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Characteristics of the study population are presented in Table 1. A total of 160 parent-child pairs completed the study (99.4%). Mean age of the participants (50.6% males) was 14.6 years, mean height was 164.3 cm, mean weight was 59.0 kg, and mean BMI was 21.7 kg/m2. Furthermore, 5.6%, 61.3%, 15.6%, and 17.5% of children were underweight, normal weight, overweight, and obese, respectively. Half of the participants were from junior middle schools.
Table 1. Socio-demographic Characteristics and Anthropometric Measurements of Participants (N = 160)a
Socio-demographic Variable Total Male (n = 81) Female (n = 79) Age (years, mean ± SD) 14.6 ± 1.4 14.7 ± 1.5 14.5 ± 1.4 Height (cm, mean ± SD) 164.3 ± 8.7 169.3 ± 8.1 159.1 ± 5.8 Weight (kg, mean ± SD) 59.0 ± 15.1 64.5 ± 16.8 53.3 ± 10.4 Body mass index (BMI) (kg/m2, mean ± SD)b 21.7 ± 4.5 22.4 ± 5.2 21.0 ± 3.5 Underweight (n, %) 9 (5.6) 6 (7.4) 3 (3.8) Normal weight (n, %) 98 (61.3) 41 (50.6) 57 (72.2) Overweight (n, %) 25 (15.6) 14 (17.3) 11 (13.9) Obesity (n, %) 28 (17.5) 20 (24.7) 8 (10.1) Grade level of school (n, %) Junior middle school 80 (50.0) 40 (49.4) 40 (50.6) senior middle school 80 (50.0) 41 (50.6) 39 (49.4) Father's education level (n, %) Primary education 6 (3.8) 3 (3.7) 3 (3.8) Secondary education 102 (63.8) 52 (64.2) 50 (63.3) Higher education 52 (32.5) 26 (32.1) 26 (32.9) Mother's education level (n, %) Primary education 14 (8.8) 8 (9.9) 6 (7.6) Secondary education 91 (56.9) 48 (59.3) 43 (54.4) Higher education 55 (34.4) 25 (30.9) 30 (38.0) Father's employment status (n, %) Not employed 2 (1.3) 1 (1.2) 1 (1.3) Employed 158 (98.8) 80 (98.8) 78 (98.7) Mother's employment status (n, %) Not employed 38 (23.8) 20 (24.7) 18 (22.8) Employed 122 (76.3) 61 (75.3) 61 (77.2) Note.aNumbers in this table represent means ± standard deviations (SD) and n (%) for continuous and categorical variables, respectively. bBMI cut-off points adapted from Chinese standard for children and adolescents. -
Table 2 shows the descriptive statistics for the mean (SD) and median (IQR) intake of 17 types of food groups and 15 types of nutrients between FFQ1 and FFQ2. Compared with FFQ2, the food intake of cereal, fresh vegetables, fresh fruits, dairy products, and red meat was slightly higher in FFQ1. Intake of other foods such as tubers, beans, poultry, eggs, nuts, and sweetened beverages was not significantly different between FFQ1 and FFQ2. Compared with FFQ2, the nutrient intake of energy, carbohydrates, cholesterol, vitamin A, calcium, phosphorus, and potassium was slightly higher in FFQ1. Intake of other nutrients such as protein, fat, dietary fiber, vitamin C, and iron was not significantly different between FFQ1 and FFQ2.
Table 2. Reliability of Intakes of Food Groups and of Nutrients between FFQ 1 and FFQ 2 (N=160)
Table 2 also shows the results from the reliability assessment of FFQ1 vs. FFQ2. The median ICC of food groups between FFQ2 and FFQ1 was 0.41 (range: 0.21-0.66). The ICCs of nutrients ranged from 0.56 to 0.76. When food groups and nutrient intakes were categorized into quartiles, the agreement rates between FFQ1 and FFQ2 in the same quartile ranged from 27.5% to 49.4%, whereas those in the same or adjacent quartiles ranged from 70.0% to 95.0%, and misclassification to an extreme quartile was rare (< 10%).
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Table 3 reports the descriptive statistics for the mean (SD) and median (IQR) intake of 17 types of food groups and 15 types of nutrients between FFQ2 and 24 h DRs. Compared with 24 h DRs, the intake of fresh vegetables, fresh fruits, dairy products, sweetened beverages, energy, cholesterol, and calcium was slightly higher in FFQ2. Intake of other foods and nutrients was not significantly different between FFQ2 and 24 h DRs.
