Advertisement
Research Research and Professional Brief| Volume 110, ISSUE 1, P111-115, January 2010

Download started.

Ok

Development and Evaluation of a Brief Calcium Assessment Tool for Adolescents

      Abstract

      Adolescence is a critical time to achieve peak bone mass. However, results of national surveys suggest that young people are not consuming adequate amounts of calcium. A simple calcium self-assessment tool with low respondent burden could provide immediate feedback that may encourage calcium consumption. This study used data reduction methods to shorten a previously evaluated calcium-specific food frequency questionnaire to the 15-item Brief Calcium Assessment Tool (BCAT). Sample 1 was a cross-sectional sample of 1,426 students in sixth and 11th grades (April 2002 to February 2003) who completed the calcium food frequency questionnaire. Sample 1 was divided into two matching samples (Group 1 and Group 2). Sample 2 was a cross-sectional sample of 745 girls in sixth grade that completed the calcium food frequency questionnaire (July 2002 to February 2005). The development of the BCAT and its calcium score used two unique samples (Group 1 of Sample 1 and Sample 2) followed by confirmation of the score in a second sample (Group 2 of Sample 1). Bone mineral content was measured among the girls in Sample 2. The BCAT calcium score was associated with total hip bone mineral content (β=.014, P=0.003) and femoral neck bone mineral content (β=.002, P=0.006) while adjusting for covariates. Sample 3 (n=265), a subsample of Sample 2, completed bone measures 12 months later. The BCAT calcium score at the baseline was a predictor of total body bone mineral content (β=.279, P=0.041) at 12 months. The correlation of BCAT scores 1 week apart was .76 (P<0.001) among a convenience sample of 41 boys and girls aged 9 to 17 years (October 2005 to December 2005). The BCAT took about 5 minutes to complete. The significant relationship between bone mass and the BCAT calcium score supports the use of BCAT as a tool to assess food calcium intake among adolescents, especially Asian, Hispanic, and non-Hispanic white girls. The reliability and low respondent burden of the BCAT make the tool useful for large-scale studies and community-based programs.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Wang M.C.
        • Crawford P.B.
        • Hudes M.
        • Van Loan M.
        • Siemering K.
        • Bachrach L.K.
        Diet in midpuberty and sedentary activity in prepuberty predict peak bone mass.
        Am J Clin Nutr. 2003; 77: 495-503
        • Teegarden D.
        • Lyle R.M.
        • Proulx W.R.
        • Johnston C.C.
        • Weaver C.M.
        Previous milk consumption is associated with greater bone density in young women.
        Am J Clin Nutr. 1999; 69: 1014-1017
        • Kalkwarf H.J.
        • Khoury J.C.
        • Lanphear B.P.
        Milk intake during childhood and adolescence, adult bone density, and osteoporotic fractures in US women.
        Am J Clin Nutr. 2003; 77: 257-265
        • Institute of Medicine, Food and Nutrition Board
        Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride.
        National Academies Press, Washington, DC1997
        • Moshfegh A.
        • Goldman J.
        • Cleveland L.
        What We Eat in America, NHANES 2001-2002: Usual Nutrient Intakes from Food Compared to Dietary Reference Intakes.
        US Department of Agriculture, Agricultural Research Service, Beltsville, MD2005
        • Bailey D.A.
        • Martin A.D.
        • McKay H.A.
        • Whiting S.
        • Mirwald R.
        Calcium accretion in girls and boys during puberty: A longitudinal analysis.
        J Bone Miner Res. 2000; 15: 2245-2250
        • Cummings S.R.
        • Block G.
        • McHenry K.
        • Baron R.B.
        Evaluation of two food frequency methods of measuring dietary calcium intake.
        Am J Epidemiol. 1987; 126: 796-802
