Nutrition Questionnaires plus (NQplus) study, a prospective study on dietary determinants and cardiometabolic health in Dutch adults

PurposeDuring the past decades, the number of people with cardiometabolic conditions substantially increased. To identify dietary factors that may be responsible for this increase in cardiometabolic conditions, the Nutrition Questionnaires plus (NQplus) study was initiated. The aim of this article is to provide an overview of the study design and baseline characteristics of the NQplus population.ParticipantsThe NQplus study is a prospective cohort study among 2048 Dutch men (52%) and women (48%) aged 20–70 years.Findings to dateAt baseline, we assessed habitual dietary intake, conducted physical examinations (measuring, eg, anthropometrics, body composition, blood pressure, pulse wave velocity, advanced glycation end product accumulation, cognitive performance), collected blood and 24-hour urine and administered a variety of validated demographic, health and lifestyle questionnaires. Participants had a mean BMI of 26.0±4.2 kg/m2, were mostly highly educated (63%), married or having a registered partnership (72%) and having a paid job (72%). Estimated daily energy and macronutrient intakes (mean±SD) were 8581±2531 kJ, 15±2energy (en%) of protein, 43±6 en% of carbohydrates, 36±5 en% of fat and 11±13 g of alcohol. Mean systolic blood pressure was 126±15 mm Hg, total cholesterol 5.3±1.1 mmol/L and haemoglobin A1c 36±5 mmol/mol. A total of 24% of the participants reported to be diagnosed with hypertension, 18% with hypercholesterolaemia and 4% with diabetes mellitus. All measurements were repeated after 1 and 2 years of follow-up.Future plansWe endeavour to continue measurements on the long-term. Moreover, dietary assessment methods used in the NQplus study will be extensively validated, that is, Food Frequency Questionnaires, 24-hour recalls and urinary and blood biomarkers of exposure. As such, the NQplus study will provide a unique opportunity to study many cross-sectional and longitudinal associations between diet and cardiometabolic health outcomes using the best dietary assessment methods available so far.

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Role of metabolomics in identification of biomarkers related to food intake

Proceedings of The Nutrition Society ◽

10.1017/s002966511900048x ◽

2019 ◽

Vol 78 (02) ◽

pp. 189-196 ◽

Cited By ~ 10

Author(s):

Cassandra Collins ◽

Aoife E. McNamara ◽

Lorraine Brennan

Keyword(s):

Food Intake ◽

Measurement Errors ◽

Dietary Assessment ◽

Assessment Methods ◽

Cross Sectional ◽

Dietary Biomarkers ◽

Dietary Assessment Methods ◽

Complementary Approach ◽

Disease Causation ◽

Experimental Approaches

Dietary assessment methods including FFQ and food diaries are associated with many measurement errors including energy under-reporting and incorrect estimation of portion sizes. Such errors can lead to inconsistent results especially when investigating the relationship between food intake and disease causation. To improve the classification of a person's dietary intake and therefore clarify proposed links between diet and disease, reliable and accurate dietary assessment methods are essential. Dietary biomarkers have emerged as a complementary approach to the traditional methods, and in recent years, metabolomics has developed as a key technology for the identification of new dietary biomarkers. The objective of this review is to give an overview of the approaches used for the identification of biomarkers and potential use of the biomarkers. Over the years, a number of strategies have emerged for the discovery of dietary biomarkers including acute and medium term interventions and cross-sectional/cohort study approaches. Examples of the different approaches will be presented. Concomitant with the focus on single biomarkers of specific foods, there is an interest in the development of biomarker signatures for the identification of dietary patterns. In the present review, we present an overview of the techniques used in food intake biomarker discover, including the experimental approaches used and challenges faced in the field. While significant progress has been achieved in the field of dietary biomarkers in recent years, a number of challenges remain. Addressing these challenges will be key to ensure success in implementing use of dietary biomarkers.

