Public Health Nutrition

Table of Contents - 2011 - Volume 14, Issue 03  

HOT TOPIC – Assessment and methodology

Validation of an FFQ and options for data processing using the doubly labelled water method in children

Alice E Dutmana1 c1, Annette Stafleua1, Astrid Kruizingaa1, Henny AM Brantsa1†, Klaas R Westerterpa2, Cor Kistemakera1, Wim JA Meulinga1 and R Alexandra Goldbohma3

a1 TNO Quality of Life, Postbus 360, 3700 AJ Zeist, The Netherlands

a2 Department of Human Biology, Maastricht University, Maastricht, The Netherlands

a3 TNO Quality of Life, Leiden, The Netherlands

Abstract

Objective To validate an FFQ designed to estimate energy intake in children against doubly labelled water (DLW). To investigate how quality control and standard beverage portion sizes affect the validity of the FFQ.

Design Thirty healthy children, aged 4–6 years, participated. Total energy expenditure (EE) was measured by the DLW method during an observation period of 15 d. At the end of this period parents filled out an FFQ designed to assess the child’s habitual energy intake (EI) of the preceding four weeks.

Setting Validation study in The Netherlands.

Subjects Thirty healthy children (fifteen boys and fifteen girls), aged 4–6 years.

Results Mean EI (6117 (sd 1025) kJ/d) did not differ significantly from mean EE (6286 (sd 971) kJ/d; P = 0·15); the mean EI:EE ratio was 0·98. The Pearson correlation coefficient between EI and EE was 0·62. The Bland–Altman plot showed no systematic bias and a constant bias close to zero. Less intensive quality control of the FFQ maintained the mean EI:EE ratio and decreased the correlation slightly. Using standard instead of individually measured beverage portion sizes decreased the mean EI:EE ratio, but maintained the correlation.

Conclusions It can be concluded that the developed FFQ is a valid instrument to estimate mean energy intake in a group of 4- to 6-year-old children and performs reasonably well to rank the subjects with respect to energy intake. It is therefore a useful instrument to estimate energy intake in children in surveys and epidemiological studies in The Netherlands.

(Received February 02 2010)

(Accepted June 02 2010)

(Online publication August 16 2010)

Keywords

  • Child;
  • Energy expenditure;
  • Energy intake;
  • Questionnaires

Correspondence:

c1 Corresponding author: Email ellen.dutman@tno.nl

Footnotes

† Current affiliation: National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.