| Childhood overweight has become a public health issue rising steadily since the 1960s. Overweight has been associated with disease and psychosocial stigmatization. Accurate assessment of eating habits in children provides information so researchers may develop strategies to combat the epidemic of overweight in children. Developmental abilities related to memory, comprehension, attention, and information processing must be understood to design a reliable and valid dietary assessment instrument. Using theoretical constructs from Piaget and Vygotsky, coupled with information processing, the Developmental Eating Habits Questionnaire (DEHQ), a food frequency questionnaire, was designed to estimate dietary intake in elementary school children by using meal categorization, visual imagery, chunking, and a child-friendly format. Response categories queried ‘usual’ dietary intake during the week and on weekend days as well as estimated portion sizes of foods eaten. Test-retest reliability was assessed. Validity was determined using 2 or 3 audiotaped food records. Analyses were performed using intraclass correlation. The DEHQ was tested in 241 elementary school children (50% female; 31.8% African American, 20.5% American Indian, 28.9% White, 18.8% Other) in Wilson County and Cherokee, North Carolina. Children randomized to one of three groups, either completed the DEHQ twice and completed audiotaped food records (n = 32), completed the DEHQ twice (n = 91) or completed the DEHQ once (n = 118). While the DEHQ is reliable (ICC = .73 [kcal] for total energy intake; .74 for fat intake [gm]) it showed no concurrent validity when compared to food records. The DEHQ overestimated and food records underestimated energy intake compared to national averages. While content validity was shown, the lack of concurrent validity may be due to the child's understanding of ‘usual’ as well as small sample size. Further validity research should be conducted more food examples, combining the lunch and after school meal categories as well as prompting cards. While FFQs are not intended to provide precise measurements of intake, they do provide evidence and specific group ranking of a child's eating patterns. |
