Journal List > Korean J Nutr > v.45(4) > 1043944

Korean J Nutr. 2012 Aug;45(4):390-399. Korean.
Published online August 31, 2012.  https://doi.org/10.4163/kjn.2012.45.4.390
© 2012 The Korean Nutrition Society
Development of a Nutrition Quotient (NQ) equation modeling for children and the evaluation of its construct validity
Hye-Young Kim,1 Sehyug Kwon,2 Jung-Sug Lee,3 Young-Sun Choi,4 Hae Rang Chung,5 Tong-Kyung Kwak,6 Juyeon Park,7 and Myung-Hee Kang8
1Department of Food & Nutrition, Yongin University, Yongin 449-714, Korea.
2Department of Statistics, Hannam University, Daejeon 306-791, Korea.
3FANSA (Food and Nutrition Statistical Analysis), Seoul 153-764, Korea.
4Department of Food & Nutrition, Daegu University, Gyeongsan 712-714, Korea.
5Nutrition for the Future Inc., Seoul 151-848, Korea.
6Department of Food & Nutrition, Yonsei University, Seoul 120-749, Korea.
7Amway Koera Ltd., Seoul 135-713, Korea.
8Department of Food & Nutrition, Daeduk Valley Campus, Hannam University, Daejeon 305-811, Korea.

To whom correspondence should be addressed. (Email: mhkang@hnu.kr )
Received July 25, 2012; Revised August 05, 2012; Accepted August 10, 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 was to develop and evaluate the construct validity of a Nutrition Quotient (NQ) for children. In a previous report (Kang, et al., 2012), the food behavior checklist for children's NQ, consisting of 19 items, was grouped into a 5-factor structure according to the exploratory factor analysis: balance, diversity, moderation, regularity, and practice. In this study, the construct validity of the NQ was assessed using a confirmatory factor analysis. Elementary school students (n = 1,393) from six large cities completed the NQ test. Indicator tests suggested an adequate model fit (goodness of fit index = 0.9613; adjusted GFI = 0.95; standardized root mean square residual = 0.0464; chi-square test statistics of < 0.001 p-value, 82.1), and item loadings were significant for all subscales (p < 0.05). The standardized path coefficients were used as the weights of the items. The NQ and the 5 factor scores of the student were calculated by the obtained weights of the questionnaire items. Logistic regression was applied to find the significant factors in order to affect a specific nutrient status. The receiver operation characteristic curve analyses were performed in order to find diagnostic cut-off points of the five factors. The food behavior checklist for children's NQ would be a handy and suitable instrument for evaluating dietary behaviors of Korean children.

Keywords: nutrition quotient; children; construct validity; dietary behavior

Figures


Fig. 1
Comparison of the distribution of NQ and factor scores by quartile between 1st and 2nd student survey.
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Fig. 2
Distribution of the NQ score of the elementary school students (n = 1,393) from the 2nd survey.
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Fig. 3
Percentage of nutrient intake to recommended nutrient intake or adequate intake from the 1st survey 1) Lowest grade: NQ percentile < 10, Low grade: 10 ≤ NQ percentile < 25, Medium grade: 25 ≤ NQ percentile < 75, High grade: 75 ≤ NQ percentile < 90, Highest grade: NQ percentile ≥ 90 2) Different alphabets are significantly different by Duncan's multiple test (p < 0.05).
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Tables


Table 1
Path coefficients of LISREL analysis from the 2nd survey and weight assignment of NQ checklist items
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Table 2
NQ score of the elementary school students from the 2nd survey
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Table 3
Correlation coefficient between NQ and each factor score
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Table 4
NQ score range by the 5 grade criterion
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Table 5
Regression coefficients from logistic regression of the 1st survey
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Table 6
Diagnostic statistics by cut-off point of the 5 factors
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Notes

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

References
1. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. The fifth Korea National Health and Nutrition Examination Survey report (KNHANES V-1). 2011.
2. Seoul City Healthy Tuckshop. [cited 2012 Jul 21].
3. Jang NS, Kang MH, Chung HK. In: Community nutrition. Paju: Kyomunsa; 2009. pp. 334.
4. Lazarou C, Newby PK. Use of dietary indexes among children in developed countries. Adv Nutr 2011;2(4):295–303.
5. Thiagarajah K, Fly AD, Hoelscher DM, Bai Y, Lo K, Leone A, Shertzer JA. Validating the food behavior questions from the elementary school SPAN questionnaire. J Nutr Educ Behav 2008;40(5):305–310.
6. Patterson RE, Haines PS, Popkin BM. Diet quality index: capturing a multidimensional behavior. J Am Diet Assoc 1994;94(1):57–64.
7. 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.
8. Kennedy ET, Ohls J, Carlson S, Fleming K. The healthy eating index: Design and applications. J Am Diet Assoc 1995;95(10):1103–1108.
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. 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.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. 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.
18. 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.
19. Kang MH, Lee JS, Kim HY, Kwon S, Choi YS, Chung HR, Kwak TK, Cho YH. Selecting items of a food behavior checklist for development of Nutrition Quotient (NQ) for children. Korean J Nutr 2012;45(4):372–389.
20. Lee RD, Nieman DC. In: Nutritional assessment. 4th ed. Boston: McGraw-Hill; 2007.
21. Johnson RA, Wichern DW. In: Applied multivariate statistical analysis. Upper Saddle River: Prentice Hall; 1992.
22. Hair FH Jr, Anderson RE, Tatham RL, Black WC. In: Multivariate data analysis. Upper Saddle River: Prentice Hall; 1995.
23. Jöreskog KG, Sörbom D. In: LISREL 8: Structural equation modelling with the SIMPLIS command language. Chicago: Scientific Software International; 1993.
24. The Korean Nutrition Society. Dietary reference intakes for Koreans. Seoul: 2010.
25. Ahn JA, Rhu KY. In: Medicine and health statistical analysis. Seoul: Hannarae Publishing Co.; 2008. pp. 297-307.
26. Kleiser C, Mensink GB, Scheidt-Nave C, Kurth BM. HuSKY: a healthy nutrition score based on food intake of children and adolescents in Germany. Br J Nutr 2009;102(4):610–618.
27. Johnson F, Wardle J, Griffith J. The adolescent food habits checklist: reliability and validity of a measure of healthy eating behaviour in adolescents. Eur J Clin Nutr 2002;56(7):644–649.
28. Smith KW, Hoelscher DM, Lytle LA, Dwyer JT, Nicklas TA, Zive MM, Clesi AL, Garceau AO, Stone EJ. Reliability and validity of the Child and Adolescent Trial for Cardiovascular Health (CATCH) food checklist: a self-report instrument to measure fat and sodium intake by middle school students. J Am Diet Assoc 2001;101(6):635–647.
29. Kant AK. Indexes of overall diet quality: a review. J Am Diet Assoc 1996;96(8):785–791.
30. Kant AK. Dietary patterns and health outcomes. J Am Diet Assoc 2004;104(4):615–635.
31. Kwon S, Kim HY, Lee JS, Kwak TK, Chung HR, Choi YS, Kang MH. Statistical approach to test construct validity and obtain weights for the children's dietary life recognition and practice index. Korean J Nutr 2011;44(1):41–48.