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Validity and reproducibility of a computerised tool for assessing the iron, calcium and vitamin C intake of Belgian women

European Journal of Clinical Nutrition volume 58, pages 1297–1305 (2004)Cite this article

Abstract

Objective: To determine the relative validity of a newly developed iron intake assessment tool, designed specifically to assess iron, calcium and vitamin C intake.

Design: Estimates of iron, calcium and vitamin C intake from a computerised iron intake assessment tool compared with those from 11-day estimated dietary records.

Setting: Region of Ghent (N=±225 000), a city in Flanders, the Dutch-speaking part of Belgium.

Subjects: In all, 50 women aged 18–39 y, participating in a large-scale epidemiological study on iron intake and iron status.

Main results: Mean dietary iron intake from the 11-day food record, the unadjusted dietary iron intake assessment tool and the adjusted tool was, respectively, 10.5±2.7, 10.4±4.3 and 9.6±2.9 mg. For the different nutrients, the correlation coefficients vary from 0.45 to 0.60 for adjusted intake. The mean difference of iron intake by the two methods (0.8±2.9 mg) did not differ significantly from zero. The new method correctly classified 38% (iron), 38% (calcium) and 58% (vitamin C) of the subjects to the correct tertile. The correlation coefficients ranged from 0.48 for adjusted vitamin C intake to 0.73 for adjusted calcium intake between two administrations.

Conclusion: The newly developed instrument can be used to assess mean group intakes of iron, calcium and vitamin C in women consuming a Western diet. However, since the ranking capability of the new tool is rather weak, further refinement of the tool is required to produce a robust method for assessing iron, calcium and vitamin C intakes of individuals.

Sponsorship: This research was supported by the Belgian National Fund for Scientific Research/Flemish Division (Fund No G.0152.01).

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References

  • Altman DG (1991): Practical Statistics for Medical Research. London: Chapman & Hall.

    Google Scholar 

  • Beaton GH, Milner J, Corey P, McGuire V, Cousins M, Stewart E, de Ramos M, Hewitt D, Grambsch PV, Kassim N & Little JA (1979): Sources of variance in 24-hour dietary recall data: implications for nutrition study design and interpretation. Am. J. Clin. Nutr. 32, 2546–2549.

    Article  CAS  Google Scholar 

  • Belton NR, Macvean ADL, Richards ND, Elton RA, Moffat WMU & Beattie TF (1997): Nutrient intake in Scottish adolescents. Proc. Nutr. Soc. B 56, 303A.

    Google Scholar 

  • Bingham SA, Nelson M, Paul AA, Haraldsdottir J, Björge Löke E & van Staveren WA (1988): Methods for data collection at an individual level, In Manual on Methodology for Food Consumption Studies, eds ME Cameron & WA van Staveren, pp 53–106. Oxford: Oxford University Press.

  • Bland JM & Altman DG (1986): Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1, 307–310.

    Article  CAS  Google Scholar 

  • Brunner E, Stallone D, Juneja M, Bingham S & Marmot M (2001): Dietary assessment in Whitehall II: comparison of 7 d diet diary and food-frequency questionnaire and validity against biomarkers. Br. J. Nutr. 86, 405–414.

    Article  CAS  Google Scholar 

  • Cade J, Thompson R, Burley V & Warm D (2002): Development, validation and utilisation of food-frequency questionnaires—a review. Public Health Nutr. 5, 567–587.

    Article  Google Scholar 

  • Cruz JA (2000): Dietary habits and nutritional status in adolescents over Europe—Southern Europe. Eur. J. Clin. Nutr. 54(Suppl 1), S29–S35.

    Article  CAS  Google Scholar 

  • de Groot C, van Staveren WA & Riboli E (1998): Abstracts of the Third International Conference on Dietary Assessment Methods. Eur. J. Clin. Nutr. 52, 51–89.

    Article  Google Scholar 

  • De Vriese SR, De Henauw S, De Backer G, Dhont M & Christophe AB (2001): Estimation of dietary fat intake of Belgian pregnant women. Comparison of two methods. Ann. Nutr. Metab. 45, 273–278.

    Article  CAS  Google Scholar 

  • Disler PB, Lynch SR, Charlton RW, Torrance JD, Bothwell TH, Walker RB & Mayet F (1975): The effect of tea on iron absorption. Gut 16, 193–200.

