Feeding is a source of interaction and communication. It affects children's physical and psychological/emotional development. The present study aims to examine the association between caregiver and child characteristics and caregivers' feeding practices among preschools in Addis Ababa. We conducted a cross-sectional study among 542 caregivers of children aged between 3 and 6 years old in selected preschools. We used the Child Feeding Questionnaire (CFQ) to measure caregivers' feeding practices. Multiple linear regression was used for analysis. Caregivers who had higher levels of perceived feeding responsibility (β 0⋅20, P < 0⋅001), who were more concerned about their child being overweight (β 0⋅11, P < 0⋅001) and who had more depressive symptoms (β 0⋅23, P 0⋅05) were associated with food restriction practice. Caregivers who were less concerned about their child being overweight (β −0⋅10, P < 0⋅001) and who had higher levels of perceived feeding responsibility (β 0⋅25, P < 0⋅001) were associated with pressure to eat practice. Caregivers who had higher education (β 0⋅29, P < 0⋅05), who had higher levels of perceived feeding responsibility (β 0⋅47, P < 0⋅001), who were more concerned about their child being overweight (β 0⋅15, P < 0⋅001) and who were less concerned about their child underweight (β −0⋅06, P < 0⋅05) were associated with monitoring feeding practice. In addition, as the children have gotten older (β 0⋅08, P < 0⋅05), there is increased use of monitoring feeding practice. This study is one of few studies that show the association between caregiver and child characteristics and feeding practices in developing countries such as Ethiopia. It is essential to include responsive feeding components in national nutritional programmes to improve preschool children's nutritional status in Ethiopia.
We developed a culturally-specific Food Frequency Questionnaire (FFQ) to the Ethiopian context and evaluate its validity in comparison to two 24-h dietary recalls (24-HRs) of food and nutrient intake. To evaluate the validity of a culturally-specific FFQ against two 24-HRs, we used a paired t-test, Wilcoxon-signed-rank test, Correlation coefficients, cross-classification, κ and Bland-Altman analysis. The FFQ was obtained 15 d after the second 24-HR was completed. A total of 105 adults, of which 43 (41 %) were men and 62 (59 %) women, aged 20–65 years participated in this present study. Mean energy and macronutrient intake obtained from the FFQ were significantly higher than those obtained from the mean of two 24-HRs. For energy and nutrient intakes, the crude correlation ranged from 0⋅05 (total fat) to 0⋅49 (vitamin B1). The de-attenuated correlation ranged from to 0⋅10 (total fat) to 0⋅80 (vitamin A). For the majority of food groups, no significant difference was observed in the median intake of food and nutrients. Crude correlation for food groups ranged from 0⋅12 (egg) to 0⋅78 (legumes). The de-attenuated correlation ranged from 0⋅24 (egg) to 1⋅00 (meat/poultry/fish and dairy). The FFQ is valid to assess and rank individuals in terms of intake of most food groups according to high and low intake categories.