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Faculty Opinions recommendation of Dietary assessment methods in epidemiologic studies.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726711683.793532919 ◽

2017 ◽

Author(s):

Pagona Lagiou

Keyword(s):

Dietary Assessment ◽

Epidemiologic Studies ◽

Assessment Methods ◽

Dietary Assessment Methods

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Dietary assessment methods in epidemiological research: current state of the art and future prospects

F1000Research ◽

10.12688/f1000research.10703.1 ◽

2017 ◽

Vol 6 ◽

pp. 926 ◽

Cited By ~ 98

Author(s):

Androniki Naska ◽

Areti Lagiou ◽

Pagona Lagiou

Keyword(s):

Dietary Assessment ◽

Smart Phone ◽

Food Composition ◽

Individual Variability ◽

Assessment Methods ◽

Nutrient Intakes ◽

Dietary Biomarkers ◽

Novel Technologies ◽

Sources Of Error ◽

Dietary Assessment Methods

Self-reported dietary intake is assessed by methods of real-time recording (food diaries and the duplicate portion method) and methods of recall (dietary histories, food frequency questionnaires, and 24-hour dietary recalls). Being less labor intensive, recall methods are more frequently employed in nutritional epidemiological investigations. However, sources of error, which include the participants’ inability to fully and accurately recall their intakes as well as limitations inherent in the food composition databases applied to convert the reported food consumption to energy and nutrient intakes, may limit the validity of the generated information. The use of dietary biomarkers is often recommended to overcome such errors and better capture intra-individual variability in intake; nevertheless, it has its own challenges. To address measurement error associated with dietary questionnaires, large epidemiological investigations often integrate sub-studies for the validation and calibration of the questionnaires and/or administer a combination of different assessment methods (e.g. administration of different questionnaires and assessment of biomarker levels). Recent advances in the omics field could enrich the list of reliable nutrition biomarkers, whereas new approaches employing web-based and smart phone applications could reduce respondent burden and, possibly, reporting bias. Novel technologies are increasingly integrated with traditional methods, but some sources of error still remain. In the analyses, food and nutrient intakes always need to be adjusted for total daily energy intake to account for errors related to reporting.

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Comparison dietary assessment methods in Sri Lankan adults: use of 24-hour dietary recall and 7-day weighed intake

BMC Nutrition ◽

10.1186/s40795-016-0059-5 ◽

2016 ◽

Vol 2 (1) ◽

Cited By ~ 5

Author(s):

Ranil Jayawardena

Keyword(s):

Dietary Assessment ◽

Assessment Methods ◽

Sri Lankan ◽

Dietary Recall ◽

Dietary Assessment Methods

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A Novel Food Record App for Dietary Assessments Among Older Adults With Type 2 Diabetes: Development and Usability Study

JMIR Formative Research ◽

10.2196/14760 ◽

2021 ◽

Vol 5 (2) ◽

pp. e14760

Author(s):

Hyunggu Jung ◽

George Demiris ◽

Peter Tarczy-Hornoch ◽

Mark Zachry

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Qualitative Data ◽

Dietary Assessment ◽

Assessment Methods ◽

Smartphone App ◽

Food Record ◽

Food Items ◽

Dietary Assessment Methods

Background More than 1 in 4 people in the United States aged 65 years and older have type 2 diabetes. For diabetes care, medical nutrition therapy is recommended as a clinically effective intervention. Previous researchers have developed and validated dietary assessment methods using images of food items to improve the accuracy of self-reporting over traditional methods. Nevertheless, little is known about the usability of image-assisted dietary assessment methods for older adults with diabetes. Objective The aims of this study were (1) to create a food record app for dietary assessments (FRADA) that would support image-assisted dietary assessments, and (2) to evaluate the usability of FRADA for older adults with diabetes. Methods For the development of FRADA, we identified design principles that address the needs of older adults and implemented three fundamental tasks required for image-assisted dietary assessments: capturing, viewing, and transmitting images of food based on the design principles. For the usability assessment of FRADA, older adults aged 65 to 80 years (11 females and 3 males) were assigned to interact with FRADA in a lab-based setting. Participants’ opinions of FRADA and its usability were determined by a follow-up survey and interview. As an evaluation indicator of usability, the responses to the survey, including an after-scenario questionnaire, were analyzed. Qualitative data from the interviews confirmed the responses to the survey. Results We developed a smartphone app that enables older adults with diabetes to capture, view, and transmit images of food items they consumed. The findings of this study showed that FRADA and its instructions for capturing, viewing, and transmitting images of food items were usable for older adults with diabetes. The survey showed that participants found FRADA easy to use and would consider using FRADA daily. The analysis of the qualitative data from interviews revealed multiple categories, such as the usability of FRADA, potential benefits of using FRADA, potential features to be added to FRADA, and concerns of older adults with diabetes regarding interactions with FRADA. Conclusions This study demonstrates in a lab-based setting not only the usability of FRADA by older adults with diabetes but also potential opportunities using FRADA in real-world settings. The findings suggest implications for creating a smartphone app for an image-assisted dietary assessment. Future work still remains to evaluate the feasibility and validity of FRADA with multiple stakeholders, including older adults with diabetes and dietitians.

