BackgroundLunch is an important part of a healthy diet, which is essential for the development, growth and academic performance of school-aged children. Currently there is an increasing number of Dutch primary schoolchildren who are transitioning from eating lunch at home to school. There is limited knowledge about the current quality of the lunches consumed by primary schoolchildren in the Netherlands and whether there are any differences between lunches consumed at home or at school. To investigate differences in content and quality of lunches consumed by Dutch primary schoolchildren at home and at school.MethodsCross-sectional study among 363 Dutch primary schoolchildren aged 4–12 years based on the first two years of the 2012–2016 Dutch National Food Consumption Survey. Demographic characteristics were obtained through a questionnaire. Diet was assessed with two non-consecutive 24-h dietary recalls. Quality of lunches was assessed on their nutritional quality whether they fitted the nutritional guidelines. ‘Nonparametric tests were used to examine the content and quality of the lunches between place of consumption and parental educational position.ResultsThe most consumed lunch products among primary schoolchildren were bread, dairy products and sugar-sweetened beverages. Fruit and vegetable consumption was very low. Consumption of milk and other dairy products was higher among children who eat lunch at home than children who eat lunch at school (p < 0.01). Consumption of sugar-sweetened beverages was higher among children who eat lunch at school than children who eat lunch at home (p < 0.01), and at school a higher proportion of the drinks did not fit within the Dutch dietary recommendations (p < 0.01).ConclusionsThe current content of the lunches consumed by Dutch primary schoolchildren leaves room for improvement, especially regarding fruit and vegetables. The statistically significantly higher consumption of sugar-sweetened beverages and lower consumption of milk and dairy products at school vs. home is worrisome, as currently more children in the Netherlands are transitioning to having lunch at school.
BACKGROUND In the Dutch national food consumption surveys, dietary intake has been assessed since 2003 through 24-h dietary recalls using the GloboDiet software. A new self-administered smartphone food record application called DitEetIk! was developed for potential use in future surveys. OBJECTIVE This study aimed to evaluate the data collected with the DitEetIk!-app and its relative validity of food group, energy, and nutrient intake as compared to GloboDiet 24-h dietary recalls. METHODS 300 men and women aged 18–79 y were recruited from a consumer panel. Participants were asked to keep a record of their consumptions using the DitEetIk!-app on three non-consecutive days. Trained dietitians conducted a 24-h dietary recall interview by telephone using GloboDiet software and recalled one of three DitEetIk! recording days. The nutrient intake was calculated with NEVO version 2021/7.0. Participants with implausible records, defined as days with energy intake less than 0.6 BMR or more than 3.0 BMR, were excluded from the analyses. For 19 food groups and 29 nutrients, differences in median intakes were assessed using the Wilcoxon signed-rank test and Spearman rank correlation coefficients were calculated. Bland–Altman plots with mean differences and 95% limits of agreement were made for energy intake and the contribution to energy intake from fat, carbohydrates, and protein. RESULTS A total of 227 participants completed a combination of an app recording day and a 24-h dietary recall interview referring to the same day. Of this group, 211 participants, 104 men and 107 women, had a plausible recording day. Of all recorded foods, 13% were scanned and 19% text searched at the brand level. For 5 of the 16 food groups, the median intake assessed with the app was >10% lower than the median intake assessed with 24-h dietary recall (P<.05). This was also the case for 4 of the 29 nutrients (P<.05). For mean intakes differences were generally smaller. For energy intake, the mean difference and 95% limits of agreement was 14 (-1096 - 1124) kcal. Compared to expected energy intake, at group level, the mean percentage of underreporting with the app was 19.8% versus 20.1% with the 24-h dietary recall. Spearman correlation coefficients between intakes assessed with the DitEetIk!-app and the 24-h dietary recall ranged from 0.48 to 0.88 (median 0.78) for food groups and from 0.58 to 0.90 (median 0.72) for nutrients. CONCLUSIONS Compared to GloboDiet 24-h dietary recalls, the DitEetIk!-app assessed similar mean levels of energy intake, but somewhat lower median levels of intake for several food groups and nutrients. It is recommended to add functionalities to the app that stimulate a more complete food recording before applying it in the national food consumption surveys. In addition, more detailed information about consumed foods can be derived by encouraging the use of barcode scanning.
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