The development and evaluation of the Australian child and adolescent recommended food score: a cross-sectional study

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Abstract

Background

Diet quality tools have been developed to assess the adequacy of dietary patterns for predicting future morbidity and mortality. This study describes the development and evaluation of a brief food-based diet quality index for use with children at the individual or population level. The Australian Child and Adolescent Recommended Food Score (ACARFS) was developed to reflect adherence to the Dietary Guidelines for Children and Adolescents in Australia and modelled on the approach of the US Recommended Food Score.

Methods

The ACARFS has eight sub-scales and is scored from zero to 73. The diet quality score was evaluated by assessing correlation (Spearman’s correlations) and agreement (weighted κ statistics) between ACARFS scores and nutrient intakes, derived from a food frequency questionnaire in 691 children (mean age 11.0, SD 1.1) in New South Wales, Australia. Nutrient intakes for ACARFS quartiles were compared with the relevant Australian nutrient reference values.

Results

ACARFS showed slight to substantial agreement (κ 0.13-0.64) with nutrient intakes, with statistically significant moderate to strong positive correlations with all vitamins, minerals and energy intake (r = 0.42-0.70). ACARFS was not related to BMI.Participants who scored less than the median ACARFS were more likely to have sub-optimal intakes of fibre, folic acid and calcium.

Conclusion

ACARFS demonstrated sufficient accuracy for use in future studies evaluating diet quality. Future research on its utility in targeting improvements in the nutritional quality of usual eating habits of children and adolescents is warranted.

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Most cited references 14

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Smoothing reference centile curves: the LMS method and penalized likelihood.

Stewart T. Cole, Peter G. Green, Mark P. Green (1992)

Refence centile curves show the distribution of a measurement as it changes according to some covariate, often age. The LMS method summarizes the changing distribution by three curves representing the median, coefficient of variation and skewness, the latter expressed as a Box-Cox power. Using penalized likelihood the three curves can be fitted as cubic splines by non-linear regression, and the extent of smoothing required can be expressed in terms of smoothing parameters or equivalent degrees of freedom. The method is illustrated with data on triceps skinfold in Gambian girls and women, and body weight in U.S.A. girls.

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A review of family and social determinants of children's eating patterns and diet quality.

Theresa Nicklas, Heather Patrick (2005)

With the growing problem of childhood obesity, recent research has begun to focus on family and social influences on children's eating patterns. Research has demonstrated that children's eating patterns are strongly influenced by characteristics of both the physical and social environment. With regard to the physical environment, children are more likely to eat foods that are available and easily accessible, and they tend to eat greater quantities when larger portions are provided. Additionally, characteristics of the social environment, including various socioeconomic and sociocultural factors such as parents' education, time constraints, and ethnicity influence the types of foods children eat. Mealtime structure is also an important factor related to children's eating patterns. Mealtime structure includes social and physical characteristics of mealtimes including whether families eat together, TV-viewing during meals, and the source of foods (e.g., restaurants, schools). Parents also play a direct role in children's eating patterns through their behaviors, attitudes, and feeding styles. Interventions aimed at improving children's nutrition need to address the variety of social and physical factors that influence children's eating patterns.

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Dietary diversity score in adolescents - a good indicator of the nutritional adequacy of diets: Tehran lipid and glucose study.

Leila Azadbakht, Parvin Mirmiran, Fereidoun Azizi … (2003)

The purpose of this study was to determine dietary diversity and its relation to dietary adequacy in 10-18 year-old adolescents of district 13 of Tehran during the period 1999-2001. After excluding for over and under reporters, dietary intake assessment was conducted on 304, 10-18 year old individuals, participants of Tehran Lipid and Glucose Study. A dietary diversity score was calculated as part of the pyramid serving database that is categorized into 23 broad food groups. Each of the 5 broad food categories received a maximum diversity score of 2 of the 10 possible score points. To be counted as a "consumer " for any of the food groups categories, a respondent needed to consume one-half serving, as defined by Food Guide Pyramid quantity criteria, at any time during a 2-day survey period. The nutrient adequacy ratio for a given nutrient is the ratio of a subject's intake to the current recommended allowance for the subject's sex and age category. Weight and height were measured and BMI was calculated. Student's t-test was used to compare the means. Those variables which had normal distribution were tested by Pearson correlation coefficient and the others were tested by the Spearman correlation coefficient. Mean +/-SD of dietary diversity score (DDS) was 6.25 +/- 1.08 (range 0-10). The maximum and minimum scores of dietary diversity were related to the fruit (1.46+/-0.61) and bread-grain (0.95+/-0.27) groups, respectively. Significant positive correlation was observed between DDS and the mean adequacy ratio (MAR) (r =0.42, P or = 6. In people with a DDS of six or over, BMI was higher (19.81 +/- 4.08vs18.95+/- 3.30 Kg/m(2), P<0.01) than others. There was a significant and positive correlation between DDS and most of the nutrient adequacy ratios (NARs). It is concluded that DDS is an appropriate method to evaluate nutrient intake adequacy in this group of adolescents.

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Author and article information

Contributors

Skye Marshall

Jane Watson

Tracy Burrows

Maya Guest

Clare E Collins

Journal

Journal ID (nlm-ta): Nutr J

Journal ID (iso-abbrev): Nutr J

Title: Nutrition Journal

Publisher: BioMed Central

ISSN (Electronic): 1475-2891

Publication date Collection: 2012

Publication date (Electronic): 19 November 2012

Volume: 11

Page: 96

Affiliations

[1 ]Lighthouse Nutrition Pty Ltd, 1/23 Namitjira Place, Ballina, 2478, NSW, Australia

[2 ]Nutrition and Dietetics, School of Health Sciences, Faculty of Health, The University of Newcastle, Callaghan, 2308, NSW, Australia

[3 ]Priority Research Centre in Physical Activity and Nutrition, Faculty of Health, The University of Newcastle, Callaghan, 2308, NSW, Australia

[4 ]Environmental and Occupational Health and Safety, School of Health Sciences, Faculty of Health, The University of Newcastle, Callaghan, 2308, NSW, Australia

[5 ]School of Health Sciences, Faculty of Health and Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, HA12 Hunter Building, University Drive, Callaghan, 2308, NSW, Australia

Article

Publisher ID: 1475-2891-11-96

DOI: 10.1186/1475-2891-11-96

PMC ID: 3546018

PubMed ID: 23164095

SO-VID: d656a0be-e595-4d40-b8dd-d840c98044ff

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The development and evaluation of the Australian child and adolescent recommended food score: a cross-sectional study

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Abstract

Background

Methods

Results

Conclusion

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Karger: Nutrition and Dietetics

Most cited references 14

Smoothing reference centile curves: the LMS method and penalized likelihood.

A review of family and social determinants of children's eating patterns and diet quality.

Dietary diversity score in adolescents - a good indicator of the nutritional adequacy of diets: Tehran lipid and glucose study.

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