Validation of a web-based dietary questionnaire designed for the DASH (Dietary Approaches to Stop Hypertension) diet: the DASH Online Questionnaire

Abstract

Objective-With the upsurge in online dietary modification programmes, online dietary assessment tools are needed to capture food intake. Although the DASH (Dietary Approaches to Stop Hypertension) diet is recommended by the US Department of Agriculture, there are no online instruments that capture DASH food servings. Our objective was to assess the validity of a new, short, online dietary questionnaire developed to capture intake of DASH food servings. The DASH Online Questionnaire (OLQ) was validated against the well-known Block Food Frequency Questionnaire (FFQ).Design-This was a cross-sectional validation of the DASH OLQ, which contained eleven food groups (breakfast cereals; dairy; drinks; fats and oils; fruits; grains and snacks; meat, fish and poultry; mixed dishes; sweets; vegetables; and nuts, seeds and legumes). Each subject completed a DASH OLQ once weekly for four weeks and one 98. NIH Public Access Author ManuscriptPublic Health Nutr. Author manuscript; available in PMC 2010 May 1. Results-There were significant positive correlations between the Block FFQ and the DASH OLQ for all food groups ranging from r=0·8 for the nuts/seeds/legumes category to r = 0·3 for vegetables and mixed dishes. A comparison of nutrient intakes found strong positive correlations in all nutrient categories. Of particular interest in the DASH diet and the web-based nutrition and physical activity programme were total fat (r=0·62), total carbohydrate (r=0·67), total K (r=0·68), total Ca (r =0·69), total vitamin C (r=0·60) and total energy intake (r=0·68). There is an ongoing need to improve eating habits and offer preventive approaches for weight management in the USA(1-3). The Internet offers great possibilities in this regard because information can be sent to a very large audience at a relatively low cost. Our nutrition research group, made up of physicians, dietitians and nutritionists from Boston University Medical Center, Duke University Medical Center and the USDA Human Nutrition Center on Aging at Tufts University, has developed an online lifestyle modification programme based on the DASH (Dietary Approaches to Stop Hypertension) diet. The DASH Online Questionnaire (OLQ) was created to capture food intake and provide realtime feedback in the form of progress reports to participants enrolled in the DASHforHealth.com programme. The aim of the DASHforHealth.com programme is to provide easily accessible nutrition education for those seeking to improve their health and/or combat weight issues via the Internet. Data collected using the DASH OLQ showed that participants significantly increased their daily fruit and vegetable consumption after one year in the DASHfor-Health.com online programme(4). The DASHforHealth.com programme is currently being offered to several US corporations as an employee wellness programme, as well as to the general public for individual subscription. We chose the DASH diet as the focus of our web-based educational programme because of its proven benefits in the areas of blood pressure reduc...

Validity and reproducibility of a web-based, self-administered food frequency questionnaire

“…Significant overestimations were observed only for a few nutrients (for example, EPA), which could be partly explained by the different nutritional contribution of the foods grouped together in the web-FFQ database (for example, types of fish) compared with specific food items in the FRs. Another factor to consider is the duration of the reference measure: 3 days of record may not have been enough to capture the real dietary intakes of the participants over 1 month, particularly for foods that are not consumed frequently (Apovian et al, 2010). Correlation coefficients considered as acceptable in FFQ validation studies range from 0.4-0.7 (Willet, 1994;Willet, 1998).…”

“…Consequently, differences in the frequency of consumption may be more likely to occur between a 3-day FR and a web-FFQ covering the previous month than between two FFQs covering the same period. In this regard, Apovian et al (2010) suggested that correlations may improve with tracking of more days of FR. Moreover, an important observation is that the IA-FFQ, like the web-FFQ, included questions about added fat and fat used for cooking and correlations for fat variables were much stronger between the IA-FFQ and the web-FFQ than between the 3-day FR and the web-FFQ.…”

Automation of Food Questionnaires in Medical Studies: A state-of-the-art review and future prospects

“…The significance of the research works that use Web-based food frequency questionnaires has increased in the last few years [6,23,24,26,29,30] and the validity and reproducibility of Web-based FFQs has also been evaluated [22,25,27,28].…”

“…FFQs [22,6,23,24,25,26,27,28,29,30], online 24 hour dietary recalls [8,31,32,33,34] and combinations of both FFQs and 24HDRs [35,36,37,38]. A few similar reviews or states-of-the-art are found in the literature [39,40,1,41].…”

Salt: importance in iodine deficiency and sodium excess

“…They therefore offer a new dietary assessment tool to measure adherence to the DASH diet, shown previously to reduce blood pressure and reduce risk of heart disease and stroke (13) . Their article provides some useful perspective on dietary measures to prevent high blood pressure.…”