    Article  CAS  Google Scholar 

  • Hallberg L, Brune M, Erlandsson M, Sandberg AS & Rossander-Hulten L (1991): Calcium: effect of different amounts on nonheme- and heme-iron absorption in humans. Am. J. Clin. Nutr. 53, 112–119.

    Article  CAS  Google Scholar 

  • Health Council Belgium (1997): Household Weights and Measures; A Manual for a Standardised Quantification of Food Items in Belgium. Brussels: Ministry of Social Affaires, Public Health and Environment, Health Council Belgium.

  • Heath AL, Skeaff CM & Gibson RS (2000): The relative validity of a computerized food frequency questionnaire for estimating intake of dietary iron and its absorption modifiers. Eur. J. Clin. Nutr. 54, 592–599.

    Article  CAS  Google Scholar 

  • Holland B, Welch A, Unwin I, Buss D, Paul A & Southgate D (1991): McCance and Widdowson's, The Composition of Foods, Fifth Revised and Extended Edition. Cambridge: Royal Society of Chemistry.

    Google Scholar 

  • Lynch SR & Cook JD (1980): Interaction of vitamin C and iron. Ann. NY. Acad. Sci. 355, 32–44.

    Article  CAS  Google Scholar 

  • Maclure M & Willett WC (1987): Misinterpretation and misuse of the kappa statistic. Am. J. Epidemiol. 126, 161–169.

    Article  CAS  Google Scholar 

  • Masson LF, McNeill G, Tomany JO, Simpson JA, Peace HS, Wei L, Grubb DA & Bolton-Smith C (2003): Statistical approaches for assessing the relative validity of a food- frequency questionnaire: use of correlation coefficients and the kappa statistic. Public Health Nutr. 6, 313–321.

    Article  CAS  Google Scholar 

  • Matthys C, De Henauw S, Devos C & De Backer G (2003): Estimated energy intake, macronutrient intake and meal pattern of Flemish adolescents. Eur. J. Clin. Nutr. 57, 366–375.

    Article  CAS  Google Scholar 

  • Michaud C, Musse N, Kahn JP, Grebert M, Burlet C & Mejean L (1989): Nutrition behavior in adolescent students (15–19 years of age) in the Nancy metropolitan area. A comparison with the recommended nutritional intake of the French population. Rev. Epidemiol. Sante Publique 37, 149–159.

    CAS  PubMed  Google Scholar 

  • Munger RG, Folsom AR, Kushi LH, Kaye SA & Sellers TA (1992): Dietary assessment of older Iowa women with a food frequency questionnaire: nutrient intake, reproducibility, and comparison with 24-hour dietary recall interviews. Am. J. Epidemiol. 136, 192–200.

    Article  CAS  Google Scholar 

  • Nelson M (1996): The validation of dietary assessment, In Design Concepts in Nutritional Epidemiology, eds BM Margetts & M Nelson, pp 241–272. Oxford: Oxford University Press.

    Google Scholar 

  • Nelson M, Atkinson M & Darbyshire S (1994): Food photography. I: The perception of food portion size from photographs. Br. J. Nutr. 72, 649–663.

    Article  CAS  Google Scholar 

  • Nelson M, Atkinson M & Darbyshire S (1996): Food photography. II: Use of food photographs for estimating portion size and the nutrient content of meals. Br. J Nutr. 76, 31–49.

    Article  CAS  Google Scholar 

  • Nelson M & Bingham S (1996): Assessment of food consumption and nutrient intake, In Design Concepts in Nutritional Epidemiology, eds BM Margetts & M Nelson, pp 123–169. Oxford: Oxford University Press.

    Google Scholar 

  • Nettleton PA, Day KC & Nelson M (1980): Dietary survey methods. 2. A comparison of nutrient intakes within families assessed by household measures and the semi-weighed method. J. Hum. Nutr. 34, 349–354.

    CAS  PubMed  Google Scholar 

  • NEVO (1996): NEVO-Table, Dutch Food Composition Table 1996. Zeist: NEVO Foundation (in Dutch).

  • NEVO (2001): NEVO-Table, Dutch Food Composition Table 2001. Zeist: NEVO Foundation (in Dutch).

  • NUBEL (1995): Belgian Food Composition Table, 2nd Edition. Brussels: Ministry of Public Health (in Dutch).

