Relative validation of Block Kids Food Screener for dietary assessment in children and adolescents

Abstract

Food frequency questionnaires (FFQs) are less time consuming and inexpensive instruments for collecting dietary intake when compared with 24-h dietary recalls or double-labelled water; however, the validation of FFQ is important as incorrect information may lead to biased conclusions about associations. Therefore, the relative validity of the Block Kids Food Screener (BKFS) developed for use with children was examined in a convenience sample of 99 youth recruited from the Portland, OR metropolitan area. Three 24-h dietary recalls served as the reference. The relative validity was analysed after natural log transformation of all variables except glycaemic index prior to correlation analysis. Daily cup equivalent totals from the BKFS and 'servings' from 24-h recalls were used to compute average daily intake of fruits, vegetables, potatoes, whole grains, legumes, meat/fish/poultry and dairy. Protein grams (g), total kcalories, glycaemic index (glucose reference), glycaemic load (glucose reference), total saturated fat (g) and added sugar (g) were also calculated by each instrument. The correlation between data obtained from the two instruments was corrected for the within-subject variation in food intake reported by the 24-h recalls using standard nutritional assessment methodology. The de-attenuated correlations in nutritional intake between the two dietary assessment instruments ranged from 0.526 for vegetables, to 0.878 for potatoes. The 24-h recall estimated higher levels of saturated fat and added sugar consumption, higher glycaemic loads and glycaemic indices; the de-attenuatted correlations of these measures ranged from 0.478 to 0.768. Assessment of Bland-Altman plots indicated no systematic difference between the two instruments for vegetable, dairy and meat/fish/poultry fat consumption. BKFS is a useful dietary assessment instrument for the nutrients and food groups it was designed to assess in children age 10-17 years.

Keywords: diet; dietary intake assessment; dietary screener; questionnaires; relative validity.