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Dietary Factors, Food Items Asked, and Testing Status for Dietary Screener Questions for NHANES 2009-10

Substantial evaluation work has been done to develop the individual questions on the Dietary Screener Questionnaire and test the performance of subsets of questions.

Evaluation & Testing Status

The following table summarizes the evaluation and testing status for each question on the screener.

Food Item Testing Status
Cognitively Tested 1 Validity Tested 2 Translated into Spanish Translation Cognitively Tested 3
Candy X Not yet performed X X
Cereal X Not yet performed X X
Cereal type X Not yet performed X X
Cheese X Indirect X X
Cookies, cake, pie X Indirect X X
Doughnuts X Indirect X X
Dried beans X Yes X X
Fruit X Yes X X
Fruit drinks X Indirect X X
Fruit juice X Yes X X
Fried potatoes X Yes X X
Ice cream X Indirect X X
Milk X Indirect X X
Other potatoes X Yes X X
Other vegetables X Yes X X
Pizza X Not yet performed X X
Popcorn X Not yet performed X X
Processed meat X Not yet performed X X
Red meat X Not yet performed X X
Salad X Yes X X
Salsa X Yes X X
Soda X Indirect X X
Sugar/honey in coffee/tea X Not yet performed X X
Tomato sauce X Yes X X
Whole grain bread X Not yet performed X X

1.Cognitively tested indicates that the wording of the item was developed through iterative cognitive testing.

2. Validity testing indicates that the screener was administered and the results compared to multiple 24-hour recalls. Indirect validity testing indicates that a “screener” was constructed post hoc from existing screener questions and Diet History Questionnaire questions and compared to multiple 24-hour recalls.

3. Translation cognitively tested indicates that the Spanish translation of the food item was adapted for Spanish speakers using cognitive testing.

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Published Evaluation Information

Thompson FE, Midthune D, Subar AF, Kahle LL, Schatzkin A, Kipnis V. Performance of a short tool to assess dietary intakes of fruits and vegetables, percentage energy from fat and fibre. Public Health Nutr 2004 Dec;7(8):1097-105. [View Abstract]

Thompson FE, Midthune D, Subar AF, McNeel T, Berrigan D, Kipnis V. Dietary intake estimates in the National Health Interview Survey, 2000: methodology, results, and interpretation. J Am Diet Assoc 2005 Mar;105(3):352-63; quiz 487. [View Abstract]

Thompson FE, McNeel TS, Dowling EC, Midthune D, Morrissette M, Zeruto CA. Interrelationships of added sugars intake, socioeconomic status, and race/ethnicity in adults in the United States: National Health Interview Survey, 2005. J Am Diet Assoc 2009 Aug;109(8):1376-83. [View Abstract]

Colón-Ramos U, Thompson FE, Yaroch AL, Moser RP, McNeel TS, Dodd KW, Atienza AA, Sugerman SB, Nebeling L. Differences in fruit and vegetable intake among Hispanic subgroups in California: results from the 2005 California Health Interview Survey. J Am Diet Assoc 2009 Nov;109(11):1878-85. [View Abstract]

Levin K, Willis GB, Forsyth BH, Norberg A, Kudela MS, Stark D, Thompson FE. Using cognitive interviews to evaluate Spanish-language translation of a dietary questionnaire. Survey Research Methods 2009; 3:13–25.

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Unpublished Evaluation Information

Analyses have compared screener estimates of various dietary factors to multiple 24-hour dietary recalls in the Observing Protein and Energy Nutrition (OPEN) Study and the Eating at America’s Table Study (EATS) (Tables 1–4). Other analyses have compared screener estimates of fruits and vegetables and added sugars from the National Health Interview Survey (NHIS) and the California Health Interview Survey (CHIS) to estimates from two 24-hour recalls in the National Health and Nutrition Examination Survey (NHANES) (Table 5). Overall, these analyses show good agreement in estimates of mean intakes between multiple 24HR and the screener-derived variables. Generally, differences in intakes by sex and race/ethnicity evident from 24HR are reflected in differences in intakes from the screener.

TABLE 1 Estimated Mean Daily Intake of Fruits and Vegetables, Fiber, Calcium, Added Sugars, and Dairy from 24-hour Dietary Recall (24HR) and Screener. De-attenuated Pearson Correlation Coefficient between True Intakea and Screener, by Sex: OPEN (2005 National Health Interview Survey Screener)
Dietary Factor N Mean Daily Intake De-attenuated Pearson Correlation Coefficient
(SEE)
24HR Screener
Total Fruits and Vegetables (Pyramid servings/day)
Men 260 6.1 5.21 0.58
(0.066)
Women 221 5.2 4.61 0.73
(0.078)
Fruits and Vegetables without French Fries (Pyramid servings/day)
Men 260 5.9 4.91 0.61
(0.067)
Women 221 5.1 4.51 0.74
(0.070)
Fiber (gm/day)
Men 260 21.5 16.81 0.52
(0.59)
Women 221 16.6 13.11 0.54
(0.70)
Calcium (mg/day)
Men 260 876 7311 0.59
(0.066)
Women 221 720 5621 0.44
(0.080)
Added Sugars (tsp/day)
Men 260 17.8 17.2 0.68
(0.039)
Women 222 13.7 12.01 0.66
(0.045)
Dairy (Pyramid servings/day)
Men 260 1.3 1.3 0.64
(0.041)
Women 221 1.1 1.0 0.64
(0.44)

a. Estimated from multiple 24-hour dietary recalls in a measurement error model.

