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    Strengthening the reporting of diet item details in feeding studies measuring the dietary metabolome: The DID-METAB core outcome set statement
    (John Wiley and Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation, 2025-04-06) Ferguson JJA; Clarke ED; Stanford J; Gómez-Martín M; Jakstas T; Collins CE; DID-METAB Delphi Working Group Authors
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    Validation and reproducibility of an iodine and selenium specific food frequency questionnaire in breastfeeding women : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand
    (Massey University, 2023) Bertasius, Charlotte
    Backgrounds: New Zealand has poor levels of iodine and selenium in its food sources. During lactation, women have increased selenium and iodine requirements, as their breastfeeding infant relies on their intake, putting them at increased risk of deficiency. Thyroid function is impacted by iodine and selenium status, and if these nutrients are low can cause consequences for the mother and breastfed infant. Dietary assessment methods, such as a Food Frequency Questionnaire (FFQ), can be utilised to assess nutrient intake, and validating an FFQ shows that the questionnaire can be used on the intended population to predict nutrient intake. To the best of our knowledge, New Zealand currently does not have a valid iodine and selenium specific FFQ for breastfeeding women. Due to this population risk with iodine and selenium, it is justified to test the validity and reproducibility of this FFQ on breastfeeding women in New Zealand. Aim: The aim of this study is to assess the validity and reproducibility of an iodine and selenium specific Food Frequency Questionnaire for breastfeeding women living in New Zealand. Methods: As part of the Mother and Infant Nutrition Investigation study (MINI), data was collected from breastfeeding mothers from three months to 12 months postpartum (PP). Participants (n = 87) were administered an iodine and selenium specific FFQ at three months and a four-day diet diary (4DDD). To assess reproducibility the FFQ was readministered at 12 months PP (FFQ2). FFQ1 was validated via 4DDD and selected biomarkers (urinary and breastmilk iodine concentrations and plasma selenium); statistical analysis was used, including Wilcoxon signed ranked test, Spearman’s correlation, cross-classifications, weighted kappa statistics, Bland Altman plots, the same statistical analysis carried out to assess reproducibility between FFQ1 and FFQ2. Results: For the validation, the correlation observed ranged from 0.317 (selenium) to 0.532 (total iodine) between the FFQ and 4DDD and for FFQ to EIB, 0.146 (selenium) and 0.155 (total iodine). Cross-classifications majority of the nutrient groups were >50% correctly classified (32.9% (selenium) to 71.6% (iodine food only)) when comparing the FFQ to 4DDD. Most of the groups were <10% misclassified (1.37% (iodine and salt) to 11.0% (selenium)). For the FFQ to EIB, the correctly classified participants were 50% (iodine) and 73.1% (selenium), and the grossly misclassified participants were 16.35% (iodine) and 3.4% (selenium). For FFQ to 4DDD, the weighted kappa values showed poor agreement (k<0.21) for two groups and fair agreement (k 0.21-0.41) for three groups. For EIB, the weighted kappa showed poor agreement (k<0.21) for four groups and fair agreement (k 0.21-0.41) for one. The Bland-Altman plots showed fair agreement for the difference between FFQ1 to 4DDD or EIB. For reproducibility, the correlation between FFQ1 and FFQ2 was 0.625 (iodine) and 0.429 (selenium). Cross-classification for correctly classified participants was >50% for iodine; for selenium and iodine, <10% were grossly misclassified. The weight kappa value showed poor agreement (k0.21) for both iodine and selenium. Conclusion: The FFQ showed reasonable validity when assessing iodine and selenium intake using the FFQ for breastfeeding women in New Zealand and showed good reproducibility for iodine and selenium. This FFQ could be used in future research on this population and could be used in primary care as a convenient way to assess iodine and selenium intake for breastfeeding women in New Zealand.
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    Determining the relative validity and reproducibility of a complementary food frequency questionnaire to assess nutrient intake in New Zealand infants aged 9 to 12 months : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand
    (Massey University, 2018) Judd, Amy
    Background: Obtaining information on dietary intake in infants is challenging but necessary to help understand the relationship between diet and growth and development. Food frequency questionnaires (FFQ) are commonly used to investigate dietary intake as they are suited for use in large population groups, can determine intake over multiple days and minimise participant and researcher burden, and associated costs. FFQs need to be specific to the population they are to be used in and validated so that their results can be interpreted with greater confidence. There are currently no simple, validated dietary assessment methods that are available to assess nutrient intake for New Zealand infants. Objective: To validate a complementary food frequency questionnaire (CFFQ) against a reference method of a four-day weighed food record (4dWFR) for assessing nutrient intakes of New Zealand infants aged 9 to 12 months. A secondary objective was to assess the reproducibility of the CFFQ by having it completed on two separate occasions, four weeks apart. Methods: A cross-sectional study design was used including ninety-five infants aged 10 ± 1 months and their primary caregiver, who completed the CFFQ twice (CFFQ-1 and CFFQ-2), approximately four weeks apart (to assess reproducibility). Four days of weighed food records (4dWFR) were collected on non-consecutive days between CFFQ administrations (validity). Validity and reproducibility were assessed for intakes of energy, macronutrients and micronutrients using paired t-tests, Pearson’s correlation coefficients, cross-classification and Bland-Altman analysis. Two data sets were created, one