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Relative validity of a brief dietary survey to assess food intake and adherence to national dietary guidelines among Sri Lankan adults.

ABSTRACT: Background: Suboptimal diet is the leading cause of global morbidity and mortality. Addressing this problem requires context-specific solutions informed by context-specific data collected by context-specific tools. This study aimed to assess the relative validity of a newly developed brief dietary survey to estimate food intake and adherence to the Food Based Dietary Guidelines for Sri Lankans.

Methods: Between December 2018 and February 2019, we interviewed 94 Sri Lankan adults living in Colombo (Western Province), Kalutara (Western Province), and Trincomalee (Eastern Province). We assessed the relative validity of the Sri Lankan Brief Dietary Survey (SLBDS) with Wilcoxon rank-sum tests, Spearman's Rho correlation coefficients, Bland-Altman plots, and Cohen's kappa tests using a 24-h Dietary Recall (24DR) as reference.

Results: Ninety-four adults (40.7?years ±12.6; 66% female) completed both surveys during the same interview. With the exception of 'Fish, pulses, meat and eggs' food group median intake, which was underestimated by the SLBDS compared to the 24DR, there was no strong evidence of difference between median intakes reported by the two methods. Correlation coefficients were highest for 'Milk and dairy products' (0.84) at the food group level and for 'dosa', 'hoppers', 'milk rice', and 'dried fish' (1.00) among individual food and beverages. Visual exploration of Bland-Altman plots showed acceptable agreement between the SLBDS and 24DR, with the SLBDS tending to overestimate consumption as the number of servings of 'Rice, bread, other cereals and yams' and 'Vegetables' consumed increased and slightly underestimate consumption as the number of servings of 'Fish, pulses, meat and eggs', 'Milk and dairy products', and 'Nuts' increased. Kappa values ranged from from 0.59 (95% CI: 0.32-0.86) for 'Vegetables' to 0.81 (95% CI: 0.66-0.96) for 'Fruit' indicating a moderate to strong level of agreement.

Conclusions: Having been developed for and relatively validated with the study population in question, our study shows that the SLBDS can be used as a fit for purpose research tool. Additional research is needed to assess SLBDS test-retest reliability and to validate further the reporting of salt, oil, and coconut intake.

SUBMITTER: Renzella J

PROVIDER: S-EPMC7690106 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Relative validity of a brief dietary survey to assess food intake and adherence to national dietary guidelines among Sri Lankan adults.

Renzella J J Fernando S S Kalupahana B B Townsend N N Rayner M M Wickramasinghe K K Katulanda P P Scarborough P P

BMC nutrition 20201126 1

<h4>Background</h4>Suboptimal diet is the leading cause of global morbidity and mortality. Addressing this problem requires context-specific solutions informed by context-specific data collected by context-specific tools. This study aimed to assess the relative validity of a newly developed brief dietary survey to estimate food intake and adherence to the Food Based Dietary Guidelines for Sri Lankans.<h4>Methods</h4>Between December 2018 and February 2019, we interviewed 94 Sri Lankan adults liv ...[more]

PMID: 33292681

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Project description:BackgroundAs the World Health Organization urges countries to strengthen their noncommunicable disease monitoring and surveillance activities, setting-specific innovations are emerging. Diet - a key, modifiable risk factor for chronic diseases - is particularly challenging to capture reliably. By socially validating self-report dietary survey tools, we may be able to increase the accuracy and representativeness of data for improved population health outcomes. The purpose of this study was to explore the factors that impact Sri Lankan Brief Dietary Survey (a newly developed tool) and 24-h Dietary Recall participation, engagement, and social validity among Sri Lankan adults.MethodsWe conducted semi-structured interviews with 93 participants (61 women and 32 men) in three Sri Lankan districts (Colombo, Kalutara, and Trincomalee). Interview data were analysed thematically and are presented as non-hierarchical thematic networks.ResultsParticipants identified a number of factors that influenced their survey participation and engagement. These included the time of day interviews occur, recall ease, level of commitment required, perceived survey value, emotional response to surveys, and interviewer positionality. Many of these factors were gendered, however, both female and male participants expressed a preference for engaging with socially valid research that they felt justified their personal investment in data collection. When explicitly asked to share ideas about how to improve the surveys, many participants opted not to provide suggestions as they felt they lacked the appropriate expertise.ConclusionsOur findings have implications for the accuracy and equity of dietary surveillance activities, and ultimately the appropriateness and effectiveness of programmes and policies informed by these data. Only through understanding how and why the target population engages with dietary research can we develop socially valid methods that assess and address the dietary risks of individuals and groups that are underrepresented by current conventions.