1. p < 0.01

TABLE 2 Estimated Mean Daily Intake of Fruits and Vegetables, Fiber, Calcium, Added Sugars, and Dairy from 24-hour Dietary Recall (24HR) and Screener. De-attenuated Pearson Correlation Coefficient between True Intakea and Screener, by Sex: EATS (2005 National Health Interview Survey Screener)
Dietary Factor N Mean Daily Intake De-attenuated Pearson Correlation Coefficient
(SEE)
24HR Screener
Total Fruits and Vegetables (Pyramid servings/day)
Men 184 6.0 5.61 0.70
(0.058)
Women 247 4.3 4.4 0.54
(0.060)
Fruits and Vegetables without French Fries (Pyramid servings/day)
Men 184 5.5 5.2 0.72
(0.054)
Women 247 4.0 4.2 0.55
(0.058)
Fiber (gm/day)
Men 184 20.3 17.41 0.60
(0.059)
Women 247 14.0 13.02 0.55
(0.054)
Calcium (mg/day)
Men 184 863 7652 0.60
(0.061)
Women 247 630 591 0.56
(0.053)
Added Sugars(tsp/day)
Men 446 18.4 19.0 0.59
(0.037)
Women 519 12.5 13.0 0.66
(0.032)
Dairy (Pyramid servings/day)
Men 446 1.3 1.4 0.74
(0.32)
Women 519 0.9 1.02 0.73
(0.029)

a. Estimated from multiple 24-hour dietary recalls in a measurement error model.

1. p < 0.05

2. p < 0.01

TABLE 3 Estimated Mean Daily Intake of Fruits and Vegetables and Added Sugars from 24-hour Dietary Recall (24HR) and Screener. De-attenuated Pearson Correlation Coefficient between True Intakea and Screener, by Sex: OPEN (2005 California Health Interview Survey Screener)
Dietary Factor N Mean Daily Intake De-attenuated Pearson Correlation Coefficient
(SEE)
24HR Screener
Total Fruits and Vegetables (Pyramid servings/day)
Men 260 5.8 5.31 0.58
(0.044)
Women 220 5.2 4.71 0.73
(0.044)
Fruits and Vegetables without French Fries (Pyramid servings/day)
Men 260 5.9 5.11 0.60
(0.043)
Women 221 5.1 4.51 0.74
(0.043)
Fruits and Vegetables without Beans (Pyramid servings/day)
Men 260 6.0 5.21 0.60
(0.044)
Women 220 5.1 4.51 0.72
(0.044)
Fruits and Vegetables without French Fries and Beans (Pyramid servings/day)
Men 260 5.7 4.91 0.62
(0.043)
Women 221 4.9 4.41 0.74
(0.043)
Added Sugars (tsp/day)
Men 256 16.0 17.0 0.69
(0.047)
Women 219 13.7 11.71 0.65
(0.076)

a. Estimated from multiple 24-hour dietary recalls in a measurement error model.

1. p < 0.01

TABLE 4 Estimated Mean Daily Intake of Fruits and Vegetables and Added Sugars from 24-hour Dietary Recall (24HR) and Screener. De-attenuated Pearson Correlation (and standard error) between True Intakea and Screener, by Sex: EATS (2005 California Health Interview Survey Screener)
Dietary Factor N Mean Daily Intake De-attenuated Pearson Correlation Coefficient
(SEE)
24HR Screener
Total Fruits and Vegetables (Pyramid servings/day)
Men 201 5.8 5.5 0.67
(0.040)
Women 260 4.2 4.51 0.49
(0.040)
Fruits and Vegetables without French Fries (Pyramid servings/day)
Men 201 5.3 5.2 0.70
(0.039)
Women 260 4.0 4.31 0.51
(0.039)
Fruits and Vegetables without Beans (Pyramid servings/day)
Men 201 5.6 5.3 0.68
(0.040)
Women 260 4.1 4.41 0.49
(0.039)
Fruits and Vegetables without French Fries and Beans (Pyramid servings/day)
Men 201 5.1 5.0 0.70
(0.039)
Women 260 3.9 4.21 0.51
(0.039)
Added Sugars (tsp/day)
Men 443 18.4 18.8 0.59
(0.037)
Women 516 12.5 12.8 0.66
(0.032)

a. Estimated from multiple 24-hour dietary recalls in a measurement error model.

1. p < 0.01

Table 5: Median Daily Intakes of Fruits and Vegetables and Added Sugars for NHANES 2001-02, NHIS 2005, and CHIS 2005, by Sex and Race/Ethnicity
Gender and Race/Ethnicity Total Fruits and Vegetables
(Pyramid Servings)
Added Sugars (tsp)
NHANES 2001-02
(24HR)
NHIS 2005
(9-item screener)
CHIS 2005
(7-item screener)
NHANES 2001-02
(24HR)
NHIS 2005
(4-item screener)
CHIS 2005
(4-item screener)
Men
Non-Hispanic White 4.7 5.2 5.5 20.5 19.0 16.9
Non-Hispanic Black 4.2 5.3 5.3 23.6 21.4 18.4
Hispanic 5.2 5.8 5.6 21.6 21.4 20.7
Women
Non-Hispanic White 4.2 4.4 4.8 14.0 12.8 11.7
Non-Hispanic Black 3.5 4.3 4.6 19.3 15.5 13.6
Hispanic 4.0 4.6 4.8 16.3 14.5 13.4

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Last Modified: 11 Apr 2014