that included milk intake (breast milk and formula) and one that excluded milk intake. The data was also adjusted for energy intake, before being reassessed for validity and reproducibility. Results: For validity, most nutrient intakes from the CFFQ were comparable to the 4dWFR (range <1% up to 27% different). The CFFQ produced significantly higher nutrient intakes for fat and saturated fat, but significantly lower nutrient intakes for carbohydrate, fibre, folate, potassium, thiamin, riboflavin, niacin and vitamin C (p<0.01). Correlation coefficients ranged from r=0.18 (saturated fat) to r=0.81 (iron; mean r=0.52). Over half of participants had the same tertile classification by both the 4dWFR and the CFFQ (mean 53.9%, range 39.0% (selenium) to 67.4% (iron)). Between 2.1% (iron and calcium) and 14.7% (saturated fat) of participants (mean 7.1%) were misclassified into opposite tertiles. Most of the nutrients showed acceptable agreement between methods (κ=0.20–0.60). Saturated fat and selenium showed poor agreement (κ<0.20) and iron showed good agreement (κ>0.60). Removing milk intake weakened the correlations (range r=0.21 for vitamin E to r=0.60 for niacin, mean r=0.44) and reduced the agreement between methods (50.3% correctly classified and 9.2% grossly misclassified). Adjustment for energy intake showed comparable correlation coefficients (range r=0.24 for fibre and r=0.78 for calcium and iron, mean r=0.52) and improved the agreement between methods (56.2% correctly classified and 6.8% grossly misclassified). The CFFQ had adequate performance for reproducibility for all nutrients and energy with acceptable correlations (r≥0.20) and good cross-classification (>50% correctly classified and <10% grossly misclassified) apart from fat and saturated fat (40.9% and 47.3% correctly classified, respectively). All nutrients showed acceptable to good agreement between the CFFQ-1 and CFFQ-2 (κ>0.20). When milk intake was excluded and when the data was adjusted for energy intake, there was comparable acceptable to good correlations and cross-classification. Conclusion: Although there were some differences in absolute energy and nutrient intakes between the methods, the CFFQ appears to have acceptable validity for assessing 14 nutrients and good reproducibility for assessing 18 nutrients and energy in infants aged 9-12 months. The CFFQ could be used in future research to investigate infant nutrient intakes where using a simple tool with little participant burden is beneficial.
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    Determining the relative validity and reproducibility of a food frequency questionnaire to assess food group intake in high performing athletes : a thesis presented in partial fulfilment of the requirements for the degree of Masters of Science in Nutrition and Dietetics, Massey University, Albany, New Zealand
    (Massey University, 2018) Stockley, Dayna
    Background: Optimal nutrition is essential for high performing athletes in order to train effectively, optimise recovery and improve their performance. Given the differences in dietary requirements and practices that exist between athletes and the general population, dietary assessment tools designed specifically for athletes are required. Food frequency questionnaires (FFQs) are commonly used to assess habitual dietary intake as they are inexpensive, quick and easy to administer. Currently there are no athlete-specific, up-to-date, valid and reproducible FFQs to assess food group intake of athletes. This study aims to determine the relative validity and reproducibility of an athlete-specific FFQ against an estimated four day food record (4DFR) to assess food group intake in high performing athletes. Methods: Data from 66 athletes (24 males, 42 females) representing their main sport at regional level or higher and aged 16 years and over, was collected as part of a validation study in 2016. Athletes completed the athlete-specific FFQ at baseline (FFQ1) and four weeks later (FFQ2) to assess reproducibility. An estimated 4DFR was completed between these assessments to determine the relative validity of the FFQ1. Foods appearing in the 4DFR were classified into the same 129 food groups as the FFQ, and then further classified into 28 food groups in gram amounts. Agreement between the two methods for intake of food group and core food group intake was assessed using Wilcoxon signed rank tests, Spearmans correlation coefficients, cross classification with tertiles, the weighted kappa statistic and Bland-Altman analysis. Results: The FFQ overestimated intake for 17 of 28 food groups compared with the 4DFR (p<0.05). Correlations ranged from 0.11 (processed foods) to 0.78 (tea, coffee & hot chocolate), with a mean of 0.41. Correct classification of food groups into the same tertile ranged from 35.4% (starchy vegetables) to 55.5% (fats & oils). Misclassification into the opposite tertile ranged from 4.6% (legumes) to 15.4% (starchy vegetables; sauces & condiments). The weighted kappa demonstrated fair to moderate agreement (k=0.21-0.60) for food groups. Bland-Altman plots suggested that for most of food groups, the difference between FFQ1 and the 4DFR increased as the amount of each food group consumed increased. Intake from FFQ1 was significantly higher than from FFQ2 for 13 of 28 food groups. All effect sizes were small (r=0.1). Reproducibility correlations ranged from 0.49 (potato chips; fats & oils) to 1.00 (tea, coffee & hot chocolate), with a mean of 0.65. For the 23 food groups classified into tertile, 20 had >50% of participants correctly classified, <10% grossly misclassified, and 20 demonstrated moderate to good agreement (k=0.61-0.80). The exceptions were dairy; fats & oils; and processed foods & drinks which presented fair agreement (k=0.21-0.40). Conclusions: The FFQ showed reasonable validity and good reproducibility for assessing food group intake in high performance athletes in New Zealand. The FFQ could be used in future research as a convenient, cost-effective and simple way to obtain athletes’ food group intake, and identify those who could benefit from interventions to improve their nutritional adequacy and potentially their athletic performance.