Project description:Background:The Norwegian food-based dietary guidelines (FBDG) aim at reducing the risk of developing chronic diseases and promote overall health. We studied the effect of the Norwegian FBDG in colorectal cancer (CRC) patients. There is a need for a time-efficient dietary assessment tool measuring adherence to these guidelines in patients treated for dietary dependent cancer, such as CRC patients. Objective:To evaluate a new short food frequency questionnaire (NORDIET-FFQ), developed to estimate adherence to the Norwegian FBDG among CRC patients. Design:Eighty-one CRC patients from both study groups in the Norwegian Dietary Guidelines and Colorectal Cancer Survival study, an ongoing dietary intervention, completed both the short 63-item NORDIET-FFQ and a 7-day weighed food record. Results:The NORDIET-FFQ was on group level able to estimate intakes of fruits, vegetables, unsalted nuts, fish, fatty fish, high fat dairy products, unprocessed meat, processed meat, red meat, water, sugar-rich beverages, alcoholic drinks, and sugar- and fat-rich foods. Ranking of individuals according to intake was good (r = 0.31-0.74) for fruits and vegetables, fruits, unsalted nuts, whole grain products, sugar-rich cereals, fish, fatty fish, dairy products, red meat, water, sugar-rich beverages, alcoholic beverages, and sugar- and fat-rich foods. The NORDIET-FFQ was able to identify the individuals who did not fulfil the recommendations of fruits, vegetables, unsalted nuts, whole grains, low-fat dairy products, processed meat, water, alcoholic beverages, and sugar- and fat-rich foods (sensitivity: 67-93%). Conclusions:The NORDIET-FFQ showed good ability in to estimate intakes of plant-based foods, fish, dairy products, meat, and energy-dense foods; adequate ranking of individuals according to intake of most recommendations except for unprocessed meat, processed meat, and vegetables; and importantly a good ability to identify those patients in need of dietary counselling for foods that are known to modulate the risk of CRC. Trial registration:National Institutes of Health ClinicalTrials.gov; Identifier: NCT01570010.

Project description:ObjectiveFood frequency questionnaires (FFQs) must be validated among the population of interest due to the specificities in dietary habits, culture and food in each country of the Mediterranean region. The objective of this study was to determine the relative validity and reproducibility of a 157 item semi-quantitative FFQ among Lebanese adult population.Material and methodsDietary intake was assessed through dietary recalls, a FFQ with food items, and traditional recipes from the Mediterranean cuisine. Validity of the FFQ was measured by comparing the intake of calories, macro and micronutrients to the mean values derived from three dietary recalls (DR). Reproducibility of the FFQ was evaluated after repeating the same FFQ among the participant after a four-month period.Results114 healthy adults aged between 18 and 60 years of which 52.6% are men participated in this study. 53 of these adults participated in the reproducibility study. Intra class correlation coefficient (ICC) between the two FFQ measurements ranged from 0.822 for sodium to 0.998 for energy indicating excellent reproducibility. The FFQ showed slightly higher intakes than the dietary recalls for most of the nutrients and foods reaching 2.1% for nutrients (polyunsaturated fatty acids) and 18% for food groups (olive oil). Correlation coefficients ranged between 0.783 (sodium) and 0.996 (carbs) for nutrients and between 0.906 (fish) and 1 (fruits and nuts) for food groups, with a significant p value (p = 0.038 for folate). Cross-classification of nutrients into quartiles showed that more than 81% of the participants were classified in the same quartile. Misclassifications were low for most nutrients with one to three persons misclassified at the extreme quartiles.ConclusionThe FFQ used in this research contained western and Mediterranean type of dishes and foods. Statistical analysis showed good reproducibility and validity of the tested tool in a heterogeneous sample of adults living in a Mediterranean country. It is a useful tool for future investigations and strategies promoting the comeback of this traditional diet.

