFQ are fairly independent, and we considered the estimated FR to be the best alternative when choosing between different dietary assessment methods (6) . The FR method has other limitations however, for example a likely change of dietary habits (38) . Under optimal research conditions, inclusion of an objective measure (e.g.…”

Methodology for estimating dietary data from the semi-quantitative food frequency questionnaire of the Mexican National Health and Nutrition Survey 2012

“…In this respect, it should be noted that the questionnaire was administered to caretakers in the presence of the children, thus allowing them to complement the information. 30 Another limitation refers to the fact that estimated DI does not include the energy and nutrients consumed from food complements/ supplements, as reported by 8.3 to 16.7% of subjects. Thus, the nutrient intake of this proportion of subjects may be underestimated to a certain degree.…”