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A Comparison of Two Dietary Assessment Methods in a Mediterranean Lebanese Adults Population: A Food Frequency Questionnaire and a Dietary Recall

Universal Journal of Public Health ◽

10.13189/ujph.2018.060505 ◽

2018 ◽

Vol 6 (5) ◽

pp. 262-273

Author(s):

Maya Tueni ◽

Afifee Mounayar ◽

Ines Birlouez-Aragon

Keyword(s):

Food Frequency Questionnaire ◽

Dietary Assessment ◽

Assessment Methods ◽

Food Frequency ◽

Dietary Recall ◽

Dietary Assessment Methods

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Development and Usability Assessment of a Food Record App for Dietary Assessments among Older Adults with Type 2 Diabetes (Preprint)

10.2196/preprints.14760 ◽

2019 ◽

Author(s):

Hyunggu Jung ◽

George Demiris ◽

Peter Tarczy-Hornoch ◽

Mark Zachry

Keyword(s):

Older Adults ◽

Qualitative Data ◽

Dietary Assessment ◽

Smartphone Application ◽

Design Principles ◽

Assessment Methods ◽

Food Record ◽

Food Items ◽

Usability Assessment ◽

Dietary Assessment Methods

BACKGROUND More than one in four people in the United States aged 65 years and older have diabetes. For diabetes care, medical nutrition therapy (MNT) is recommended as a clinically effective intervention. Prior researchers have developed and validated dietary assessment methods using images of food items for improving the accuracy of self-reporting over traditional methods. Nevertheless, little is known about the usability of image-assisted dietary assessment methods for older adults with diabetes. OBJECTIVE The aims of this study were: a) to create a food record app for dietary assessments (FRADA) that would support image-assisted dietary assessments, and b) to evaluate the usability of FRADA for older adults with diabetes. METHODS For the development of FRADA, we identified design principles that address the needs of older adults and implemented three fundamental tasks required for image-assisted dietary assessments: capturing, viewing, and transmitting images of food based on the design principles. For the usability assessment of FRADA, older adults aged 65 to 80 (11 females and 3 males) were assigned to interact with FRADA in a lab-based setting. Participants’ opinions of FRADA and its usability were determined by a follow-up survey and interview. As an evaluation indicator of usability, the responses to the survey including an After-Scenario Questionnaire were analyzed. Qualitative data from the interviews confirmed the responses to the survey. RESULTS We developed a smartphone application that enables older adults with diabetes to capture, view, and transmit images of food items they consumed. The findings of this study showed that FRADA and its instructions for capturing, viewing, and transmitting images of food items were usable for older adults with diabetes. The survey showed that FRADA was easy to use, and study participants would consider using FRADA daily. The analysis of the qualitative data from interviews revealed multiple themes, such as the usability of FRADA, potential benefits and features of FRADA, and concerns of older adults with diabetes when interacting with FRADA. CONCLUSIONS This study demonstrates in a lab-based setting, not only the usability of FRADA with older adults who have diabetes, but it also demonstrates potential opportunities using FRADA in real-life settings. The findings suggest implications for creating a smartphone application for an image-assisted dietary assessment. Future work still remains to evaluate the feasibility and validity of FRADA with multiple stakeholders involving older adults with diabetes and dietitians.

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