Table 3. Agreement between Intake of Food Groups and Nutrients between 24 h DRs and FFQ 2(N=160)
Results obtained from the validity assessment of FFQ2 vs. 24 h DRs are presented in Table 3 and Figure 2. The Spearman's correlation coefficients (rs) of food groups and nutrients between FFQ2 and 24 h DRs ranged from −0.04 to 0.59 and 0.08 to 0.45, respectively. When food groups and nutrient intakes were categorized into quartiles, the agreement rates between FFQ2 and 24 h DRs in the same quartile ranged from 23.8% to 45.0%, whereas those in the same or adjacent quartiles ranged from 50.0% to 100.0%. Misclassification to an extreme quartile was rare. Figure 2 depicts the Bland-Altman plots for energy, protein, carbohydrates, and fat. With the exception of a few, the majority of data points lied between 95% limits of agreement, closer to the middle horizontal line.
doi: 10.3967/bes2019.066
Food Frequency Questionnaire for Chinese Children Aged 12-17 Years: Validity and Reliability
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Abstract:
Objective The primary objective of this study was to examine the validity and reliability of a semi-quantitative food frequency questionnaire (FFQ) among Chinese children aged 12-17 years. Methods A semi-quantitative 72-food item FFQ was developed for children aged 12-17 years. The reliability and validity of this FFQ were evaluated against 24-h dietary recalls (24 h DRs) to measure the consumption of foods and nutrients. We administered two FFQs and three DRs to children (N=160) over a period of 1 month to evaluate the reliability and validity. Reliability was examined by quartile agreement and intraclass correlation coefficients (ICCs), and validity was examined by quartile agreement, Bland-Altman plots and correlation with DRs. Results For reliability, the ICCs between the two FFQs ranged from 0.21 to 0.76 for foods and nutrients, and the quartile agreement ranged from 70.0% to 95.0% in the same or adjacent quartiles. Spearman's correlation coefficients of foods and nutrients between the second FFQ and the 24 h DRs ranged from -0.04 to 0.59. The Bland-Altman plots demonstrated good agreement across the range of intakes among nutrients. The quartile agreement ranged from 50.0% to 100.0%, with infrequent misclassification. Conclusion The FFQ assessment of dietary intakes demonstrated acceptable relative validity and high reproducibility for Chinese children aged 12-17 years. -
Key words:
- Reliability /
- Validity /
- Food frequency questionnaire /
- Chinese children
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Table 1. Socio-demographic Characteristics and Anthropometric Measurements of Participants (N = 160)a
Socio-demographic Variable Total Male (n = 81) Female (n = 79) Age (years, mean ± SD) 14.6 ± 1.4 14.7 ± 1.5 14.5 ± 1.4 Height (cm, mean ± SD) 164.3 ± 8.7 169.3 ± 8.1 159.1 ± 5.8 Weight (kg, mean ± SD) 59.0 ± 15.1 64.5 ± 16.8 53.3 ± 10.4 Body mass index (BMI) (kg/m2, mean ± SD)b 21.7 ± 4.5 22.4 ± 5.2 21.0 ± 3.5 Underweight (n, %) 9 (5.6) 6 (7.4) 3 (3.8) Normal weight (n, %) 98 (61.3) 41 (50.6) 57 (72.2) Overweight (n, %) 25 (15.6) 14 (17.3) 11 (13.9) Obesity (n, %) 28 (17.5) 20 (24.7) 8 (10.1) Grade level of school (n, %) Junior middle school 80 (50.0) 40 (49.4) 40 (50.6) senior middle school 80 (50.0) 41 (50.6) 39 (49.4) Father's education level (n, %) Primary education 6 (3.8) 3 (3.7) 3 (3.8) Secondary education 102 (63.8) 52 (64.2) 50 (63.3) Higher education 52 (32.5) 26 (32.1) 26 (32.9) Mother's education level (n, %) Primary education 14 (8.8) 8 (9.9) 6 (7.6) Secondary education 91 (56.9) 48 (59.3) 43 (54.4) Higher education 55 (34.4) 25 (30.9) 30 (38.0) Father's employment status (n, %) Not employed 2 (1.3) 1 (1.2) 1 (1.3) Employed 158 (98.8) 80 (98.8) 78 (98.7) Mother's employment status (n, %) Not employed 38 (23.8) 20 (24.7) 18 (22.8) Employed 122 (76.3) 61 (75.3) 61 (77.2) Note.aNumbers in this table represent means ± standard deviations (SD) and n (%) for continuous and categorical variables, respectively. bBMI cut-off points adapted from Chinese standard for children and adolescents. Table 2. Reliability of Intakes of Food Groups and of Nutrients between FFQ 1 and FFQ 2 (N=160)
Table 3. Agreement between Intake of Food Groups and Nutrients between 24 h DRs and FFQ 2(N=160)
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