Food intake of Portuguese school-aged children: Development and trial of a new evaluation tool 

Research Project supervised by Professor José Pereira Miguel (Institute of Preventive Medicine, Faculty of Medicine of the University of Lisbon) and co-supervised by Professor Ana Rito (National Health Institute Dr Ricardo Jorge)

Introduction: 
Eating and Nutrition account for two primary determining factors in some chronic diseases (Nestle, 2007; Shetty, 2009), namely child obesity, which stands out as one of the most serious challenges to public health in the 21st century (James, 2006). Prevention and treatment of child obesity become a priority, since it is more difficult to reverse obesity in adulthood and to treat related co-morbidities (Branca, Nikogosian, & Lobstein, 2007). However, the design of interventions aiming to prevent and treat this pathology is based on shortage of valid and reliable evaluation methods that assess the effectiveness of interventions, namely in what concerns children’ food consumption, and that can identify nutritional deficits and emphasize the need for a diversified and balanced diet in the prevention of this disease. (Shetty, 2009).

To date, there is no gold standard to evaluate children’s food intake. Despite the fact that Portuguese Food Balances provide consumption estimates based on food availability, and that National Health Surveys give information on the individual food intake with regard to some types of food, this information is insufficient to enable us to know the real food intake trend and eating habits of the Portuguese population (Lopes et al., 2006), namely of children. Thus, food intake evaluation becomes a priority in monitoring the nutritional status of children, and is crucial for undertaking epidemiological studies aiming to establish a relationship between eating and children’s health status. It is necessary to develop valid and reliable tools to evaluate the food intake of Portuguese school-aged children that are suitable and specific to those ages, genders and distinct ethnic groups.

Objectives:
To build, validate and trial a new tool to evaluate the food intake of Portuguese school-aged children.

Methods:
An online questionnaire for individual filling is currently being prepared aimed at Portuguese children between 7 and 10 years of age. The sample does not include children under 7, as below that age children are unable to conceptualize the real notion of time, for which reason any evaluation of their food intake needs to rely on information provided by their families (Livingstone, Robson, & Wallace, 2004). In addition, it does not include children older than 10 years of age because above that age group, energetic and nutritional needs increase significantly, which makes it necessary to use food portions of different sizes to estimate food intake above this age group (Wrieden et al., 2008). Literature suggest that from the ages of 7-8, children have competences enabling them to answer questionnaires on food taken for a period of time not exceeding the previous 24 hours without parental assistance (Livingstone, Robson, & Wallace, 2004). Accordingly, it was decided to adapt a questionnaire to the previous 24 hours and made it available online, given that using a PC has indicated children’s increased motivation to fill it in. (Moore et al., 2008).

The research project will be developed according to the following stages: I) Devising a tool for evaluating the eating intake of Portuguese children aged 7-10; II) Study of the validity of contents, reliability and the construct validity of a tool for evaluating the eating intake of Portuguese children aged 7-10; and III) Pilot trial to evaluate the food intake of Portuguese children aged 7-10 using the tool developed previously.

Expected results: 
Development of a valid, reliable and simple tool that is simultaneously appealing to Portuguese school-aged children and allows gathering detailed information on the quality and amount of food taken, in addition to offering an estimation of the energetic and nutritional intake of these children.

Conclusion: 
The development of this new evaluation tool will enable the systematic monitoring of Portuguese school-aged children’s food intake and food policy planning, the development of eating education initiatives, and will act as a fundamental descriptive basis for the future planning of analytical research.

Maria Ana Carvalho
PhD student in the Metabolic Sciences and Eating Behaviour Degree of the Faculty of Medicine of the University of Lisbon
mariaanacarvalho@gmail.com
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Bibliography:

Branca, F., Nikogosian, H., & Lobstein, T (Eds.). (2007). The challenge of obesity in the WHO European Region and the strategies for response. Copenhagen: World Health Organization Regional Office for Europe.

James, W.P. (2006). The challenge of childhood obesity. International Journal of Pediatric Obesity, 1(1), 7-10.

Livingstone, M. B. E., Robson, P. J., Wallace, J. M. W. (2004). Issues in dietary intake assessment of children and adolescents. British Journal of Nutrition, 92 (Suppl 2), S213-S222.

Lopes, C., Oliveira, A., Santos, A. C., Ramos, E., Gaio, A. R., Severo, M., Barros, H. (2006). Consumo alimentar no Porto. Porto: Carla Lopes.

Moore, H.J., Ells, L.J., McLure, S.A., Crooks, S., Cumbor, D., Summerbell, C. D., Batterham, A. M. (2008). The development and evaluation of a novel computer program to assess previous-day dietary and physical activity behaviours in school children: Tha Synchronised Nutrition and Activity ProgramTM (SNAPTM). British Journal of Nutrition, 99, 1266-1274.

Nestle, M. (2007). Nutrition in Public Health and Preventive Medicine. In Wallace, R. B & Kohatsu, N., Public Health & Preventive Medicine (15th ed., pp. 1195-1203). Iowa City: McGraw-Hill.

Shetty, P. S. (2009). Food and nutrition. In Detels, R., Beaglehole, R., Lansang, M. A., Gulliford, M., Oxford Textbook of Public Health (5th ed., pp.177-196). USA: Oxford University Press.

Wrieden, W. L., Longbottom, P. J., Adamson, A. J., Ogston, S. A, Payne, A., Haleem, M. A., Barton, K. L. (2008). Estimation of typical food portion sizes for children of different ages in Great Britain. British Journal of Nutrition, 99, 1344-1353.