Selecting items of a food behavior checklist for the development of Nutrition Quotient (NQ) for children

doi:10.4163/kjn.2012.45.4.372

Journal List > Korean J Nutr > v.45(4) > 1043943


Korean J Nutr. 2012 Aug;45(4):372-389. Korean. Published online August 31, 2012. https://doi.org/10.4163/kjn.2012.45.4.372
© 2012 The Korean Nutrition Society


Selecting items of a food behavior checklist for the development of Nutrition Quotient (NQ) for children
Myung-Hee Kang,¹ Jung-Sug Lee,² Hye-Young Kim,³ Sehyug Kwon,⁴ Young-Sun Choi,⁵ Hae Rang Chung,⁶ Tong-Kyung Kwak,⁷ and Yang-Hee Cho⁸
¹Department of Food & Nutrition, Daeduk Valley Campus, Hannam University, Daejeon 305-811, Korea.
²FANSA (Food and Nutrition Statistical Analysis), Seoul 153-764, Korea.
³Department of Food & Nutrition, Yongin University, Yongin 449-714, Korea.
⁴Department of Statistics, Hannam University, Daejeon 306-791, Korea.
⁵Department of Food & Nutrition, Daegu University, Daegu 712-714, Korea.
⁶Nutrition for the Future Inc., Seoul 151-848, Korea.
⁷Department of Food & Nutrition, Yonsei University, Seoul 120-749, Korea.
⁸Amway Korea Ltd., Seoul 135-713, Korea.
To whom correspondence should be addressed. (Email: mhkang@hnu.kr )

Received July 23, 2012; Revised August 02, 2012; Accepted August 06, 2012.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract
The objective of this study is to select a simple and easy measurable food behavior checklist for the development of Nutrition Quotient (NQ) for children, which reflects children's diet quality, as well as to evaluate the validity of the items in the food behavior checklist. The first 36 items in the checklist were established by an expert review, modifying the preliminary 50 items in the checklist, which had been selected by a literature review and the Korean National Health and Nutrition Examination Survey data. 341 children in 5th and 6th grades at an elementary school participated in a one-day dietary record survey, and later responded to 36 food behavior questions of the checklist. Pearson's correlation coefficients between the responses to the food behavior checklist items along with the mean nutrient intakes of the children were calculated. From the result, in which responses of food frequency and food behavior items showed certain association with the dietary record data, a second checklist with 22 items was selected. A survey was conducted by using the second checklist. 1,393 children in the 5th and 6th grades at 12 elementary schools in metropolitan cities, such as Seoul, Busan, Gwangju, Daegu, Daejeon, and Incheon, participated in the survey. Further, an exploratory factor analysis was performed. After the analysis, 19 items (10 items from food frequency and 9 items from food behavior) were finalized as the food behavior checklist items for the NQ. The final 19 food behavior checklist items were composed of 5 factors: 'Balance', 'Diversity', 'Moderation', 'Regularity', and 'Practice'. This study is a significant first trial to establish a comprehensive system for evaluating children's food habit and diet quality. This checklist might need continuous modification and revision reflecting the change of children's dietary life and the social environment.


Keywords: nutrition quotient; children; food behavior checklist; dietary record

Figures


	Fig. 1 Development of the NQ checklist items.
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	Fig. 2 Percentage of average nutrient intake of the children to recommended nutrient intake (RNI) or adequate intake (AI). ^*: Nutrient intake of male subjects are significantly different from those of female subjects by Student t-test at α = 0.05 level.
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	Fig. 3 Percentage of children below Estimated Average Requirement (EAR). ^*: Nutrient intake of male subjects are significantly different from those of female subjects by Student t-test at α = 0.05 level.
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	Fig. 4 Food behavior checklist for children's NQ.
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Tables


	Table 1 The first tentative checklist of 36 food frequency and food behavior items for the nutrient survey for children
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	Table 2 Anthropometric characteristics of the children
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	Table 3 Nutrient intakes of the children
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	Table 4 Nutrient intakes per 1,000 kcal of the children
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	Table 5 Mean scores and significant correlations of the food frequency checklist items with dietary quality variables by the 10 to 11 years-old children1)
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	Table 6 Mean scores and significant correlations of the food behavior checklist items with dietary quality variables by the 10 to 11 years-old children1)
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	Table 7 Factor loading coefficients of the survey data with 22 checklist items for NQ
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	Table 8 Factor loading coefficients of final 19 NQ checklist items
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Notes

This research was supported by a grant from Amway Korea Ltd. in 2011.

References


1.	Lee JS, Kim HY, Choi YS, Kwak TK, Chung HR, Kwon S, Choi YJ, Lee SK, Kang MH. Comparison of perception and practice levels of dietary life in elementary school children according to gender and obesity status. Korean J Nutr 2011;44(6):527–536.

2.	Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. The fourth Korea National Health and Nutrition Examination Survey report (KNHANES IV-3). 2010.

3.	Kant AK. Indexes of overall diet quality: a review. J Am Diet Assoc 1996;96(8):785–791.

4.	Kant AK. Dietary patterns and health outcomes. J Am Diet Assoc 2004;104(4):615–635.

5.	Michels KB, Schulze MB. Can dietary patterns help us detect diet-disease associations? Nutr Res Rev 2005;18(2):241–248.