Project description:BackgroundIn developing countries, including Sri Lanka, a high proportion of acute poisoning and other medical emergencies are initially treated in rural peripheral hospitals. Patients are then usually transferred to referral hospitals for further treatment. Guidelines are often used to promote better patient care in these emergencies. We conducted a cluster randomized controlled trial (ISRCTN73983810) which aimed to assess the effect of a brief educational outreach ('academic detailing') intervention to promote the utilization of treatment guidelines for acute poisoning.Methods and findingsThis cluster RCT was conducted in the North Central Province of Sri Lanka. All peripheral hospitals in the province were randomized to either intervention or control. All hospitals received a copy of the guidelines. The intervention hospitals received a brief out-reach academic detailing workshop which explained poisoning treatment guidelines and guideline promotional items designed to be used in daily care. Data were collected on all patients admitted due to poisoning for 12 months post-intervention in all study hospitals. Information collected included type of poison exposure, initial investigations, treatments and hospital outcome. Patients transferred from peripheral hospitals to referral hospitals had their clinical outcomes recorded. There were 23 intervention and 23 control hospitals. There were no significant differences in the patient characteristics, such as age, gender and the poisons ingested. The intervention hospitals showed a significant improvement in administration of activated charcoal [OR 2.95 (95% CI 1.28-6.80)]. There was no difference between hospitals in use of other decontamination methods.ConclusionThis study shows that an educational intervention consisting of brief out-reach academic detailing was effective in changing treatment behavior in rural Sri Lankan hospitals. The intervention was only effective for treatments with direct clinician involvement, such as administering activated charcoal. It was not successful for treatments usually administered by non-professional staff such as forced emesis for poisoning.Trial registrationControlled-Trials.com ISRCTN73983810 ISRCTN73983810.

Project description:BackgroundAccurate dietary assessment is key to understanding nutrition-related outcomes and for estimating the dietary change in nutrition-based interventions. When researching the habitual consumption of selected food groups, it is essential to be aware of factors that could possibly affect reporting accuracy.ObjectiveThis study aimed to evaluate the relative validity of the current-day dietary recall, a method based on a smartphone app called electronic 12-hour dietary recall (e-12HR), to categorize individuals according to habitual intake, in the whole sample of adults and in different strata thereof.MethodsUniversity students and employees over 18 years recorded the consumption of 10 selected groups of food using e-12HR during 28 consecutive days. During this period, they also completed 4 dietary records. Once the period was finished, the subjects then completed a food frequency questionnaire (FFQ) and a usability-rating questionnaire for e-12HR. The food group intakes estimated by the e-12HR app, the dietary records, and the FFQ were categorized into sextiles: less than once a week, once or twice a week, 3-4 times a week, 5-6 times a week, once or twice a day, and 3 or more times a day. The 10 selected groups with e-12HR were compared with 4 dietary records and an FFQ reference method, in the whole sample and in different strata thereof: age (years): <25 and ?25; gender: females and males; occupation: students and employees; smoking: no and yes; physical activity (minutes/week): ?150 and <150; and body mass index (kg/m2): <25 and ?25. The association between the different methods was assessed using Spearman correlation coefficient (SCC). Cross-classification and kappa statistic were used as a measure of agreement between the different methods.ResultsIn total, 203 participants completed the study (56.7% [115/203] women, and 43.3% [88/203] men). For all food groups and all participants, the mean SCC for e-12HR versus FFQ was 0.67 (?0.62 for all strata). On average, 50.7% of participants were classified into the same category (?47.0% for all strata) and 90.2% within the nearest category (?88.6% for all strata). Mean weighted kappa was 0.49 (?0.44 for all strata). For e-12HR versus RDs, mean SCC was 0.65 (?0.57 for all strata). On average, 50.0% of participants were classified into the same category (?47.0% for all strata) and 88.2% within the nearest category (?86.1% for all strata). Mean weighted kappa was 0.50 (?0.44 for all strata).ConclusionsThe results indicate that e-12HR generated categories of dietary intake highly comparable with the 2 reference methods in the whole sample and in different strata thereof. The inclusion of photographs to facilitate estimation of the servings consumed generated correlation/agreement data between e-12HR and the FFQ that were similar to a previous study using an older version of the app, which did not include photographs.

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Relative validity of a brief dietary survey to assess food intake and adherence to national dietary guidelines among Sri Lankan adults.

Publications

Relative validity of a brief dietary survey to assess food intake and adherence to national dietary guidelines among Sri Lankan adults.

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