Validation Information: CADET
Christian 2015
Measuring diet in primary school children aged 8-11 years: validation of the Child and Diet Evaluation Tool (CADET) with an emphasis on fruit and vegetable intake.
Background/Objectives: The Child And Diet Evaluation Tool (CADET) is a 24-h food diary that measures the nutrition intake of children aged 3-7 years, with a focus on fruit and vegetable consumption. Until now CADET has not been used to measure nutrient intake of children aged 8-11 years. To ensure that newly assigned portion sizes for this older age group were valid, participants were asked to complete the CADET diary (the school and home food diary) concurrently with a 1-day weighed record.
Subjects/Methods: A total of 67 children with a mean age of 9.3 years (s.d.: ± 1.4, 51% girls) participated in the study. Total fruit and vegetable intake in grams and other nutrients were extracted to compare the mean intakes from the CADET diary and Weighed record using t-tests and Pearson's r correlations. Bland-Altman analysis was also conducted to assess the agreement between the two methods.
Results: Correlations comparing the CADET diary to the weighed record were high for fruit, vegetables and combined fruit and vegetables (r=0.7). The results from the Bland-Altman plots revealed a mean difference of 54 g (95% confidence interval: -88, 152) for combined fruit and vegetables intake. CADET is the only tool recommended by the National Obesity Observatory that has been validated in a U.K. population and provides nutrient level data on children's diets.
Conclusions: The results from this study conclude that CADET can provide high-quality nutrient data suitable for evaluating intervention studies now for children aged 3-11 years with a focus on fruit and vegetable intake.
Total number of nutrients validated: 9
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: 5
- Micronutrients: 3
| Comparator | Lifestage | Sex | Nutrient Measured | Mean Difference | Standard Deviation | Correlation Coefficient | Cohen's Kappa Coefficient | Percentage Agreement | Percentage Agreement Categories | Lower Limits of Agreement | Upper Limits of Agreement |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Weighed Food Diary | Children | Both | Energy (kcal) | 228 | 914 | 0.2 (P) | -1497 | 1881 | |||
| Protein (g) | 5 | 36 | 0.2 (P) | -66 | 76 | ||||||
| Fat (g) | 17 | 41 | 0.3 (P) | -63 | 99 | ||||||
| Carbohydrates (g) | 27 | 135 | 0.3 (P) | -238 | 292 | ||||||
| Total Sugars (g) | 28 | 80 | 0.3 (P) | -129 | 185 | ||||||
| Fibre (NSP) (g) | 1 | 10 | 0.3 (P) | -19 | 20.6 | ||||||
| Sodium (mg) | 151 | 1546 | 0.2 (P) | -2879 | 3181 | ||||||
| Calcium (mg) | 185 | 332 | 0.6 (P) | -466 | 836 | ||||||
| Vitamin C (mg) | -27 (Median) | 0.4 (P) | |||||||||
| Fruit (g) | 22 | 116 | 0.7(P) | -207 | 250 | ||||||
| Vegetables (g) | 32 | 61 | 0.7(P) | -88 | 152 | ||||||
| Fruit and vegetables (g) | 54 | 142 | 0.7(P) | -226 | 333 |
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.
Christian MS, Evans CEL, Nykjaer C, Hancock N, Cade JE. Measuring diet in primary school children aged 8-11 years: validation of the Child and Diet Evaluation Tool (CADET) with an emphasis on fruit and vegetable intake. Eur J Clin Nutr 2014, 69 (2).234 - 241.