Factors associated with longitudinal food record compliance in a paediatric cohort study

Abstract

Objective: Non-compliance with food record submission can induce bias in nutritional epidemiological analysis and make it difficult to draw inference from study findings. We examined the impact of demographic, lifestyle and psychosocial factors on such non-compliance during the first 3 years of participation in a multidisciplinary prospective paediatric study.

Design: The Environmental Determinants of Diabetes in the Young (TEDDY) study collects a 3 d food record quarterly during the first year of life and semi-annually thereafter. High compliance with food record completion was defined as the participating families submitting one or more days of food record at every scheduled clinic visit.

Setting: Three centres in the USA (Colorado, Georgia/Florida and Washington) and three in Europe (Finland, Germany and Sweden).

Subjects: Families who finished the first 3 years of TEDDY participation (n 8096).

Results: High compliance was associated with having a single child, older maternal age, higher maternal education and father responding to study questionnaires. Families showing poor compliance were more likely to be living far from the study centres, from ethnic minority groups, living in a crowded household and not attending clinic visits regularly. Postpartum depression, maternal smoking behaviour and mother working outside the home were also independently associated with poor compliance.

Conclusions: These findings identified specific groups for targeted strategies to encourage completion of food records, thereby reducing potential bias in multidisciplinary collaborative research.

Keywords: Dietary assessment; Food record compliance; Longitudinal study; Paediatrics; TEDDY.

Fig. 1

Participant flow diagram based on the inclusion and exclusion criteria used in the analysis of food record compliance in The Environmental Determinants of Diabetes in the Young (TEDDY) study