Few studies exist on the validity of food frequency questionnaires (FFQs) administered to elderly people. The aim of this study was to assess the validity of a short FFQ on present dietary intake, developed specially for the AGES-Reykjavik Study, which includes 5,764 elderly individuals. Assessing the validity of FFQs is essential before they are used in studies on diet-related disease risk and health outcomes.
128 healthy elderly participants (74 y ± 5.7; 58.6% female) answered the AGES-FFQ, and subsequently filled out a 3-day weighed food record. Validity of the AGES-FFQ was assessed by comparing its answers to the dietary data obtained from the weighed food records, using Spearman's rank correlation, Chi-Square/Kendall's tau, and a Jonckheere-Terpstra test for trend.
For men a correlation = 0.4 was found for potatoes, fresh fruits, oatmeal/muesli, cakes/cookies, candy, dairy products, milk, pure fruit juice, cod liver oil, coffee, tea and sugar in coffee/tea (r = 0.40-0.71). A lower, but acceptable, correlation was also found for raw vegetables (r = 0.33). The highest correlation for women was found for consumption of rye bread, oatmeal/muesli, raw vegetables, candy, dairy products, milk, pure fruit juice, cod liver oil, coffee and tea (r = 0.40-0.61). An acceptable correlation was also found for fish topping/salad, fresh fruit, blood/liver sausage, whole-wheat bread, and sugar in coffee/tea (r = 0.28-0.37). Questions on meat/fish meals, cooked vegetables and soft drinks did not show a significant correlation to the reference method. Pearson Chi-Square and Kendall's tau showed similar results, as did the Jonckheere-Terpstra trend test.
A majority of the questions in the AGES-FFQ had an acceptable correlation and may be used to rank individuals according to their level of intake of several important foods/food groups. The AGES-FFQ on present diet may therefore be used to study the relationship between consumption of several specific foods/food groups and various health-related endpoints gathered in the AGES-Reykjavik Study.
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Knowledge of dietary habits makes the basis for public nutrition policy. The aim of this study was to assess dietary intake of Icelandic six-year-olds.
Subjects were randomly selected six-year-old children (n=162). Dietary intake was assessed by three-day-weighed food records. Food and nutrient intake was compared with the Icelandic food based dietary guidelines (FBDG) and recommended intake of vitamins and minerals.
Fruit and vegetable intake was on average 275Â±164 g/d, and less than 20% of the subjects consumed =400 g/day. Fish and cod liver oil intake was in line with the FBDG among approximately 25% of subjects. Most subjects (87%) consumed at least two portions of dairy products daily. Food with relatively low nutrient density (cakes, cookies, sugar sweetened drinks, sweets and ice-cream) provided up to 25% of total energy intake. The contribution of saturated fatty acids to total energy intake was 14.1%. Less than 20% of the children consumed dietary fibers in line with recommendations, and for saturated fat and salt only 5% consumed less than the recommended upper limits. Average intake of most vitamins and minerals, apart from vitamin-D, was higher than the recommended intake.
Although the vitamin and mineral density of the diet seems adequate, with the exception of vitamin-D, the contribution of low energy density food to total energy intake is high. Intake of vegetables, fruits, fish and cod liver oil is not in line with public recommendations. Strategies aiming at improving diet of young children are needed.
We examined whether there are sex differences in children's fruit and vegetable (FV) intake and in descriptive norms (i.e. perceived FV intake) related to parents and friends. We also studied whether friends' impact is as important as that of parents on children's FV intake. Data from the PRO GREENS project in Finland were obtained from 424 children at the age 11 years at baseline. At baseline, 2009 children filled in a questionnaire about descriptive norms conceptualised as perceived FV intake of their parents and friends. They also filled in a validated FFQ that assessed their FV intake both at baseline and in the follow-up in 2010. The associations were examined with multi-level regression analyses with multi-group comparisons. Girls reported higher perceived FV intake of friends and higher own fruit intake at baseline, compared with boys, and higher vegetable intake both at baseline and in the follow-up. Perceived FV intake of parents and friends was positively associated with both girls' and boys' FV intake in both study years. The impact of perceived fruit intake of the mother was stronger among boys. The change in children's FV intake was affected only by perceived FV intake of father and friends. No large sex differences in descriptive norms were found, but the impact of friends on children's FV intake can generally be considered as important as that of parents. Future interventions could benefit from taking into account friends' impact as role models on children's FV intake.
This study tested whether socio-economic status (SES) moderated the association between the psychosocial constructs included in the attitude-social influence-self-efficacy (ASE) model and fruit intake in Norwegian schoolchildren. The sample consisted of 962 Norwegian sixth graders, mean age 11.3 years. They were split into three SES groups, and multi-group structural equation modeling (MSEM) was used. Children in the highest SES group reported eating fruit more frequently and reported more positive ASE variables than children in the lower SES groups. This was particularly true for social environmental factors, home availability of fruit and intention to eat fruit. MSEM showed that the relationships specified in the adapted ASE model were moderated by SES, as we did not find support for equal model structure across the three samples. Model modification for each SES group separately showed that the relation between home availability and fruit intake was not significant for the medium and low SES groups, and the relation between self-efficacy and intention to eat fruit was not significant for the medium SES group. Future interventions aiming at increasing fruit intake in children need to be sensitive to such SES-related differences and should in particular affect factors that may impede fruit intake in the lower SES groups.
