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Validation Information: Estimated Food Diary (Toddlers)

Cheng 2012

Relative validity of a 3 d estimated food record in German toddlers

Objective: To determine the relative validity of a 3 d estimated food record (EFR) used to assess energy and nutrient intakes in toddlers, using a 3 d weighed food record (WDR) as the reference method.

Design: Parents reported the food and beverage intakes of their children using an EFR concurrently with a WDR over three consecutive days. Estimation of mean differences, Spearman correlation coefficients, cross-classifications and Bland–Altman plots were used to assess the agreement between the intakes of energy and fourteen nutrients obtained from the EFR and the WDR. Setting: Data obtained from a representative sample of infants or toddlers in Germany.

Subjects: Sixty-seven toddlers aged 10–36 months who had completed an EFR for a 3 d recording period that corresponded to the WDR were included in the present analysis.

Results: Energy and nutrient intakes did not differ between the EFR and the WDR, except for linoleic acid and retinol. For all dietary intakes, Spearman rank correlation coefficients between the EFR and the WDR ranged from 0.35 to 0.80 (P≤ 0.004). The proportion of participants correctly classified into quartiles ranged from 75 % for ascorbic acid intake to 96 % for Fe intake, and the percentage of misclassification was 9 % or less. The weighed k values ranking the participants ranged from 0.23 for ascorbic acid intake to 0.59 for Fe intake. The Bland–Altman plots indicated a good agreement for all dietary intakes estimated from the EFR.

Conclusions: Our study suggests that this EFR is a valid assessment instrument for estimating the energy and nutrient intakes among toddlers at the group level.

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Validation Information

Author
Cheng
Year of Publication
2012

Tool Information

Dietary Exposure Measured
Full Nutrient
Tool Type
Food Diary Estimated
Timeframe Tool Measures info
1 day
Portion Size Measures info
Portion sizes were estimated, pictures of common household measures were included in the booklet to aid estimation
Reporting Method info
Prospective
Format info
Online
Supplements Measured
Not reported
Administration Method info
By proxy; parent

Study Information

Study Location
Germany
Associated Nutrient Database
LEBTAB
Comparator Validated Against
Weighed Food Diary

Participants

Sample Size
67
Lifestage
Infants and toddlers
Age of Population

Range: 10-35 months; Mean (SD): 22 (7.5) months

Sex
Both
Other Notable Characteristics
Parental social class was evenly distributed

Total number of nutrients validated: 14 info

Not all of the nutrients validated in the validation studies are included in the table below, as statistical data was only selected to be displayed for a number of nutrients, this included:

  • Energy
  • Fat
  • Saturated Fat
  • Mono-unsaturated Fat
  • Poly-unsaturated Fat
  • Carbohydrates
  • Protein
  • Sugar
  • Non‐starch polysaccharides(NSP)
  • Sodium
  • Calcium
  • Iron
  • Zinc
  • Retinol
  • Folate
  • Folic Acid
  • Vitamin B12
  • Vitamin C
  • Fruit & Vegetables
  • Urinary Nitrogen

To find information on the other validated nutrients please read the validation study.

  • Energy
  • Macronutrients: 3
  • Micronutrients: 11
Comparator Lifestage Sex Nutrient Measured info Mean Difference Standard Deviation info Correlation Coefficient info Cohen's Kappa Coefficient Percentage Agreement Percentage Agreement Categories info Lower Limits of Agreement Upper Limits of Agreement
Weighed Food Diary Infants and toddlers Both Energy (kJ) 2 (Median) 0.61 (S); 0.12 (P) 0.42 (W) 88 4 0.63 1.63
Protein (g) 0.61 (Median) 0.63 (S) 0.47 (W) 87 4
Fat (g) 1.42 (Median) 0.58 (S); -0.13 (P) 0.45 (W) 84 4
Carbohydrate (g) -4.97 (Median) 0.68 (S) 0.45 (W) 94 4
Calcium (mg) 21.7 (Median) 0.76 (S) 0.52 (W) 94 4
Iron (mg) 0.33 (Median) 0.8 (S); -0.14 (P) 0.59 (W) 96 4
Zinc (mg) 0.16 (Median) 0.67 (S) 0.47 (W) 87 4
Folate (µg) 1.89 (Median) 0.41 (S) 0.33 (W) 82 4

Some results have been calculated using statistical techniques based on the published data.

For further information on statistical terms click on Statistical tests used in validation studies

All correlations coefficients in the table are unadjusted unless stated otherwise. For adjusted correlation coefficients and other statistical methods used in the study e.g. paired t-tests, please read the validation articles.

  • # Adjusted
  • † Energy adjusted.
  • ‡ For loge-transformed, energy-adjusted nutrient intakes.
  • ^ Adjacent included.
  • ᵟ Participants provided identical responses.
  • (w) = Weighted.

Cheng G, Hilbig A, Drossard C, Alexy U, Kersting M. Relative validity of a 3 d estimated food record in German toddlers. Public health nutrition. 2013 Apr;16(4):645-52.