        • Angus R.M.
        • Sambrook P.N.
        • Pocock N.A.
        • Eisman J.A.
        A simple method for assessing calcium intake in Caucasian women.
        J Am Diet Assoc. 1989; 89: 209-214
        • Hertzler A.A.
        • Frary R.B.
        A dietary calcium rapid assessment method (RAM).
        Top Clin Nutr. 1994; 9: 76-85
        • Blalock S.J.
        • Currey S.S.
        • DeVellis R.F.
        • Gold D.T.
        • Dooley M.A.
        Using a short food frequency questionnaire to estimate dietary calcium consumption: A tool for patient education.
        Arthritis Care Res. 1998; 11: 479-484
        • Montomoli M.
        • Gonnelli S.
        • Giacchi M.
        • Mattei R.
        • Cuda C.
        • Rossi S.
        • Gennari C.
        Validation of a food frequency questionnaire for nutritional calcium intake assessment in Italian women.
        Eur J Clin Nutr. 2002; 56: 21-30
        • Blalock S.J.
        • Norton L.L.
        • Patel R.A.
        • Cabral K.
        • Thomas C.L.
        Development and assessment of a short instrument for assessing dietary intakes of calcium and vitamin D.
        J Am Pharm Assoc. 2003; 43: 685-693
        • Ward K.D.
        • Hunt K.M.
        • Berg M.B.
        • Slawson D.A.
        • Vukadinovich C.M.
        • McClanahan B.S.
        • Clemons L.H.
        Reliability and validity of a brief questionnaire to assess calcium intake in female collegiate athletes.
        Int J Sport Nutr Exerc Metab. 2004; 14: 209-221
        • Wilson P.
        • Horwath C.
        Validation of a short food frequency questionnaire for assessment of dietary calcium intake in women.
        Eur J Clin Nutr. 1996; 50: 220-228
        • Magkos F.
        • Manios Y.
        • Babaroutsi E.
        • Sidossis L.S.
        Development and validation of a food frequency questionnaire for assessing dietary calcium intake in the general population.
        Osteoporos Int. 2006; 17: 304-312
        • Musgrave K.O.
        • Giambalvo L.
        • Leclerc H.L.
        • Cook R.A.
        • Rosen C.J.
        Validation of a quantitative food frequency questionnaire for rapid assessment of dietary calcium intake.
        J Am Diet Assoc. 1989; 89: 1484-1488
        • Hacker-Thompson A.
        • Robertson T.P.
        • Sellmeyer D.E.
        Validation of two food frequency questionnaires for dietary calcium assessment.
        J Am Diet Assoc. 2009; 109: 1237-1240
        • Barr S.I.
        Associations of social and demographic variables with calcium intakes of high school students.
        J Am Diet Assoc. 1994; 94 (269): 260-266
        • Taylor R.W.
        • Goulding A.
        Validation of a short food frequency questionnaire to assess calcium intake in children aged 3 to 6 years.
        Eur J Clin Nutr. 1998; 52: 464-465
        • Harnack L.
        • Lytle L.A.
        • Story M.
        • Galuska D.A.
        • Schmitz K.
        • Jacobs D.R.
        Reliability and validity of a brief questionnaire to assess calcium intake of middle-school-aged children.
        J Am Diet Assoc. 2006; 106: 1790-1795
        • Jensen J.K.
        • Gustafson D.
        • Boushey C.J.
        • Auld G.
        • Bock M.A.
        • Bruhn C.M.
        • Gabel K.
        • Misner S.
        • Novotny R.
        • Peck L.
        • Read M.
        Development of a food frequency questionnaire to measure calcium intake of Asian, Hispanic, and white youth.
        J Am Diet Assoc. 2004; 104: 762-769
        • Boushey C.
        Nutritional epidemiology.
        in: Weaver C. Heaney R.P. Calcium in Human Health. Humana Press Inc, Totowa, NJ2006: 39-63
        • Weaver C.M.
        • McCabe L.D.
        • McCabe G.P.
        • Novotny R.
        • Van Loan M.
        • Going S.
        • Matkovic V.
        • Boushey C.
        • Savaiano D.A.
        • ACT Research Team
        Bone mineral and predictors of bone mass in white, Hispanic, and Asian early pubertal girls.
