Abstract
The ability of parents to accurately report energy intake in toddlers has rarely been
validated using the gold-standard doubly labeled water (DLW) method to assess total
energy expenditure (TEE). The aim of the study was to evaluate the accuracy of toddler
energy intake (EI), estimated using the Australian Child and Adolescent Eating Survey
(ACAES) food frequency questionnaire (FFQ) by parent report compared with a weighed
food record (WFR) and TEE measured by DLW. Twelve toddlers had TEE assessed over 10
days using DLW. Usual energy intake was estimated by the primary caregiver, using
standard toddler portions in ACAES-FFQ and a 4-day WFR and daily EI (in kilocalories)
derived using national nutrient databases. Accuracy of reporting was calculated from
absolute (EI-TEE) and percentage (EI/TEE×100) differences between EI and TEE and Pearson
correlations and limits of agreement from Bland-Altman plots. Toddlers (n=12, 7 boys)
had a mean age of 3.2±0.5 years, body mass index 16.2±0.9 kg, body mass index z score 0.1±0.8, EI from ACAES-FFQ 1,183±281kcal/day, and WFR 1,179±278 kcal/day and
DLW TEE 1,251±149 kcal/day. The mean difference and limits of agreement (±2 standard
deviations) compared with DLW was −68 (−623, 488) kcal/day for the FFQ and for the
WFR −72 (−499, 354) kcal/day. Although both a semiquantitative FFQ and WFR can adequately
estimate toddler energy intake at the group level in this population, toddler-specific
portion size estimates should be assigned to foods listed in the FFQ. Choice of method
is likely to depend on practical issues, including cost and burden.
Keywords
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Biography
C. E. Collins is a professor, School of Health Sciences, Faculty of Health and Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, New South Wales, Australia.
Biography
T. L. Burrows is a lecturer, School of Health Sciences, Faculty of Health and Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, New South Wales, Australia.
Biography
R. Callister is a professor, School of Biomedical Sciences and Pharmacy, Faculty of Health and Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, New South Wales, Australia.
Biography
H. Truby is a professor, Department of Nutrition and Dietetics, Southern Clinical School of Medicine, Monash University, Victoria, Australia.
Biography
P. J. Morgan is a professor, School of Education, Faculty of Education and Arts and Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, New South Wales, Australia.
Biography
I. M. R. Wright is an associate professor, School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Callaghan, New South Wales, Australia, and a senior staff specialist neonatologist, John Hunter Children's Hospital and the Mother and Babies Research Centre, Hunter Medical Research Institute, Rankin Park, New South Wales, Australia.
Biography
P. S. W. Davies is a professor, Children's Nutrition Research Centre, School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Article info
Publication history
Published online: January 11, 2013
Accepted:
September 21,
2012
Footnotes
Available online 11 January 2013
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This study was supported from a Hunter Children's Research Foundation and Hunter Medical Research Institute grant and researcher support from a National Health and Medical Research Council Career Development Fellowship.
Identification
Copyright
© 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
