Validation of a diet history questionnaire for use with Costa Rican adults

Abstract

Objective: To validate a diet history questionnaire (DHQ) using a weighed food record (WFR) as the standard method in the estimation of food consumption and nutrient intake in a group of adults. Design: WFR: all foods consumed by subjects during 7 consecutive days were weighed and recorded by nutrition students. Two DHQ interviews were carried out on days 1 (first diet history questionnaire, DHQ1) and 28 (second diet history questionnaire, DHQ2). Setting: Costa Rica. Subjects: Sixty adults: 30 men and 30 women; 30 living in urban and 30 in rural areas. Results: In comparison to the WFR, the DHQ1 gave statistically significant higher estimates of the mean intake of 19 nutrients for men and of three nutrients for women. The uncorrected correlation coefficients for nutrient intake according to both methods ranged from 0.40 to 0.83 for males and from 0.22 to 0.62 for females. Percentage of subjects classified in the same quartiles of nutrient intake according to each method ranged from 33.3% to 63.3% for males and from 23.3% to 53.3% for females. Misclassification in extreme quartiles ranged from 0% to 13.3% for both sexes. The mean food group consumption, according to the DHQ1, when compared with the WFR, gave statistically significant differences for three of the 18 food groups for men and for two groups in the case of women. The two applications of the DHQ gave similar results. Conclusion: Validation of a DHQ using a WFR as the standard method gave results that compare favourably with those reported by other authors. This study found important differences in the response of men and women to the DHQ: among men, the estimates of mean nutrient intake from DHQ1 were significantly greater than those of the WFR, while in the case of women, the mean nutrient intake estimates from both methods were not significantly different. There was a higher degree of correlation between the DHQ1 and the WFR mean nutrient intakes among men than among women. The DHQ showed good reproducibility. Keywords Diet History Questionnaire Dietary assessment methods Nutritional epidemiologyThe health and nutrition situation of the Costa Rican population is one of transition. The health indicators show a reduction in the incidence of childhood infectious diseases and an increase in chronic diseases among adults 1 , a transformation that is associated, among other things, with changing lifestyle patterns and, more specifically, changes in diet. A few studies have been carried out in Costa Rica on the relationship between diet and chronic diseases. Data have been published on the prevalence of cardiovascular risk factors 2 , cervical cancer 3-5 and gastric cancer 6-10 , which is of special interest as Costa Rica has one of the highest incidence and death rates for this type of cancer in the world 11 .The study of diet in epidemiological research requires methods that measure food consumption over the longer rather than shorter term, which can be applied to groups with different characteristics and not just those who are highly motivated an...

Comparison of food consumption and nutrient intake assessed with three dietary assessment methods: results of the German National Nutrition Survey II

“…Several studies report higher intakes of energy and nutrients assessed by diet history interviews in comparison with food records [27, 28, 36–40] or 24-h recalls [29]. The relative differences described in these studies are comparable to the presented results.…”

“…As in the present study, Chinnock [27] found the best agreement coefficients between different methods for beverages. Possible reasons for the good agreement of beverages are the small variance of household measures, such as glasses, cups or bottles, and constant day-to-day habits of beverage consumption.…”

“…Few other published studies describe food consumption of a diet history method in comparison with food records or 24-h recalls. Chinnock [27] validated a diet history questionnaire using a weighed food record as reference method in a group of 60 adults in Costa Rica. Mean food consumption assessed with the diet history questionnaire gave higher estimates for three of the 18 food groups compared with the weighed food records in men and for one food group in women.…”

“…Several studies found low correlation coefficients between two methods for vitamin A [27,29,30,39]. A possible reason for these low correlation coefficients is the large random variation in the daily intake of vitamin A [2] and the large inhomogeneity of the food groups fruit and vegetables.…”

Public Health Nutrition: a truly global journal

“…Three papers in this issue focus on validation testing of dietary intake assessment tools. Marcotte et al (8) assess a calcium checklist for early elementary-school children, Chinnock (9) validates a diet history questionnaire for use with Costa Rican adults and Charlton et al (10) validate a short questionnaire to assess sodium intake. It seems that much of what we do in public health nutrition comes back to assessment and measurement, so these papers will no doubt be of interest.…”