  • NUBEL (1999): Belgian Food Composition Table, 3rd Edition. Brussels: Ministry of Public Health (in Dutch).

  • Robson PJ & Livingstone MB (2000): An evaluation of food photographs as a tool for quantifying food and nutrient intakes. Public Health Nutr. 3, 183–192.

    Article  CAS  Google Scholar 

  • Rolland-Cachera MF, Bellisle F & Deheeger M (2000): Nutritional status and food intake in adolescents living in Western Europe. Eur. J. Clin. Nutr. 54(Suppl 1), S41–S46.

    Article  CAS  Google Scholar 

  • Roma-Giannikou E, Adamidis D, Gianniou M, Nikolara R & Matsaniotis N (1997): Nutritional survey in Greek children: nutrient intake. Eur. J. Clin. Nutr. 51, 273–285.

    Article  CAS  Google Scholar 

  • Samuelson G (2000): Dietary habits and nutritional status in adolescents over Europe. An overview of current studies in the Nordic countries. Eur. J. Clin. Nutr. 54(Suppl 1), S21–S28.

    Article  Google Scholar 

  • Sempos CT (1992): Some limitations of semiquantitative food frequency questionnaires. Am. J. Epidemiol. 135, 1127–1132, [invited commentary].

    Article  Google Scholar 

  • Spanjersberg MQI & Jansen EHJM (2000): Iron deficiency and Overload in Relation to Nutrition. Bilthoven, The Netherlands: Rijksinstituut voor Volksgezondheid en Milieu.

    Google Scholar 

  • SPSS (1999): Statistical Package for the Social Sciences, 10th Edition Chicago: SPSS.

  • Tylavsky FA & Sharp GB (1995): Misclassification of nutrient and energy intake from use of closed-ended questions in epidemiologic research. Am. J. Epidemiol. 142, 342–352.

    Article  CAS  Google Scholar 

  • Unilever (1992): Becel Nutrient Calculation Program. Rotterdam: Nederlandse Unilever Bedrijven B.V.

  • Willett WC (1994): Future directions in the development of food-frequency questionnaires. Am. J. Clin. Nutr. 59, 171S–174S.

    Article  CAS  Google Scholar 

  • Willett WC (1998): Nutritional Epidemiology. New York: Oxford University Press.

    Book  Google Scholar 

  • World Health Organization (1995): Physical Status: The Use and Interpretation of Anthropometry, Technical Report Series 854 Geneva: WHO.

Download references

Acknowledgements

We thank the dietitians Mrs M Bellemans and Mrs M De Maeyer for their important contribution to the fieldwork and the data input, Mr R Preece (Institute of Food Research, UK) and Mr B Sterken for their contribution in the software development, and Professor Dr D De Bacquer for his statistical advice. The assessment tool is available on request. This work was financially supported by the Belgian National Fund for Scientific Research/Flemish Division (Fund No G.0152.01). Iron research at the Institute of Food Research is funded by the Biotechnology and Biological Sciences Research Council and the UK Food Standards Agency.

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Authors and Affiliations

  1. Department of Public Health, Ghent University, Ghent, Belgium

    C Matthys, I Pynaert & S De Henauw

  2. Institute of Food Research, Colney, Norwich, UK

    M Roe & S J Fairweather-Tait

  3. Department of Human Nutrition, University of Otago, Dunedin, New Zealand

    A-LM Heath

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  1. C Matthys
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  2. I Pynaert
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  3. M Roe
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  4. S J Fairweather-Tait
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  5. A-LM Heath
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  6. S De Henauw
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Contributions

Guarantor: C Matthys.

Contributors: CM designed the study, analysed and interpreted the data and wrote the initial draft of the manuscript. IP assisted in collecting data and assisted in the preparation of the manuscript. MR assisted in the design of the computerised questionnaire and assisted in the preparation of the manuscript. SJF-T assisted in interpreting the data and in preparing the manuscript. A-LMH assisted in the design of the computerised questionnaire and in the preparation of the manuscript. SDH designed the study, interpreted the data and assisted in the preparation of the manuscript.

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Correspondence to C Matthys.

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Matthys, C., Pynaert, I., Roe, M. et al. Validity and reproducibility of a computerised tool for assessing the iron, calcium and vitamin C intake of Belgian women. Eur J Clin Nutr 58, 1297–1305 (2004). https://doi.org/10.1038/sj.ejcn.1601965

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