Development of a Nutrition Quotient (NQ) equation modeling for children and the evaluation of its construct validity

Hye-Young Kim; Sehyug Kwon; Jung-Sug Lee; Young-Sun Choi; Hae Rang Chung; Tong-Kyung Kwak; Juyeon Park; Myung-Hee Kang

doi:10.4163/kjn.2012.45.4.390

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

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim, Kwon, Lee, Choi, Chung, Kwak, Park, and Kang: Development of a Nutrition Quotient (NQ) equation modeling for children and the evaluation of its construct validity

Research Article

Korean Journal of Nutrition

Korean Journal of Nutrition 2012; 45(4): 390-399.

Published online: 31 August 2012

DOI: https://doi.org/10.4163/kjn.2012.45.4.390

Development of a Nutrition Quotient (NQ) equation modeling for children and the evaluation of its construct validity

Hye-Young Kim¹, Sehyug Kwon², Jung-Sug Lee³, Young-Sun Choi⁴, Hae Rang Chung⁵, Tong-Kyung Kwak⁶, Juyeon Park⁷, 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. (mhkang@hnu.kr)

Received 25 July 2012 Revised 5 August 2012 Accepted 10 August 2012

(open-access):

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 and Tables

Fig. 1

Comparison of the distribution of NQ and factor scores by quartile between 1^st and 2^nd student survey.

Fig. 2

Distribution of the NQ score of the elementary school students (n = 1,393) from the 2^nd survey.

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).

Table 1

Path coefficients of LISREL analysis from the 2nd survey and weight assignment of NQ checklist items

1) LISREL result: χ² = 82.06, p = 1.0, GFI = 0.96, AGFI = 0.95, SRMR = 0.046, 2) Item weight within NQ = rounded factor weight within NQ × rounded item weight within a factor

^*: p < 0.05, ^**: p < 0.01

Table 2

NQ score of the elementary school students from the 2nd survey

1) factor score = sum of [checklist item score (0-100) × rounded item weight within a factor], NQ score = sum of [checklist item score (0-100) × item weight within NQ] 2) Mean ± SD 3) NS: not significant between boys and girls by the t-test

Table 3

Correlation coefficient between NQ and each factor score

Table 4

NQ score range by the 5 grade criterion

Table 5

Regression coefficients from logistic regression of the 1st survey

1) ≤ 125% of energy intake = 0, > 125% of energy intake = 1 2) ≥ 75% of RNI or AI of a nutrient = 0, < 75% of RNI or AI = 1 3) MAR (mean adequacy ratio): ≥ 0.75 of MAR = 0, < 0.75 of MAR = 1

^*: p <0.1, ^**: p <0.05, ^***: p <0.01

Table 6

Diagnostic statistics by cut-off point of the 5 factors

1) MAR: mean adequacy ratio of protein, calcium, iron, vitamin A, vitamin B2, vitamin C, folate and zinc

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. Available from: http://www.healthytuckshop.or.kr.

3. Jang NS, Kang MH, Chung HK. Community nutrition. 2009. Paju: Kyomunsa;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. Development and evaluation of the healthy eating index-2005. Technical report. 2007. Alexandria (VA): Center for Nutrition Policy and Promotion, U.S. Department of Agriculture.

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. Nutritional assessment. 2007. 4th ed. Boston: McGraw-Hill.

21. Johnson RA, Wichern DW. Applied multivariate statistical analysis. 1992. Upper Saddle River: Prentice Hall.

22. Hair FH Jr, Anderson RE, Tatham RL, Black WC. Multivariate data analysis. 1995. Upper Saddle River: Prentice Hall.

23. Jöreskog KG, Sörbom D. LISREL 8: Structural equation modelling with the SIMPLIS command language. 1993. Chicago: Scientific Software International.

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

25. Ahn JA, Rhu KY. Medicine and health statistical analysis. 2008. Seoul: Hannarae Publishing Co.;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.

TOOLS

Similar articles