Background: To date, there is no culture-specific and validated Food Frequency Questionnaire (FFQ) available in Ethiopia. We developed a FFQ and evaluated its validity as compared to estimates of a food group and nutrient intakes derived from two 24-Hour Dietary Recalls (24-HRs).Method: A total of 105 adults, of which 43 (41%) were men and 62 (59%) women aged 20-65 years participated in this study. To evaluate the validity of FFQ against two 24-HRs, we used a paired t-test and Wilcoxon- signed rank test to compare mean and median daily nutrient and food intakes obtained from the averages of the two 24-HRs and the FFQ, correlation coefficients to measure the strength and direction of the correlation, Cross-classification and kappa to assess classification agreement and Bland-Altman analysis for assessing limits of agreement between the two methods.Results: Mean energy and macronutrient intakes obtained from the FFQ were significantly higher than those obtained from the mean of two 24-HRs. For energy and macronutrients, the crude correlation between two instruments ranged from 0.05 (total fat) to 0.32 (carbohydrate). Whereas, for micronutrients, it ranged from 0.1 (calcium) to 0.49 (vitamin B1). The de-attenuated correlation ranged from to 0.10 (total fat) to 0.80 (vitamin A) Visual inspection of the Bland-Altman plots for both energy and macronutrients shows no consistent trend across the intake values. For the majority of the food groups, no significant difference was observed in median intake of foods and nutrients between 24-HRs and FFQ. Crude correlation for food groups ranged from 0.12 (egg) to 0.78 (legumes). The de-attenuated correlation ranged from 0.24 (egg) to 0.10 (Meat/Poultry/Fish). The FFQ showed a fair classification agreement with the 24-HRs for cereals, legumes, and roots and tubers intakes. A systematic trend of overestimation for roots and tubers and under estimation of beverage intakes at higher values was observed when we used FFQ.Conclusion: The FFQ is valid to assess and rank individuals in terms of intakes of most food groups according to high and low intake categories. Individual level validity was acceptable for energy and most nutrients as indicated by de-attenuated correlation coefficients and Bland-Altman plots. However, group level validity was poor for most nutrients.
Eating behaviours have been associated both with being underweight or overweight and poor growth. The Children's Eating Behaviour Questionnaire (CEBQ) is a widely used measure of child eating behaviours. The instrument is, however, mostly validated in high-income countries, with a scarcity of evidence among developing countries such as Ethiopia. The present study aims to assess the cultural adaptability and validity of the CEBQ to be used in Ethiopia. We conducted a school-based cross-sectional study among 542 caregivers of children aged 3–6 years in selected preschools. Tests of factorial validity, convergent validity and reliability were performed. The Confirmatory Factor Analysis model indicated that eight subscales provided the best fit (root-mean-square error of approximation = 0⋅05 (90 % CI 0⋅045, 0⋅055); Comparative Fit Index = 0⋅92 and Tucker–Lewis Index = 0⋅90) after seven items from the original CEBQ were removed. Convergent validity with child's weight status was found for emotional overeating, food fussiness, satiety responsiveness and slowness in eating subscales. Reliability, measured using Cronbach's α, provided values between 0⋅50 and 0⋅79. The eight-factor structure of the CEBQ showed adequate content validity and provided factorial, discriminant and convergent validity among preschool children. Further replication of the study among low-income countries is essential to improve the literature on children's eating behaviours.
Background: To date, there is no culture-specific and validated Food Frequency Questionnaire (FFQ) available in Ethiopia. We developed a FFQ and evaluated its validity as compared to estimates of a food group and nutrient intakes derived from two 24-Hour Dietary Recalls (24-HRs).Method: The FFQ has a total of 89 food items. A total of 105 adults aged 20–65 years participated in this study. Wilcoxon- signed rank test, Spearman’s correlation, Cross-classification, kappa, and Bland-Altman analysis were used to validate food group intakes and nutrients derived from FFQ against two 24-HRs.Results: Mean energy and macronutrient intakes obtained from the FFQ were significantly higher than those obtained from the mean of two 24-HRs. For energy and macronutrients, the correlation between two instruments ranged from 0.05 (total fat) to 0.32 (carbohydrate). Whereas, for micronutrients it ranged from 0.1 (calcium) to 0.49 (vitamin B1). Visual inspection of the Bland-Altman plots for both energy and macronutrients shows no consistent trend across the intake values. For the majority of the food groups, no significant difference was observed in median intake of foods and nutrients between 24-HRs and FFQ. Correlation coefficients for food groups ranged from 0.12 (egg) to 0.78 (legumes). The FFQ showed a fair classification agreement with the 24-HRs for cereals, legumes, and roots and tubers intakes. A systematic trend of overestimation for roots and tubers and under estimation of beverage intakes at higher values was observed when we used FFQ.Conclusion: The FFQ is valid to assess and rank individuals in terms of intakes of most food groups according to high and low intake categories. However, estimates of roots and tuber and beverages should be interpreted with caution.
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