This study reports the effect of the Fruits and Vegetables Make the Marks intervention, a school-based fruit and vegetable intervention consisting of a home economics classroom component and parental involvement and encouraged participation in the Norwegian School Fruit Programme, all delivered during the school year of 2001-02. Nine randomly chosen schools received the intervention and 10 schools served as control schools. Participating pupils completed questionnaires at baseline (September 2001), at Follow-up 1 (May-June 2002) and at Follow-up 2 (May 2003). A total of 369 pupils (69%; mean age, 11.3 years at baseline) participated in all three surveys. No effect of the intervention was found for intake of fruit and vegetables eaten at school or all day, neither at Follow-up 1 nor at Follow-up 2. On analysing the effects on potential mediators, significant differences between intervention and control groups were found for Awareness of the five-a-day recommendations only. The intervention programme was rated as very good by the teachers, and the pupils reported that they enjoyed it. However, the intervention failed to change fruit and vegetable intake, probably because it did not succeed in changing the pupils' preferences for or the accessibility of fruit and vegetables--the two strongest correlates of children's fruit and vegetable intake.
Little is known about the mediating effects of the determinants of fruit and vegetable (FV) intake in school-based interventions that promote FV intake, and few studies have examined the impact of the degree of implementation on the effects of an intervention. The present study examined whether the degree of implementation of an intervention had an effect on children's fruit or vegetable intake and determined possible mediators of this effect. The study is part of the European PRO GREENS intervention study which aimed to develop effective strategies to promote consumption of fruit and vegetables in schoolchildren across Europe. Data from 727 Finnish children aged 11 years were used. The baseline study was conducted in spring 2009 and the follow-up study 12 months later. The intervention was conducted during the school year 2009-2010. The effects were examined using multilevel mediation analyses. A high degree of implementation of the intervention had an effect on children's fruit intake. Knowledge of recommendations for FV intake and liking mediated the association between a high degree of implementation of the intervention and an increase in the frequency of fruit intake. Knowledge of recommendations for FV intake and bringing fruits to school as a snack mediated the association between a low degree of implementation of the intervention and an increase in the frequency of fruit intake. Overall, the model accounted for 34 % of the variance in the change in fruit intake frequency. Knowledge of recommendations acted as a mediator between the degree of implementation of the intervention and the change in vegetable intake frequency. In conclusion, the degree of implementation had an effect on fruit intake, and thus in future intervention studies the actual degree of implementation of interventions should be assessed when considering the effects of interventions.
OBJECTIVES: To investigate the internal consistency of the scales and the test-retest reliability and predictive validity of behaviour theory-based constructs measuring personal, social and environmental correlates of fruit and vegetable intake in 10-11-year-old children. DESIGN: Test-retest with one-week interval. SETTING: Five European countries: Norway, Spain, Denmark, Portugal, Belgium. SUBJECTS: Three hundred and twenty-six children completed the questionnaire during class hours. RESULTS: For the total sample across all countries, the test-retest reliability was good to very good (intra-class correlation coefficient (ICC) >0.60) for 12 out of the 15 fruit constructs and also for 12 out of the 15 vegetable constructs. Acceptable ICCs, ranging between 0.50 and 0.59, were found for the remaining constructs. Test-retest reliability was comparable across countries. Only in Portugal were some significantly lower ICCs found for some constructs (knowledge and barriers related to fruit, general self-efficacy related to fruit and vegetables) compared with the other countries. Cronbach's alpha values were moderate to high (range 0.52 to 0.89) with the exception of the general self-efficacy scale, which had a value below 0.50 for both fruit (alpha=0.42) and vegetables (alpha=0.49). Spearman correlations with intake ranged between -0.16 and 0.54 for personal determinants and between 0.05 and 0.38 for environmental determinants. Compared with other studies, predictive validity can be considered moderate to good. CONCLUSIONS: The questionnaire provides a reliable, valid and easy-to-administer tool for assessing personal, social and environmental factors of potential influence on fruit and vegetable intake in 10-11-year-olds.
OBJECTIVE: Reproducible and valid methods for measuring fruit and vegetable consumption among young school children are urgently needed. The aim of this study was to test the reproducibility and the validity of a newly developed questionnaire on the intake of fruit and vegetable among Norwegian 6th graders. The questionnaire consisted of a 24-h recall part and a food frequency part. DESIGN: A total of 114 pupils completed the questionnaire two times 14 days apart, and another 85 pupils completed the questionnaire and 7-day food diaries. SUBJECTS: Pupils of 6th grade with a mean age of 11.9 y. RESULTS: Spearman correlation coefficients between the frequency part of the questionnaire administered two times varied from 0.62 for fruit to 0.83 for potato, and no difference was seen between the average intakes from the two 24-h recalls. The 24-h recall part of the questionnaire gave higher estimates for the average intake of fruit and juice compared to the 7-day record, while no difference was observed for vegetable intake. Spearman correlation coefficients between the frequency part and the records varied from 0.21 for fruit and potato to 0.32 for the total intake of fruit and vegetable. CONCLUSION: Both the 24-h recall and the frequency part gave a consistent response on separate occasions over the test-retest study period. The 6th graders were capable of recording yesterday's intake of vegetable, but overestimated the intake of fruit and juice. The ability to rank subjects based on the frequency part was rather low.