Assessing Initial Validity and Reliability of a Beverage Intake Questionnaire in Hispanic Preschool-Aged Children

Published:August 21, 2016DOI:



      Understanding the relationship between high-calorie beverage consumption and weight gain requires an accurate report of dietary intake. A critical need exists to develop and test the psychometrics of brief quantitative tools for minority pediatric populations.


      To modify the adult beverage intake questionnaire (BEVQ-15) for Hispanic preschool-aged children (BEVQ-PS) and test its validity and test–retest reliability in children aged 3 to 5 years.


      Cross-sectional. The modified quantitative 12-beverage category questionnaire assessed consumption of water, fruit juice, sweetened juice drinks, whole milk, reduced-fat milk, low-fat milk, flavored milk, carbonated sweetened drinks, diet carbonated drinks, sweet tea, tea with or without artificial sweetener, and sport drinks consumed during the past month. Hispanic mothers (n=109) recruited from day-care centers provided one 4-day food intake record (FIR) and completed two BEVQ-PS surveys during a 2-week period for their preschool-aged child. Data collection was conducted through one-on-one interviews in Spanish. Validity was assessed by comparing amounts (in grams) and energy intake (in kilocalories) for each beverage category between the first BEVQ-PS and the mean of the FIRs using paired t tests and Pearson’s correlation coefficient. Criteria for validity were nonsignificant mean differences in grams and kilocalories from the first BEVQ-PS and mean of the FIRs beverage categories, and significant correlation coefficients between beverage categories. Test–retest reliability was assessed by comparing grams and kilocalories for each beverage category in the first BEVQ-PS with those from the second BEVQ-PS using Pearson’s correlation coefficient. The criterion for reliability was a significant correlation coefficient between beverage categories. Significance was set at P<0.05.


      Mean differences between the first BEVQ-PS and FIR for water (42.4±23.1 g), sweetened juice drinks (–1.6±11.0 g), whole milk (18.3±9.91 g), sweetened carbonated drinks (–13.0±7.9 g), and total sugar-sweetened beverages (SSB) (1.4±8.9 g) were not significantly different, but were significantly correlated (r=0.20 to 0.37; P<0.05). Thus, validity criteria were met. With the exception of flavored milk and tea with or without artificial sweeteners, the remaining beverage categories—total beverages and SSB—in the first BEVQ-PS were correlated with those from the second BEVQ-PS (r=0.20 to 0.68; P<0.05), meeting reliability criteria.


      Researchers and clinicians may use the BEVQ-PS to assess SSB, water, and whole-milk intake in Hispanic children. Additional modifications should be evaluated to assess total beverage intake.


