Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-13T01:38:25.689Z Has data issue: false hasContentIssue false
  • English
  • Français

A Belgian study on the reliability and relative validity of the Health Behaviour in School-Aged Children food-frequency questionnaire

Published online by Cambridge University Press:  16 August 2007

Carine A Vereecken  and
Lea Maes
Carine A Vereecken*
Affiliation:
Department of Public Health, Ghent University, University Hospital, Bloc A, 2nd Floor, De Pintelaan 185, B-9000 Ghent, Belgium
Lea Maes
Affiliation:
Department of Public Health, Ghent University, University Hospital, Bloc A, 2nd Floor, De Pintelaan 185, B-9000 Ghent, Belgium
*
*Corresponding author: Email Carine.Vereecken@rug.ac.be
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

In the Health Behaviour in School-Aged Children (HBSC) survey, the frequency of consumption of a limited number of food items – focusing on fibre, calcium and less healthy items – is queried using a 15-item food-frequency questionnaire (FFQ). The present study was conducted to assess the reliability and relative validity of the HBSC FFQ among school pupils in Belgium.

Design and subjects:

To assess the reliability of the FFQ, 207 pupils aged 11–12 years and 560 pupils aged 13–14 years completed the questionnaire twice, with a test–retest interval of 6 to 15 days. To assess the relative validity of the FFQ, in a first study data were collected as part of the Flemish HBSC 2000 survey: 7072 pupils (11–18 years) completed the FFQ and a 24-hour food behaviour checklist (FBC). In a second study, 101 pupils (11–12 years) completed the FFQ and a 7-day food diary (FD).

Results:

Reliability – weighted kappa values between test and retest ranged from 0.43 to 0.70, percentage agreement from 37 to 87%, and Spearman correlations from 0.52 to 0.82. Relative validity – comparison of the FBC with the percentage of respondents who should have consumed the food items on a random day, computed from the FFQ, showed good agreement between the FFQ and the FBC for most items. Only for cereals, diet soft drinks and other milk products were considerably higher food frequencies than expected found from the FBC. Comparison of the FFQ with the FD showed overestimation for all but three food items (cheese, soft drinks and chips). Spearman correlations ranged between 0.10 for crisps and 0.65 for semi-skimmed milk.

Conclusion:

The HBSC FFQ is a reliable questionnaire that can be used for ranking subjects for most food items, although one must consider the overestimation when the FFQ is used for estimating prevalences.

Keywords

Food-frequency questionnaireReliabilityValidityChildrenAdolescents
Type
Research Article
Information
Public Health Nutrition , Volume 6 , Issue 6 , September 2003 , pp. 581 - 588
Copyright
Copyright © The Authors 2003

