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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.

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Validation Information

Author
Christian
Year of Publication
2015

Tool Information

Dietary Exposure Measured
Full Nutrient, Food Groups
Tool Type
Food Checklist
Timeframe Tool Measures info
1 Day
Portion Size Measures info
Based on mean food intakes from the National Diet and Nutrition Survey (NDNS) results for children. The portion sizes were age- and sex-specific.
Reporting Method info
Prospective; Retrospective
Format info
Paper
Supplements Measured
Not Reported
Administration Method info
The tool has three parts. Part 1 - by-proxy: parent or caregiver. Part 2 - by-proxy: trained fieldworker, dinner supervisor or parent classroom assistant. Part 3 - self completion with assistance from the classroom teacher.

Study Information

Study Location
Leeds and the West Yorkshire area, England
Associated Nutrient Database
DANTE (Diet And Nutrition Tool for Evaluation)
Comparator Validated Against
Weighed Food Diary

Participants

Sample Size
67
Lifestage
Children
Age of Population

Range: 8-11 years

Mean(SD): 9.3(1.4) years

Sex
Both
Other Notable Characteristics
N/A

Total number of nutrients validated: 9 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: 5
  • Micronutrients: 3
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 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.