6.	Patterson RE, Haines PS, Popkin BM. Diet quality index: capturing a multidimensional behavior. J Am Diet Assoc 1994;94(1):57–64.

7.	Kennedy ET, Ohls J, Carlson S, Fleming K. The Healthy Eating Index: design and applications. J Am Diet Assoc 1995;95(10):1103–1108.

8.	Haines PS, Siega-Riz AM, Popkin BM. The Diet Quality Index revised: a measurement instrument for populations. J Am Diet Assoc 1999;99(6):697–704.

9.	Guenther PM, Reedy J, Krebs-Smith SM, Reeve BB, Basiotis PP. In: Development and evaluation of the healthy eating index-2005. Technical report. Alexandria (VA): Center for Nutrition Policy and Promotion, U.S. Department of Agriculture; 2007.

*10.*	Serra-Majem L, Ribas L, Ngo J, Ortega RM, García A, Pérez-Rodrigo C, Aranceta J. Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean Diet Quality Index in children and adolescents. Public Health Nutr 2004;7(7):931–935.

*11.*	Blackburn ML, Townsend MS, Kaiser LL, Martin AC, West EA, Turner B, Joy AB. Food behavior checklist effectively evaluates nutrition education. Calif Agric 2006;60(1):20–24.

*12.*	Townsend MS, Kaiser LL, Allen LH, Joy AB, Murphy SP. Selecting items for a food behavior checklist for a limited-resource audience. J Nutr Educ Behav 2003;35(2):69–77.

*13.*	Branscum P, Sharma M, Kaye G, Succop P. An evaluation of the validity and reliability of a food behavior checklist modified for children. J Nutr Educ Behav 2010;42(5):349–352.

*14.*	Kim KN, Hyun T, Lee JW. Development of a simple screening test for identifying Korean elderly at risk of undernutrition. Korean J Community Nutr 2000;5(3):475–483.

*15.*	Park YS, Han JL, Lee JW, Cho HS, Koo J, Kim JH, Yoon JS. The development of a simple evaluation questionnaire for screening the overweight-type dietary pattern in 30 to 49 year old adults. Korean J Community Nutr 2002;7(4):495–505.

*16.*	Park YS, Lee JW. Development of a simple evaluation questionnaire for screening the dietary patterns of overweight young adults. Korean J Community Nutr 2002;7(5):675–685.

*17.*	Park JA, Yoon JS. A screening tool for identifying high-risk pregnant women of Fe deficiency anemia: Process I. Korean J Community Nutr 2001;6(5):734–743.

*18.*	Park JA, Yoon JS. A screening tool for identifying high-risk pregnant women of Fe deficiency anemia: Process II. Korean J Community Nutr 2003;8(2):160–170.

*19.*	Yon M, Hyun T. Development of an eating habit checklist for screening elementary school children at high risk of energy overintake. Korean J Nutr 2008;41(5):414–427.

*20.*	Yon M, Hyun T. Development of an eating habit checklist for screening elementary school children at risk of inadequate micronutrient intake. Korean J Nutr 2009;42(1):38–47.

*21.*	Kang MH, Kwak TK, Choi YS, Chung HR, Kim HY, Lee JS, Yi NY, Choi JH. In: KFDA report. 2009. Production and evaluation of safety index for children's dietary life.

*22.*	Ministry of Health and Welfare. Dietary guidelines leaflet for Korean. Seoul: 2009.

*23.*	Feskanich D, Rockett HR, Colditz GA. Modifying the Healthy Eating Index to assess diet quality in children and adolescents. J Am Diet Assoc 2004;104(9):1375–1383.

*24.*	Kim JA, Lee SY. Nutritional evaluation of served menu in Korean temples. Korean J Nutr 2007;40(2):172–181.

*25.*	The Korean Nutrition Society. Dietary reference intakes for Koreans. Seoul: 2010.

*26.*	Lee RD, Nieman DC. In: Nutritional assessment. 4th ed. Boston: McGraw-Hill; 2007.

*27.*	Lazarou C, Newby PK. Use of dietary indexes among children in developed countries. Adv Nutr 2011;2(4):295–303.

*28.*	Kourlaba G, Panagiotakos D. The number of index components affects the diagnostic accuracy of a diet quality index: the role of intracorrelation and intercorrelation structure of the components. Ann Epidemiol 2009;19(10):692–700.

*29.*	Kourlaba G, Panagiotakos D. The diagnostic accuracy of a composite index increases as the number of partitions of the components increases and when specific weights are assigned to each component. J Appl Stat 2010;37(4):537–554.

*30.*	Murphy SP, Kaiser LL, Townsend MS, Allen LH. Evaluation of validity of items for a food behavior checklist. J Am Diet Assoc 2001;101(7):751–761.

*31.*	Taylor JP, Evers S, McKenna M. Determinants of healthy eating in children and youth. Can J Public Health 2005;96 Suppl 3:S20–S26. S22–S29.

*32.*	Davis MM, Gance-Cleveland B, Hassink S, Johnson R, Paradis G, Resnicow K. Recommendations for prevention of childhood obesity. Pediatrics 2007;120 Suppl 4:S229–S253.

*33.*	Hurley KM, Oberlander SE, Merry BC, Wrobleski MM, Klassen AC, Black MM. The healthy eating index and youth healthy eating index are unique, nonredundant measures of diet quality among low-income, African American adolescents. J Nutr 2009;139(2):359–364.