References

1Centers for Disease Control and Prevention. Guidelines for school health programs to promote lifelong healthy eating. Journal of School Health 1997; 67: 9–26.CrossRefGoogle Scholar
2Williams, CL, Bollella, M, Wynder, EL. A new recommendation for dietary fiber in childhood. Pediatrics 1995; 96: 985–8.CrossRefGoogle ScholarPubMed
3Kelder, SH, Perry, CL, Klepp, KI, Lytle, LL. Longitudinal tracking of adolescent smoking, physical activity, and food choice behaviors. American Journal of Public Health 1994; 84: 1121–6.CrossRefGoogle ScholarPubMed
4Perks, SM, Roemmich, JN, Sandow-Pajewski, M, Clark, PA, Thomas, E, Weltman, A, et al. Alterations in growth and body composition during puberty. IV. Energy intake estimated by the youth–adolescent food-frequency questionnaire: validation by the doubly labeled water method. American Journal of Clinical Nutrition 2000; 72: 1455–60.CrossRefGoogle ScholarPubMed
5Hammond, J, Nelson, M, Chinn, S, Rona, RJ. Validation of a food frequency questionnaire for assessing dietary intake in a study of coronary heart disease risk factors in children. European Journal of Clinical Nutrition 1993; 47: 242–50.Google Scholar
6Currie, C. Health Behaviour in School-Aged Children: Research Protocol for the 1997–1998 Survey [online], 1998. Available at http://www.ruhbc.ed.ac.uk/hbsc/.Google Scholar
7Buzzard, IM, Faucett, CL, Jeffery, RW, McBane, L, McGovern, P, Baxter, JS, et al. Monitoring dietary change in a low-fat diet intervention study: advantages of using 24-hour dietary recalls vs food records. Journal of the American Dietetic Association 1996; 96: 574–9.CrossRefGoogle Scholar
8Rockett, HR, Colditz, GA. Assessing diets of children and adolescents. American Journal of Clinical Nutrition 1997; 65: 1116S–22S.CrossRefGoogle ScholarPubMed
9Baranowski, T, Domel, SB. A cognitive model of children's reporting of food intake. American Journal of Clinical Nutrition 1994; 95: S212–17.CrossRefGoogle Scholar
10Livingstone, MB, Robson, PJ. Measurement of dietary intake in children. Proceedings of the Nutrition Society 2000; 59: 279–93.CrossRefGoogle ScholarPubMed
11Health Behaviour in School-Aged Children: a WHO Cross-National Study. Research Protocol for the 2001–2002 survey. Edinburgh: University of Edinburgh, 2002.Google Scholar
12Willet, W. Nutritional Epidemiology, 2nd ed. New York: Oxford University Press, 1998.CrossRefGoogle Scholar
13Vereecken, C. Paper pencil versus pc administered querying of a study on health behaviour in school-aged children. Archives of Public Health 2001; 59: 43–61.Google Scholar
14Kramer, MS, Feinstein, AR. Clinical biostatistics. LIV. The biostatistics of concordance. Clinical Pharmacology and Therapeutics 1981; 29: 111–23 [published erratum appears in Clinical Pharmacology and Therapeutics 1989; 46(3): 309].CrossRefGoogle ScholarPubMed
15Block, G. A review of validations of dietary assessment methods. American Journal of Epidemiology 1982; 115: 492–505.CrossRefGoogle ScholarPubMed
16Serdula, MK, Alexander, MP, Scanlon, KS, Bowman, BA. What are preschool children eating? A review of dietary assessment. Annual Review of Nutrition 2001; 21: 475–98.CrossRefGoogle ScholarPubMed
17Kristal, AR, Abrams, BF, Thornquist, MD, Disogra, L, Croyle, RT, Shattuck, AL, et al. Development and validation of a food use checklist for evaluation of community nutrition interventions. American Journal of Public Health 1990; 80: 1318–22.CrossRefGoogle ScholarPubMed
18Smith, KW, Hoelscher, DM, Lytle, LA, Dwyer, JT, Nicklas, TA, Zive, MM, et al. Reliability and validity of the Child and Adolescent Trial for Cardiovascular Health (CATCH) Food Checklist: a self-report instrument to measure fat and sodium intake by middle school students. Journal of the American Dietetic Association 2001; 101: 635–42, 647.CrossRefGoogle ScholarPubMed
19Koehler, KM, Cunningham-Sabo, L, Lambert, LC, McCalman, R, Skipper, BJ, Davis, SM. Assessing food selection in a health promotion program: validation of a brief instrument for American Indian children in the southwest United States. Journal of the American Dietetic Association 2000; 100: 205–11.CrossRefGoogle Scholar
20Mcpherson, RS, Hoelscher, DM, Alexander, M, Scanlon, KS, Serdula, MK. Dietary assessment methods among school-aged children: validity and reliability. Preventive Medicine 2000; 31: S11–33.CrossRefGoogle Scholar
21Ling, AM, Horwath, C, Parnell, W. Validation of a short food frequency questionnaire to assess consumption of cereal foods, fruit and vegetables in Chinese Singaporeans. European Journal of Clinical Nutrition 1998; 52: 557–64.CrossRefGoogle Scholar
22Edmunds, H, Hill, AJ. Dieting and the family context of eating in young adolescent children. International Journal of Eating Disorders 1999; 25: 435–40.3.0.CO;2-3>CrossRefGoogle ScholarPubMed
23Frank, GC, Nicklas, TA, Webber, LS, Major, C, Miller, JF, Berenson, GS. A food frequency questionnaire for adolescents: defining eating patterns. Journal of the American Dietetic Association 1992; 92: 313–8.CrossRefGoogle ScholarPubMed
24Speck, BJ, Bradley, CB, Harrell, JS, Belyea, MJ. A food frequency questionnaire for youth: psychometric analysis and summary of eating habits in adolescents. Journal of Adolescent Health 2001; 28: 16–25.CrossRefGoogle ScholarPubMed
25Rockett, HR, Wolf, AM, Colditz, GA. Development and reproducibility of a food frequency questionnaire to assess diets of older children and adolescents. Journal of the American Dietetic Association 1995; 95: 336–40.CrossRefGoogle ScholarPubMed
26Buzzard, IM, Stanton, CA, Figueiredo, M, Fries, EA, Nicholson, R, Hogan, CJ, et al. Development and reproducibility of a brief food frequency questionnaire for assessing the fat, fiber, and fruit and vegetable intakesof rural adolescents. Journal of the American Dietetic Association 2001; 101: 1438–46.CrossRefGoogle Scholar
27Baranowski, T, Smith, M, Baranowski, J, Wang, DT, Doyle, C, Lin, LS, et al. Low validity of a seven-item fruit and vegetable food frequency questionnaire among third-grade students. Journal of the American Dietetic Association 1997; 97: 66–8.CrossRefGoogle ScholarPubMed
28Domel, SB, Baranowski, T, Davis, H, Leonard, SB, Riley, P, Baranowski, J. Fruit and vegetable food frequencies by fourth and fifth grade students: validity and reliability. Journal of the American College of Nutrition 1994; 13: 33–9.CrossRefGoogle ScholarPubMed
29Thompson, FE, Byers, T. Dietary assessment resource manual. Journal of Nutrition 1994; 124: 2245S–317.Google ScholarPubMed
30Basch, CE, Shea, S, Arliss, R, Contento, IR, Rips, J, Gutin, B, et al. Validation of mothers' reports of dietary intake by four to seven year-old children. American Journal of Public Health 1990; 80: 1314–7.CrossRefGoogle ScholarPubMed
31Reynolds, LA, Johnson, SB, Silverstein, J. Assessing daily diabetes management by 24-hour recall interview: the validity of children's reports. Journal of Pediatric Psychology 1990; 15: 493–509.CrossRefGoogle ScholarPubMed
32Samuelson, G. An epidemiological study of child health and nutrition in a northern Swedish county. II. Methodological study of the recall technique. Nutrition andMetabolism 1970; 12: 321–40.Google Scholar