Measuring diet in primary school children aged 8-11 years: validation of the Child and Diet Evaluation Tool (CADET) with an emphasis on fruit and vegetable intake

Abstract

The Child And Diet Evaluation Tool (CADET) diary designed by the Nutritional Epidemiology Group at the University of Leeds is a 24-hour food diary that measures the nutrition intake of children aged 3-7 years old, with a focus on fruit and vegetable consumption. CADET has never been used to measure nutrient intake of children aged 8 to 11 years old. To ensure that these portion sizes reflect actual dietary intake, participants were asked to complete the CADET diary (i.e. the School and Home Food Diary) concurrently with a one day weighed record diary. Total fruit and vegetable intake in grams and other nutrients were extracted to compare the mean intakes from the CADET diary and Weighed Food Dairy using t-tests and Pearson's r correlations. Bland-Altman analysis was also conducted to assess the agreement between these two methods. A total of 67 children with a mean age of 9.3 years old (SD: +/-1.4, 51% girls) participated in the study. Correlations comparing the CADET diary to the weight food diary were high for fruit, vegetables and combined fruit and vegetables (r=0.7). The results from the Bland Altman plots revealed a mean difference of only 54 grams (-88, 152) for combined fruit and vegetables intake. These results suggest the CADET diary is a valuable nutritional epidemiological tool for measuring children's diets from age 3 to 11 years. It is easy to implement in large studies, and only requires a basic level of literacy to complete.

Evaluation of the impact of school gardening interventions on children's knowledge of and attitudes towards fruit and vegetables. A cluster randomised controlled trial

“…The secondary outcomes for the trial were measured using a child questionnaire developed for the study (Christian, Evans, Nykjaer, Hancock, & Cade, 2014b). To help with any difficult words the questionnaire was read out to the children as a class by trained university students, and the children completed the questionnaire individually.…”

“…The School Food Diary was completed by a fieldworker at school for all school time meals, while the children were given the Home Food Diary to take home for their parents to complete. The diaries were the Child and Diet Evaluation Tool (CADET) which has been validated in 8-11 year olds with an emphasis on fruit and vegetable intake (Christian et al, 2014b). Power calculations for the trial based on FV intake, the primary outcome, were previously described, along with additional information Christian et al, 2014a).…”

Mechanisms Linking Interparental Aggression to Child Dental Caries

“…These issues are also applicable to our measure of interparental aggression. Moreover, diary measures of diet [e.g., Christian et al, 2014] are the present state of the art and they are thought to provide more accurate assessments than retrospective measures such as those used herein. This logic likely applies to the measurement of oral hygiene routines and interparental aggression as well.…”

The relations of child adiposity with parent-to-child and parent-to-parent hostility

“…Diary measures of diet (e.g., Christian et al, 2014) are the present state-of-the-art and are thought to provide more accurate assessments than do retrospective measures such as those used in this study. Our dietary assessment might have been further improved by the inclusion of direct measures of stress eating, with such measures reflecting the tendency to eat differently when experiencing stress (Nguyen-Rodriguez et al, 2009).…”