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        • Ogden C.L.
        • Carroll M.D.
        • Kit B.K.
        • Flegal K.M.
        Prevalence of childhood and adult obesity in the United States, 2011-2012.
        JAMA. 2014; 311: 806-814
        • Pan L.
        • Blanck H.M.
        • Sherry B.
        • Dalenius K.
        • Grummer-Strawn L.M.
        Trends in the prevalence of extreme obesity among US preschool-aged children living in low-income families, 1998-2010.
        JAMA. 2012; 308: 2563-2565
        • Lee J.M.
        • Pilli S.
        • Gebremariam A.
        • et al.
        Getting heavier, younger: Trajectories of obesity over the life course.
        Int J Obes (Lond). 2010; 34: 614-623
        • Lasater G.
        • Piernas C.
        • Popkin B.M.
        Beverage patterns and trends among school-aged children in the US, 1989-2008.
        Nutr J. 2011; 10: 103
        • Hu F.B.
        • Malik V.S.
        Sugar-sweetened beverages and risk of obesity and type 2 diabetes: Epidemiologic evidence.
        Physiol Behav. 2010; 100: 47-54
        • Malik V.S.
        • Schulze M.B.
        • Hu F.B.
        Intake of sugar-sweetened beverages and weight gain: A systematic review.
        Am J Clin Nutr. 2006; 84: 274-288
        • Wang Y.C.
        • Bleich S.N.
        • Gortmaker S.L.
        Increasing caloric contribution from sugar-sweetened beverages and 100% fruit juices among US children and adolescents, 1988-2004.
        Pediatrics. 2008; 121: e1604-e1614
        • Reedy J.
        • Krebs-Smith S.M.
        Dietary sources of energy, solid fats, and added sugars among children and adolescents in the United States.
        J Am Diet Assoc. 2010; 110: 1477-1484
        • Miller P.E.
        • McKinnon R.A.
        • Krebs-Smith S.M.
        • et al.
        Sugar-sweetened beverage consumption in the U.S.: Novel assessment methodology.
        Am J Prev Med. 2013; 45: 416-421
        • Bortsov A.V.
        • Liese A.D.
        • Bell R.A.
        • et al.
        Sugar-sweetened and diet beverage consumption is associated with cardiovascular risk factor profile in youth with type 1 diabetes.
        Acta Diabetol. 2011; 48: 275-282
      1. Beverage Consumption Among High School Students—United States, 2010. Centers for Disease Control and Prevention, Atlanta, GA2011
        • Gibson R.S.
        Principles of Nutritional Assessment.
        2nd ed. Oxford University Press, New York, NY2005
        • Willett W.C.
        • Lenart E.
        Nutritional Epidemiology.
        2nd ed. Oxford University Press, New York, NY1998
        • Willett W.C.
        Future directions in the development of food-frequency questionnaires.
        Am J Clin Nutr. 1994; 59: 171S-174S
        • Lee H.
        • Kang M.
        • Song W.O.
        • Shim J.E.
        • Paik H.Y.
        Gender analysis in the development and validation of FFQ: A systematic review.
        Br J Nutr. 2016; 115: 666-671
        • Wilson A.M.
        • Lewis R.D.
        Disagreement of energy and macronutrient intakes estimated from a food frequency questionnaire and 3-day diet record in girls 4 to 9 years of age.
        J Am Diet Assoc. 2004; 104: 373-378
        • Fumagalli F.
        • Pontes Monteiro J.
        • Sartorelli D.S.
        • Vieira M.N.
        • de Lourdes Pires Bianchi M.
        Validation of a food frequency questionnaire for assessing dietary nutrients in Brazilian children 5 to 10 years of age.
        Nutrition. 2008; 24: 427-432
        • Kobayashi T.
        • Tanaka S.
        • Toji C.
        • et al.
        Development of a food frequency questionnaire to estimate habitual dietary intake in Japanese children.
        Nutr J. 2010; 9: 17
        • Hedrick V.E.
        • Comber D.L.
        • Estabrooks P.A.
        • Savla J.
        • Davy B.M.
        The beverage intake questionnaire: Determining initial validity and reliability.
        J Am Diet Assoc. 2010; 110: 1227-1232
        • Hedrick V.E.
        • Savla J.
        • Comber D.L.
        • et al.
        Development of a brief questionnaire to assess habitual beverage intake (BEVQ-15): Sugar-sweetened beverages and total beverage energy intake.
        J Acad Nutr Diet. 2012; 112: 840-849
        • Marshall T.A.
        • Eichenberger Gilmore J.M.
        • Broffitt B.
        • Levy S.M.
        • Stumbo P.J.
        Relative validation of a beverage frequency questionnaire in children ages 6 months through 5 years using 3-day food and beverage diaries.
        J Am Diet Assoc. 2003; 103 (discussion 720): 714-720
        • Henriksson H.
        • Bonn S.E.
        • Bergstrom A.
        • et al.
        A new mobile phone-based tool for assessing energy and certain food intakes in young children: A validation study.
        JMIR MHealth UHealth. 2015; 3: e38
        • Hendrie G.A.
        • Viner Smith E.
        • Golley R.K.
        The reliability and relative validity of a diet index score for 4-11-year-old children derived from a parent-reported short food survey.
        Public Health Nutr. 2014; 17: 1486-1497
        • Magarey A.
        • Golley R.
        • Spurrier N.
        • Goodwin E.
        • Ong F.
        Reliability and validity of the Children's Dietary Questionnaire; a new tool to measure children's dietary patterns.
        Int J Pediatr Obes. 2009; 4: 257-265
        • Neuhouser M.L.
        • Lilley S.
        • Lund A.
        • Johnson D.B.
        Development and validation of a beverage and snack questionnaire for use in evaluation of school nutrition policies.
        J Am Diet Assoc. 2009; 109: 1587-1592
        • Lindsay A.C.
        • Sussner K.M.
        • Greaney M.
        • Wang M.L.
        • Davis R.
        • Peterson K.E.
        Using qualitative methods to design a culturally appropriate child feeding questionnaire for low-income, Latina mothers.
        Matern Child Health J. 2012; 16: 860-866
        • Lora K.R.
        • Lewis N.M.
        • Eskridge K.M.
        • Stanek-Krogstrand K.
        • Ritter-Gooder P.
        Validity and reliability of an omega-3 fatty acid food frequency questionnaire for first-generation Midwestern Latinas.
        Nutr Res. 2010; 30: 550-557
        • Geisinger K.F.
        Cross-cultural normative assessment: Translation and adaptation issues influencing the normative interpretation of assessment instruments.
        Psychol Assessment. 1994; 6: 304
        • Bogart L.M.
        • Cowgill B.O.
        • Sharma A.J.
        • et al.
        Parental and home environmental facilitators of sugar-sweetened beverage consumption among overweight and obese Latino youth.
        Acad Pediatr. 2013; 13: 348-355
        • Sharkey J.R.
        • Dean W.R.
        • Nalty C.
        Convenience stores and the marketing of foods and beverages through product assortment.
        Am J Prev Med. 2012; 43: S109-S115
        • Sharma S.
        • Yacavone M.
        • Cao X.
        • Pardilla M.
        • Qi M.
        • Gittelsohn J.
        Dietary intake and development of a quantitative FFQ for a nutritional intervention to reduce the risk of chronic disease in the Navajo Nation.
        Public Health Nutr. 2010; 13: 350-359
        • Han E.
        • Powell L.M.
        Consumption patterns of sugar-sweetened beverages in the United States.
        J Acad Nutr Diet. 2013; 113: 43-53
        • Pennington J.A.
        • Spungen J.S.
        Bowes & Church's Food Values of Portions Commonly Used.
        19th ed. Lippincott Williams & Wilkins, Philadelphia, PA2010
      2. US Department of Agriculture, Agricultural Research Service. What we eat in America. Accessed December 21, 2015.

