(PTFS01-04-23) The Relative Validity of a Food Frequency Questionnaire for Toddlers Aged 18 and 24 Months

Objectives: The early life diet is a modifiable factor and critical for optimal growth, neurodevelopment and long-term health. Despite its significance, there is a lack of data and gap in validated tools that assess Canadian toddlers’ diets. Food frequency questionnaires (FFQ) estimate the usual intake over a defined period, e.g., previous month, and thus represent a fitting and convenient tool to assess intakes during a life stage of highly dynamic food preferences and varying daily intakes. The objective of this research was to determine the validity of a semi-quantitative FFQ for toddlers at 18 and 24 months of age.

Methods: Data for this research was derived from the Growing Up Milk Intake and Nutrient Status Study (NCT03038854), a 6-month intervention trial. The participants’ caregivers completed a FFQ and 5-Day Food Records (FR) at baseline and endline. Spearman’s rank correlation corrected for within- and between-participant variance was used to determine the validity of the FFQ relative to the 5d FR in a sample of 155 toddlers.

Results: Nutrient intakes at both time points were significantly correlated between the FFQ and 5d FR. The de-attenuated energy adjusted correlation coefficients (rho) were acceptable (range of 0.3-0.49) for 5 nutrients, good (0.5-0.7) for 14, and excellent ( >0.7) for 7 nutrients at 18months, and acceptable for 3, good for 12, and excellent for 11 nutrients at 24months (p < 0.05; all). The coefficients ranged from 0.39 for vitamin B6 to 0.85 for choline at 18months and 0.43 for α-linolenic acid to 1.0 for DHA at 24 months. The FFQ overestimated energy intake by 144% and 131% at 18 and 24 months of age, respectively.

Conclusions: The FFQ used in this study is an acceptable and valid tool to determine usual dietary intake in 18- and 24-month-old toddlers. A conversion factor may be beneficial to address potential overestimation of intake for this tool. This FFQ allows for the characterization of usual dietary intakes in Canadian toddlers with the goal to monitor nutrient adequacy in this critical life stage and facilitate early intervention and optimization of health outcomes.

Funding Sources: This study is supported by The University of British Columbia, and the British Columbia Children’s Hospital Research Institute, Canada, and is funded by an unrestricted grant from Société des Produits Nestlé S.A.