Validation testing of a short food‐group‐based questionnaire to assess dietary risk in preschoolers aged 3–5 years

This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for self-archiving'. Copyright (2018) Dietitians Association of Australia. All rights reserved. This author accepted manuscript is made available following 12 month embargo from date of publication (February 2018) in accordance with the publisher’s archiving policy.Background: Short questionnaire-style dietary assessment methods are useful for monitoring compliance with dietary guidelines. A reliable and valid short food-based questionnaire for assessing dietary risk in toddlers aged 1-3 years was recently adapted for use in pre-schoolers. This study aimed to determine the reliability and validity of this 19-item Preschooler Dietary Questionnaire (PDQ) that assesses dietary risk of 3-5 year-olds. Methods: Primary caregivers of preschoolers completed a two-stage online survey: 1) a demographic questionnaire and the PDQ; 2) a second PDQ and a validated 54-item semi-quantitative food frequency questionnaire (FFQ). Dietary risk scores (0-100; higher score=higher risk) derived from the two PDQ administrations (2.1±1.0 weeks apart) were compared and average scores assessed against the FFQ. Cross-classification into dietary risk categories (low, 0-24; moderate, 25-49; high, 50-74; very high, 75- 100) was determined. The relationship of dietary risk scores with BMI z-score was assessed using standard linear regression. Results: Preschoolers’ (n=74) risk scores were highly correlated yet statistically different for reliability (ICC=0.87; mean bias 1.51, 95% CI 0.07, 2.95, p=0.040) and validity (r=0.85; mean bias -1.64, 95% CI -2.86, -0.43, p=0.009). There was no systematic bias between the two tools. All participants were classified into the same (80%) or adjacent (20%) category upon administration of each tool. Risk scores were not associated with BMIz scores (β -0.09, 95%CI -0.02,-0.04, p=0.512). Conclusion: The PDQ is a novel and useful screening instrument to rapidly identify preschooler dietary, but not obesity, risk. The tool could facilitate referral to appropriate health professionals for detailed assessment and intervention