        Calcif Tissue Int. 2007; 81: 352-363
        • Matlik L.
        • Savaiano D.
        • McCabe G.
        • VanLoan M.
        • Blue C.L.
        • Boushey C.J.
        Perceived milk intolerance is related to bone mineral content in 10-13 year-old adolescent females.
        Pediatrics. 2007; 120: e669-e677
        • Novotny R.
        • Going S.
        • Teegarden D.
        • Van Loan M.
        • McCabe G.
        • McCabe L.
        • Daida Y.G.
        • Boushey C.J.
        • ACT Research Team
        Hispanic and Asian pubertal girls have higher android/gynoid fat ratio than whites.
        Obesity. 2007; 15: 1565-1570
        • Siris E.S.
        • Miller P.D.
        • Barrett-Connor E.
        • Faulkner K.G.
        • Wehren L.E.
        • Abbott T.A.
        • Berger M.L.
        • Santora A.C.
        • Sherwood L.M.
        Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: Results from the National Osteoporosis Risk Assessment.
        JAMA. 2001; 286: 2815-2822
        • Wong S.S.
        • Boushey C.J.
        • Novotny R.
        • Gustafson D.R.
        Evaluation of a computerized food frequency questionnaire to estimate calcium intake of Asian, Hispanic, and non-Hispanic white youth.
        J Am Diet Assoc. 2008; 108: 539-543
        • Tanner J.M.
        Growth at Adolescence.
        2nd ed. Blackwell Scientific, Oxford, UK1962
        • Aaron D.J.
        • Kriska A.M.
        • Dearwater S.R.
        • Cauley J.A.
        • Metz K.F.
        • LaPorte R.E.
        Reproducibility and validity of an epidemiologic questionnaire to assess past-year physical activity in adolescents.
        Am J Epidemiol. 1995; 142: 191-201
        • Aaron D.J.
        • Kriska A.M.
        • Dearwater S.R.
        • Anderson R.L.
        • Olsen T.L.
        • Cauley J.A.
        • LaPorte R.E.
        The epidemiology of leisure physical activity in an adolescent population.
        Med Sci Sports Exerc. 1993; 25: 847-853
        • Ainsworth B.E.
        • Haskell W.L.
        • Whitt M.C.
        • Irwin M.L.
        • Swartz A.M.
        • Strath S.J.
        • O'Brien W.L.
        • Bassett Jr, D.R.
        • Schmitz K.H.
        • Emplaincourt P.O.
        • Jacobs Jr, D.R.
        • Leon A.S.
        Compendium of physical activities: An update of activity codes and MET intensities.
        Med Sci Sports Exerc. 2000; 32: S498-S504
        • Noethlings U.
        • Hoffman K.
        • Bergmann M.M.
        • Boeing H.
        Portion size adds limited information on variance in food intake of participants in the EPIC-Potsdam Study.
        J Nutr. 2003; 133: 510-515
        • Moore L.L.
        • Singer M.R.
        • Qureshi M.M.
        • Bradlee M.L.
        Dairy intake and anthropometric measures of body fat among children and adolescents in NHANES.
        J Am Coll Nutr. 2008; 27: 702-710
        • Molgaard C.
        • Thomsen B.L.
        • Michaelsen K.F.
        The influence of calcium intake and physical activity on bone mineral content and bone size in healthy children and adolescents.
        Osteoporos Int. 2001; 12: 887-894
        • Weaver C.M.
        • Wastney M.
        • Spence L.
        Quantitative clinical nutrition approaches to the study of calcium and bone metabolism.
        Clin Rev Bone Miner Metab. 2002; 1: 219-232

      Biography

      Y. J. Yang is a research professor, Department of Medicine, College of Medicine, Hanyang University, Seoul, Korea; at the time of the study, she was a research assistant and doctoral degree candidate, Department of Foods and Nutrition, Purdue University, West Lafayette, IN.

      Biography

      B. R. Martin is a research associate, Department of Foods and Nutrition, Purdue University, West Lafayette, IN.

      Biography

      C. J. Boushey is an associate professor, Department of Foods and Nutrition, Purdue University, West Lafayette, IN.