Reproducibility of food consumption frequencies derived from the Children's Eating Habits Questionnaire used in the IDEFICS study

Abstract

Objective: To investigate the reproducibility of food consumption frequencies derived from the food frequency section of the Children's Eating Habits Questionnaire (CEHQ-FFQ) that was developed and used in the IDEFICS (Identification and prevention of dietary-and lifestyle-induced health effects in children and infants) project to assess food habits in 2-to 9-year-old European children. Design and methods: From a subsample of 258 children who participated in the IDEFICS baseline examination, parental questionnaires of the CEHQ were collected twice to assess reproducibility of questionnaire results from 0 to 354 days after the first examination. Weighted Cohen's kappa coefficients (k) and Spearman's correlation coefficients (r) were calculated to assess agreement between the first and second questionnaires for each food item of the CEHQ-FFQ. Stratification was performed for sex, age group, geographical region and length of period between the first and second administrations. Fisher's Z transformation was applied to test correlation coefficients for significant differences between strata. Results: For all food items analysed, weighted Cohen's kappa coefficients (k) and Spearman's correlation coefficients (r) were significant and positive (Po0.001). Reproducibility was lowest for diet soft drinks (k ¼ 0.23, r ¼ 0.32) and highest for sweetened milk (k ¼ 0.68, r ¼ 0.76). Correlation coefficients were comparable to those of previous studies on FFQ reproducibility in children and adults. Stratification did not reveal systematic differences in reproducibility by sex and age group. Spearman's correlation coefficients differed significantly between northern and southern European countries for 10 food items. In nine of them, the lower respective coefficient was still high enough to conclude acceptable reproducibility. As expected, longer time (4128 days) between the first and second administrations resulted in a generally lower, yet still acceptable, reproducibility. Conclusion: Results indicate that the CEHQ-FFQ gives reproducible estimates of the consumption frequency of 43 food items from 14 food groups in European children.

Evaluation of tools used to measure calcium and/or dairy consumption in children and adolescents

“…For two tools there were two articles reporting on each (12)(13)(14)(15) , and another article reported on two other tools (16) . Only two of the tools assessed dairy intake, ten assessed Ca intake and five assessed both.…”

“…The more comprehensive results of the study by Veerecken and Maes assessing four dairy items in two age groups demonstrated only moderate repeatability for most of the items with the younger age group tending to perform better than the older group (22) . Similarly, the five dairy items in the Child Eating Habits Questionnaire assessed by Lanfer et al also showed moderate repeatability (15) . Huybrechts et al reported a weighted k value of 0?60 representing only 'good' agreement for their tool but a high correlation (0?80), a non-significant mean difference of only 24 mg, and 57 % correctly classified and no gross misclassification (25) .…”

“…The statistical analyses varied with correlation (Pearson, Spearman or intra-class) being the most frequently used test and six studies reporting mean values for each administration, with only Lanfer et al (15) not reporting standard deviations or conducting t-test analysis. Three studies reported k values (15,22,25) and two of these studies also reported classification agreement (22,25) . The tools were mostly used in children aged 10 years and older, with eight of the studies having a sample size over 100 and the other two less than fifty.…”

Maternal employment and childhood obesity – A European perspective

“…Because there is no corresponding index for European children nor common European guidelines on which to base one, the YHEI, although based on U.S. dietary guidelines, is the best available instrument for generating comparable data among the eight survey countries and drawing conclusions on the relative healthiness of a diet. This index, which measures food consumption and food-related behavioural patterns, is based on food consumption frequencies, which are collected in the IDEFICS survey using the Children's Eating Habits Questionnaire (CEHQ) (Lanfer et al, 2011 Table 1 about here…”

Five-minutes-to-twelve for implementation of early changes in dietary and lifestyle behaviour across Europe

“…This supplement contains many studies carried out to ensure the quality and rigour of measures included in the IDEFICS study. This measurement rigour has been applied to diet 8,9 and physical activity, [10][11][12] as well as to measurement of social and biological determinants [13][14][15] and health consequences. [16][17][18][19][20] Furthermore, the detailed description of both the strengths and limitations with regard to measurement selection and development is an important resource for dissemination, given its potential for shaping future studies.…”