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Validation of New Interactive Nutrition Assistant - Diet in India Study of Health (NINA-DISH) FFQ with multiple 24-h dietary recalls among pregnant women in Pune, India.

ABSTRACT: Adequate dietary intake is critical to prevent adverse pregnancy outcomes. India has a high burden of maternal and child morbidity and mortality, but there is a lack of adequate tools to assess dietary intake. We validate an FFQ, New Interactive Nutrition Assistant - Diet in India Study of Health (NINA-DISH), among pregnant women living with and without HIV in Pune, India. Women were selected from a cohort study investigating immune responses to HIV and latent tuberculosis during pregnancy. The FFQ was administered during the third trimester and validated against multiple 24-h dietary recalls (24-HDR) collected in second and third trimesters. Data for analysis were available from fifty-eight women out of seventy enrolled into this sub-study, after excluding those with incomplete data or implausible energy intake. The median (Q1, Q3) age of study participants was 23 (20, 25) years. Median (Q1, Q3) daily energy intakes were 10 552 (8000, 11 958) and 10 673 (8510, 13 962) kJ by 24-HDR and FFQ, respectively, with FFQ overestimating nutrient intake. Pearson correlations between log-transformed estimates from FFQ and 24-HDR for energy, protein, carbohydrate, fat, Fe and Zn were 0·47, 0·48, 0·45, 0·33, 0·4 and 0·54, respectively. Energy-adjusted and de-attenuated correlations ranged from 0·41 (saturated fat) to 0·73 (Na). The highest misclassification into extreme tertiles was observed for fat (22 %), saturated fat (21 %) and Na (21 %). Bias existed at higher intake levels as observed by Bland-Altman plots. In conclusion, NINA-DISH is a valid and feasible tool for estimating dietary intakes among urban pregnant women in Western India.

SUBMITTER: Rajagopalan K

PROVIDER: S-EPMC8236492 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

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Validation of New Interactive Nutrition Assistant - Diet in India Study of Health (NINA-DISH) FFQ with multiple 24-h dietary recalls among pregnant women in Pune, India.

Rajagopalan Kripa K Alexander Mallika M Naik Shilpa S Patil Nikhil N Mehta Shivani S Leu Cheng-Shiun CS Bhosale Ramesh R Mathad Jyoti S JS Caulfield Laura E LE Gupta Amita A Talegawkar Sameera A SA Shivakoti Rupak R

The British journal of nutrition 20201228 8

Adequate dietary intake is critical to prevent adverse pregnancy outcomes. India has a high burden of maternal and child morbidity and mortality, but there is a lack of adequate tools to assess dietary intake. We validate an FFQ, New Interactive Nutrition Assistant - Diet in India Study of Health (NINA-DISH), among pregnant women living with and without HIV in Pune, India. Women were selected from a cohort study investigating immune responses to HIV and latent tuberculosis during pregnancy. The ...[more]

PMID: 33357249

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Project description:BackgroundThere is an increasing interest in estimating environmental impact of individuals' diets by using individual-level food consumption data. However, like assessment of nutrient intakes, these data are prone to substantial measurement errors dependent on the method of dietary assessment, and this often result in attenuation of associations.PurposeTo investigate the performance of a food frequency questionnaire (FFQ) for estimating the environmental impact of the diet as compared to independent 24-h recalls (24hR), and to study the association between environmental impact and dietary quality for the FFQ and 24hR.MethodsWe analysed cross-sectional data from 1169 men and women, aged 20-76 years, who participated in the NQplus study, the Netherlands. They completed a 216-item FFQ and two replicates of web-based 24hR. Life cycle assessments of 207 food products were used to calculate greenhouse gas emissions, fossil energy and land use, summarised into an aggregated score, pReCiPe. Validity of the FFQ was evaluated against 24hRs using correlation coefficients and attenuation coefficients. Associations with dietary quality were based on Dutch Healthy Diet 15-index (DHD15-index) and Nutrient Rich Diet score (NRD9.3).ResultsFor pReCiPe, correlation coefficient between FFQ and 24hR was 0.33 when adjusted for covariates age, gender and BMI, and increased to 0.76 when de-attenuated for within-subject variation in the 24hR. Energy-adjustment slightly reduced these correlations (r = 0.71 for residuals of observed values and 0.59 for residuals of density values). Covariate-adjusted attenuation coefficient for the FFQ was 0.56 (ʎ1 = 0.56 and ʎ1 = 0.65 for observed and density residuals), slightly lower than without covariate adjustment. Diet-related environmental impact was inversely associated with the food-based DHD15-index for both FFQ and 24hR, while associations with the nutrient-based NRD9.3 were inconsistent.ConclusionsThe FFQ slightly underestimated environmental impact when compared to 24hR. Associations with dietary quality are highly dependent on the diet score used, and less dependent on the method of dietary assessment.

