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A systematic review of brief dietary questionnaires suitable for clinical use in the prevention and management of obesity, cardiovascular disease and type 2 diabetes

European Journal of Clinical Nutrition volume 69, pages 977–1003 (2015)Cite this article

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Abstract

The aim of this systematic review was to identify and describe brief dietary assessment tools suitable for use in clinical practice in the management of obesity, cardiovascular disease and type 2 diabetes. Papers describing development of brief (<35 items) dietary assessment questionnaires, that were accessible, simple to score and assessed aspects of the diet of relevance to the conditions of interest were identified from electronic databases. The development of 35 tools was described in 47 papers. Ten tools assessed healthy eating or healthy dietary patterns, 2 assessed adherence to the Mediterranean diet, 18 assessed dietary fat intake, and 5 assessed vegetable and/or fruit intake. Twenty tools were developed in North America. Test-retest reliability was conducted on 18 tools; correlation coefficients for total scores ranged from 0.59 to 0.95. Relative validation was conducted on 34 tools. The most common reference variable was percentage energy from fat (15 tools) and correlation coefficients ranged from 0.24, P<0.001 to 0.79, P<0.002. Tools that have been evaluated for reliability and/or relative validity are suitable for guiding clinicians when providing dietary advice. Variation in study design, settings and populations makes it difficult to recommend one tool over another, although future developers can enhance the understanding and use of tools by giving clear guidance as to the strengths and limitations of the study design. When selecting a tool, clinicians should consider whether their patient population is similar in characteristics to the evaluation sample.

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Acknowledgements

We thank the developers of brief questionnaires who provided access to their questionnaires for evaluation, their scoring algorithms and supplementary information on usage and copyright. We thank Amir Emadian for independent data extraction on 25% of the included papers. Clare England is supported by NIHR Clinical Doctoral Research Fellowship 10-017. The study was carried out at The University of Bristol, Senate House, Tyndall Avenue, Bristol BS8 1TH.

Author Contributions

The work contained in this article is part of the PhD of Clare England which is supervised by Drs’ Andrews, Jago and Thompson. All authors assisted in the design of the data extraction form and development of the search strategy. Ms England screened all titles and abstracts and extracted the data with advice on clinical application from Dr Andrews and final inclusion from Professor Thompson. Professor Jago provided analytical guidance. The first draft of the manuscript was prepared by Ms England with critical input and revisions by all other authors. All authors approved the final manuscript.

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This submission represents original work that has not been published previously and it is not being considered for publication elsewhere.

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Authors and Affiliations

  1. Centre for Exercise Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK

    C Y England & R Jago

  2. School of Clinical Sciences, University of Bristol, Learning and Research, Southmead Hospital, Bristol, UK

    R C Andrews

  3. University of Birmingham, School of Sport, Exercise & Rehabilitation Sciences, Edgbaston, Birmingham, UK

    J L Thompson

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  1. C Y England
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England, C., Andrews, R., Jago, R. et al. A systematic review of brief dietary questionnaires suitable for clinical use in the prevention and management of obesity, cardiovascular disease and type 2 diabetes. Eur J Clin Nutr 69, 977–1003 (2015). https://doi.org/10.1038/ejcn.2015.6

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