Abstract
Background
A dietary assessment instrument designed for use in a nationally representative pediatric
population was required to examine associations between calcium intake and bone mineral
accrual in a large, multicenter study.
Objective
To determine the reproducibility and intermethod reliability of a youth calcium food
frequency questionnaire (FFQ) in a multiracial/ethnic sample of children and adolescents.
Design
Reproducibility (n=69) and intermethod reliability (n=393) studies were conducted
by administering repeat FFQs and three unannounced 24-hour dietary recalls to stratified
random samples of individuals participating in the Bone Mineral Density in Childhood
Study.
Participants/setting
Children and adolescents ages 5 to 21 years.
Main outcome measures
Calcium intake estimated from the FFQ and 24-hour dietary recalls.
Statistical analysis
Reproducibility was assessed by the intraclass correlation coefficient (ICC). Intermethod
reliability was assessed by deattenuated Pearson correlations between the FFQ and
24-hour recalls. Attenuation factors and calibration corrected effect estimates for
bone density were calculated to determine the potential influence of measurement error
on associations with health outcomes.
Results
The ICC (0.61) for repeat administrations and deattenuated Pearson correlation between
the FFQ and 24-hour recalls (r=0.60) for all subjects indicated reproducibility and intermethod reliability (Pearson
r=0.50 to 0.74 across sex and age groups). Attenuation factors were ≤0.50 for all sex
and age groups and lower for non-Hispanic blacks (λ=0.20) and Hispanics (λ=0.26) than
for non-Hispanic whites (λ=0.42).
Conclusions
The Bone Mineral Density in Childhood Study calcium FFQ appears to provide a useful
tool for assessing calcium intake in children and adolescents drawn from multiracial/ethnic
populations and/or spanning a wide age range. However, similar to other FFQs, attenuation
factors were substantially <1, indicating the potential for appreciable measurement
error bias. Calibration correction should be performed and racial/ethnic differences
in performance considered when analyzing and interpreting findings based on this instrument.
Keywords
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Biography
N. J. Ollberding is an assistant professor, Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.
Biography
H. J. Kalkwarf is a professor, Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.
Biography
V. Gilsanz is a professor, Division of Radiology, Children’s Hospital of Los Angeles, Los Angeles, CA.
Biography
J. M. Lappe is a professor, Division of Endocrinology, Creighton University, Omaha, NE.
Biography
S. E. Oberfield is a professor, Division of Pediatric Endocrinology Diabetes and Metabolism, Columbia University, New York, NY.
Biography
J. A. Shepherd is an associate adjunct professor, Department of Radiology, University of California, San Francisco.
Biography
K. K. Winer is director, Pediatric Endocrinology Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.
Biography
B. S. Zemel is a professor, Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA.
Article info
Publication history
Published online: February 12, 2015
Accepted:
December 23,
2014
Footnotes
Supplementary materials: The Figure and Table 5 are available online at www.andjrnl.org
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (contracts N01-HD-1-3228, -3329, -3330, -3331, -3332, and -3333), the National Center for Research Resources (contracts UL1 RR026314 and UL1 RR024134), and General Clinical Research Grants (nos. M01-RR-000240 and M01-RR-08084).
Identification
Copyright
© 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
