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Validation of a Brief Dietary Assessment Tool for Estimating Dietary EPA and DHA Intake in Australian Adults at Risk of Cardiovascular Disease.
J Am Coll Nutr 2015; 34(4):333-9JA

Abstract

BACKGROUND

Short food frequency questionnaires (FFQs) are powerful screening instruments for estimating nutrient intakes and play an important role in risk stratification in vulnerable populations. Omega-3 fatty acids are of increasing importance in the prevention of chronic and degenerative disease, especially in older adults who are at higher risk of these chronic conditions. A short FFQ exists to rapidly assess omega-3 intake from marine sources, however it has not previously been validated for agreement with total omega-3 intake and ability to identify suboptimal omega-3 intakes in older adults or for use in Australia.

OBJECTIVE

The aim of the study was to validate a 9-item marine omega-3 FFQ (MFQ) for assessment of omega-3 intake against a validated 74-item semiquantitative FFQ.

METHODS

One hundred and eight participants (mean age 67 ± 10 years, 47% male) completed the MFQ designed to estimate omega-3 intake from marine sources and the 74-item FFQ designed to estimate usual omega-3 and total energy intake in addition to other nutrients. To test agreement between the two questionnaires for estimating total omega-3 intake, mean bias and 95% limits of agreement (LOA) were calculated. Sensitivity and specificity were assessed using 2 × 2 contingency tables based on whether participants did or did not meet National Heart Foundation (NHF) recommendations for omega-3 intake per day.

RESULTS

Mean intake of omega-3 estimated from the MFQ was 210 ± 235 mg/day compared with 295 ± 260 mg/day as estimated by the FFQ. Mean bias (95% LOA) for omega-3 assessed by the two questionnaires was 89 mg/day (-475 mg to 653 mg). The MFQ achieved 98% sensitivity and 31% specificity for the omega-3 cut-off of 500 mg/day. When nutrient composition of the marine products were replaced with Australian data, mean intake of omega-3 was 230 ± 253 mg and the mean bias improved to 64 mg (-681 mg to 553 mg) and achieved 93% sensitivity and 40% specificity.

CONCLUSIONS

The MFQ shows promise as a rapid screening tool for identifying older adults with intakes of omega-3 fatty acids likely to be below recommendations for chronic and degenerative disease risk reduction. Given the clinically meaningful mean bias and wide LOA, it cannot be recommended as an appropriate tool for the purpose of reporting average intake of individuals. Use of Australian nutrient data improved the mean bias of the tool in estimating total omega-3 intake. The values should be replaced and the MFQ could then be a useful tool for research purposes at the population level.

Authors+Show Affiliations

a Department of Nutrition and Dietetics , Flinders University , Adelaide , AUSTRALIA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Validation Studies

Language

eng

PubMed ID

25864413

Citation

Dickinson, Kacie M., et al. "Validation of a Brief Dietary Assessment Tool for Estimating Dietary EPA and DHA Intake in Australian Adults at Risk of Cardiovascular Disease." Journal of the American College of Nutrition, vol. 34, no. 4, 2015, pp. 333-9.
Dickinson KM, Delaney CL, Allan R, et al. Validation of a Brief Dietary Assessment Tool for Estimating Dietary EPA and DHA Intake in Australian Adults at Risk of Cardiovascular Disease. J Am Coll Nutr. 2015;34(4):333-9.
Dickinson, K. M., Delaney, C. L., Allan, R., Spark, I., & Miller, M. D. (2015). Validation of a Brief Dietary Assessment Tool for Estimating Dietary EPA and DHA Intake in Australian Adults at Risk of Cardiovascular Disease. Journal of the American College of Nutrition, 34(4), pp. 333-9. doi:10.1080/07315724.2014.962191.
Dickinson KM, et al. Validation of a Brief Dietary Assessment Tool for Estimating Dietary EPA and DHA Intake in Australian Adults at Risk of Cardiovascular Disease. J Am Coll Nutr. 2015;34(4):333-9. PubMed PMID: 25864413.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Validation of a Brief Dietary Assessment Tool for Estimating Dietary EPA and DHA Intake in Australian Adults at Risk of Cardiovascular Disease. AU - Dickinson,Kacie M, AU - Delaney,Christopher L, AU - Allan,Richard, AU - Spark,Ian, AU - Miller,Michelle D, Y1 - 2015/04/11/ PY - 2015/4/14/entrez PY - 2015/4/14/pubmed PY - 2016/4/19/medline KW - dietary intake assessment KW - fatty acids KW - food frequency questionnaire KW - omega-3 SP - 333 EP - 9 JF - Journal of the American College of Nutrition JO - J Am Coll Nutr VL - 34 IS - 4 N2 - BACKGROUND: Short food frequency questionnaires (FFQs) are powerful screening instruments for estimating nutrient intakes and play an important role in risk stratification in vulnerable populations. Omega-3 fatty acids are of increasing importance in the prevention of chronic and degenerative disease, especially in older adults who are at higher risk of these chronic conditions. A short FFQ exists to rapidly assess omega-3 intake from marine sources, however it has not previously been validated for agreement with total omega-3 intake and ability to identify suboptimal omega-3 intakes in older adults or for use in Australia. OBJECTIVE: The aim of the study was to validate a 9-item marine omega-3 FFQ (MFQ) for assessment of omega-3 intake against a validated 74-item semiquantitative FFQ. METHODS: One hundred and eight participants (mean age 67 ± 10 years, 47% male) completed the MFQ designed to estimate omega-3 intake from marine sources and the 74-item FFQ designed to estimate usual omega-3 and total energy intake in addition to other nutrients. To test agreement between the two questionnaires for estimating total omega-3 intake, mean bias and 95% limits of agreement (LOA) were calculated. Sensitivity and specificity were assessed using 2 × 2 contingency tables based on whether participants did or did not meet National Heart Foundation (NHF) recommendations for omega-3 intake per day. RESULTS: Mean intake of omega-3 estimated from the MFQ was 210 ± 235 mg/day compared with 295 ± 260 mg/day as estimated by the FFQ. Mean bias (95% LOA) for omega-3 assessed by the two questionnaires was 89 mg/day (-475 mg to 653 mg). The MFQ achieved 98% sensitivity and 31% specificity for the omega-3 cut-off of 500 mg/day. When nutrient composition of the marine products were replaced with Australian data, mean intake of omega-3 was 230 ± 253 mg and the mean bias improved to 64 mg (-681 mg to 553 mg) and achieved 93% sensitivity and 40% specificity. CONCLUSIONS: The MFQ shows promise as a rapid screening tool for identifying older adults with intakes of omega-3 fatty acids likely to be below recommendations for chronic and degenerative disease risk reduction. Given the clinically meaningful mean bias and wide LOA, it cannot be recommended as an appropriate tool for the purpose of reporting average intake of individuals. Use of Australian nutrient data improved the mean bias of the tool in estimating total omega-3 intake. The values should be replaced and the MFQ could then be a useful tool for research purposes at the population level. SN - 1541-1087 UR - https://www.unboundmedicine.com/medline/citation/25864413/Validation_of_a_Brief_Dietary_Assessment_Tool_for_Estimating_Dietary_EPA_and_DHA_Intake_in_Australian_Adults_at_Risk_of_Cardiovascular_Disease_ L2 - http://www.tandfonline.com/doi/full/10.1080/07315724.2014.962191 DB - PRIME DP - Unbound Medicine ER -