Reliability and validity of a short tool assessing Australian toddlers’ dietary risk (#178)
Identifying toddlers at dietary risk is crucial for determining who requires intervention to improve dietary patterns and reduce health consequences. We aimed to determine the reliability and validity of a new simple tool that assesses dietary risk patterns of Australian toddlers.
The 19-item Toddler Dietary Questionnaire (TDQ) was developed based on Australian dietary guidelines and recent toddler dietary intake data. It assesses the previous week’s intake of ‘core’ (e.g. fruit, vegetables, dairy, meat, water) and ‘discretionary’ (high-fat, -sugar and/or -salt foods, sweetened beverages) food-groups, which is evaluated using a scoring system to determine total dietary risk (0-100; higher score=higher risk). Parents (n=111) of children aged 12-36 months completed the TDQ for their child, and 2-4 weeks later completed a second TDQ and a validated Food Frequency Questionnaire (FFQ). FFQ data were converted to a third TDQ and risk score calculated. Test-retest reliability and relative validity of total dietary risk scores and cross-classification of risk scores into categories (low, moderate, high, very high) were assessed.
Reliability testing showed dietary risk scores between two administrations of the TDQ were highly correlated (ICC=0.91) but significantly different (28.0 SD 8.9 v 28.3 SD 9.4, p=0.005). Dietary risk scores between the TDQ and FFQ were highly correlated (r=0.81) and not significantly different (p=0.157), suggesting ability to identify dietary risk based on the TDQ at the individual and group level. All participants were classified into the same (reliability n=87, 78%; validity n=84, 76%) or adjacent (reliability n=24, 22%; validity n=26, 24%) dietary risk category.
The TDQ is a moderately reliable and valid assessment tool that screens toddlers to identify those at-risk requiring intervention. It can be used for population health monitoring, evaluating interventions and furthering our understanding of the relationship between dietary risk and health outcomes, including the development of childhood obesity.