Project description:BackgroundStatistical methods to model the usual dietary intake of foods in a population generally ignore the additional information on the never-consumers. The objective of this study is to determine the added value of Food Frequency Questionnaire (FFQ) data allowing distinguishing the never-consumers from the non-consumers while modeling the usual intake distribution.MethodsThree food items with a different proportion of never-consumers were selected from the database of the Belgian food consumption survey of 2004 (N = 3200). The usual intake distribution for these food items was modeled with the Statistical Program for Analysis of Dietary Exposure (SPADE) and modeling parameters were extracted. These parameters were used to simulate (a) a new database with two 24-h recalls per respondent and (b) a "true" usual intake distribution. The usual intake distribution from the new database was obtained by modeling the 24-h recalls with SPADE, once without and once with the inclusion of the FFQ data on the never-consumers. Ratios were calculated for the different percentiles of the usual intake distribution: the modeled usual intake (g/day) (for both SPADE with and without the inclusion of FFQ data on never-consumers) was divided by the corresponding percentile of the simulated "true" usual intake (g/day). The closer the ratio is to one, the better the model fits the data.ResultsInclusion of the FFQ information to identify the never-consumers did not improve the estimation of the higher percentiles of the usual intake distribution. However, taking into account this FFQ information improved the estimation of the lower percentiles of the usual intake distribution even when the proportion of never-consumers was low.ConclusionsThe inclusion of FFQ information to identify the never-consumers is beneficial when interested in the whole usual intake distribution or in the lower percentiles only, no matter how low the proportion of never-consumers for that food item may be. However, when interest is only in the higher percentiles of the usual intake distribution, inclusion of FFQ information to identify the never-consumers will have no benefit.

Project description:BackgroundThe Minimum Dietary Diversity for Women of Reproductive Age (MDD-W) indicator was validated as a proxy of micronutrient adequacy among nonpregnant women in low- and middle-income countries (LMICs). At that time, indeed, there was insufficient data to validate the indicator among pregnant women, who face higher micronutrient requirements.ObjectiveThis study aimed to validate a minimum food group consumption threshold, out of the 10 food groups used to construct MDD-W, to be used as a population-level indicator of higher micronutrient adequacy among pregnant women aged 15-49 y in LMICs.MethodsWe used secondary quantitative 24-h recall data from 6 surveys in 4 LMICs (Bangladesh, Burkina Faso, India, and Nepal, total n = 4909). We computed the 10-food group Women's Dietary Diversity Score (WDDS-10) and calculated the mean probability of adequacy (MPA) of 11 micronutrients. Linear regression models were fitted to assess the associations between WDDS-10 and MPA. Sensitivity, specificity, and proportion of individuals correctly classified were used to assess the performance of MDD-W in predicting an MPA of >0.60.ResultsIn the pooled sample, median values (interquartile range) of WDDS-10 and MPA were 3 (1) and 0.20 (0.34), respectively, whereas the proportion of pregnant women with an MPA of >0.60 was 9.6%. The WDDS-10 was significantly positively associated with MPA in each survey. Although the acceptable food group consumption threshold varied between 4 and 6 food groups across surveys, the threshold of 5 showed the highest performance in the pooled sample with good sensitivity (62%), very good specificity (81%), and percentage of correctly classified individuals (79%).ConclusionsThe WDDS-10 is a good predictor of dietary micronutrient adequacy among pregnant women aged 15-49 y in LMICs. Moreover, the threshold of 5 or more food groups for the MDD-W indicator may be extended to all women of reproductive age, regardless of their physiologic status.

Dataset Information

Validation of New Interactive Nutrition Assistant - Diet in India Study of Health (NINA-DISH) FFQ with multiple 24-h dietary recalls among pregnant women in Pune, India.

Publications

Validation of New Interactive Nutrition Assistant - Diet in India Study of Health (NINA-DISH) FFQ with multiple 24-h dietary recalls among pregnant women in Pune, India.

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