        • Livingstone M.B.
        • Robson P.J.
        • Wallace J.M.
        Issues in dietary intake assessment of children and adolescents.
        Br J Nutr. 2004; 92: S213-S222
      3. SAS version 9.3 [computer program]. SAS Institute Inc, Cary, NC; 2012.

      4. National Cancer Institute. Data collection instruments: Register of validated short dietary assessment instruments.[]=ffq&numitems=any&size=any&age=any&gender=any&loc=. Accessed November 19, 2015.

        • Tooze J.A.
        • Midthune D.
        • Dodd K.W.
        • et al.
        A new statistical method for estimating the usual intake of episodically consumed foods with application to their distribution.
        J Am Diet Assoc. 2006; 106: 1575-1587
        • Jarman M.
        • Fisk C.M.
        • Ntani G.
        • et al.
        Assessing diets of 3-year-old children: Evaluation of an FFQ.
        Public Health Nutr. 2014; 17: 1069-1077
        • Lanfer A.
        • Hebestreit A.
        • Ahrens W.
        • et al.
        Reproducibility of food consumption frequencies derived from the Children's Eating Habits Questionnaire used in the IDEFICS study.
        Int J Obes (Lond). 2011; 35: S61-S68
        • Wong J.E.
        • Parnell W.R.
        • Black K.E.
        • Skidmore P.M.
        Reliability and relative validity of a food frequency questionnaire to assess food group intakes in New Zealand adolescents.
        Nutr J. 2012; 11: 65
        • Jaceldo-Siegl K.
        • Knutsen S.F.
        • Sabate J.
        • et al.
        Validation of nutrient intake using an FFQ and repeated 24 h recalls in black and white subjects of the Adventist Health Study-2 (AHS-2).
        Public Health Nutr. 2010; 13: 812-819
        • Johnson-Kozlow M.
        • Matt G.E.
        • Rock C.L.
        • de la Rosa R.
        • Conway T.L.
        • Romero R.A.
        Assessment of dietary intakes of Filipino-Americans: Implications for food frequency questionnaire design.
        J Nutr Educ Behav. 2011; 43: 505-510
      5. National Cancer Institute. Dietary asessment primer: Glossary. Accessed November 24, 2015.

      6. Centers for Disease Control and Prevention. NHANES dietary web tutorial: Key concepts about measurement error. Accessed November 24, 2015.

        • Klohe D.M.
        • Clarke K.K.
        • George G.C.
        • Milani T.J.
        • Hanss-Nuss H.
        • Freeland-Graves J.
        Relative validity and reliability of a food frequency questionnaire for a triethnic population of 1-year-old to 3-year-old children from low-income families.
        J Am Diet Assoc. 2005; 105: 727-734
        • Davis J.N.
        • Koleilat M.
        • Shearrer G.E.
        • Whaley S.E.
        Association of infant feeding and dietary intake on obesity prevalence in low-income toddlers.
        Obesity. 2014; 22: 1103-1111
        • Bleich S.N.
        • Wolfson J.A.
        Trends in SSBs and snack consumption among children by age, body weight, and race/ethnicity.
        Obesity. 2015; 23: 1039-1046
        • Cullen K.W.
        • Zakeri I.
        The youth/adolescent questionnaire has low validity and modest reliability among low-income African-American and Hispanic seventh- and eighth-grade youth.
        J Am Diet Assoc. 2004; 104: 1415-1419
        • Block G.
        • Wakimoto P.
        • Jensen C.
        • Mandel S.
        • Green R.R.
        Validation of a food frequency questionnaire for Hispanics.
        Prev Chronic Dis. 2006; 3: A77


      K. R. Lora is an adjunct professor, Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City.


      M. P. Anderson is an assistant professor, Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City.


      B Davy is a professor, Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg.


      V. Hedrick is an assistant professor, Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg.


      A. M. Ferris is a professor emerita, Center for Public Health and Health Policy, University of Connecticut Health, Farmington.


      D. Wakefield is a research associate, Center for Public Health and Health Policy, University of Connecticut Health, Farmington.