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Background: Dietary nitrates may play a role in mediating several key physiological processes impacting health and/or exercise performance. However, current methods for assessing dietary nitrate (NO3−) consumption are inadequate. The present study aimed to examine the dietary nitrate intake in a sample of 50 healthy adults, as well as test the validity of a purposefully developed food frequency questionnaire (FFQ). Methods: Dietary nitrate intake was estimated over a week using (i) three 24‐h dietary recalls; (ii) a short‐term (7‐day) FFQ; and (iii) a biomarker (urinary nitrate), in conjunction with a nitrate reference database. Results: Daily dietary nitrate intake estimates were 130.94 mg (average of three 24‐h recalls) and 180.62 mg (FFQ). The mean urinary NO3− excretion was 1974.79 µmol day–1 (or 917.9 µmol L–1). Despite the difference between the two dietary assessment methods, there was a moderate positive correlation (r = 0.736, ρ < 0.001) between the two tools. There was also a positive correlation between urinary NO3− and 24‐h recall data (r = 0.632, ρ < 0.001), as well as between urinary NO3− and FFQ (r = 0.579, ρ < 0.001). Conclusions: The ability to accurately estimate nitrate intakes depends on having suitable reference methods to estimate the concentrations of nitrate in the food supply, coupled with valid and reliable dietary assessment tools. Based on the findings from the present study, at an individual level, dietary recalls or records may be more accurate in estimating intakes of NO3−. However, given the lower cost and time needed for administration relative to recalls, the FFQ has merit for estimating NO3− intakes in health interventions, dietary surveys and surveillance programs. Key points: Nitrate occurs naturally in plant foods and water, and are also commonly used as food additives in cured products. Dietary nitrates may be beneficial for health and exercise performance; however, current methods to assess dietary nitrate consumption are inadequate.Estimates of nitrate intake from our purposefully designed food frequency questionnaire showed moderate associations with estimates from 24‐h food recalls, as well as from a urinary biomarker.At an individual level, dietary recalls or records may be more accurate in estimating dietary nitrate intake. However, the food frequency questionnaire developed in the present study may be useful to estimate nitrate intake in health interventions, dietary surveys and surveillance programs. [ABSTRACT FROM AUTHOR]

Objective: Previous studies of sociodemographic and lifestyle correlates of dietary patterns among young adults have primarily focused on physical activity and smoking, with inconclusive results. This study aims to examine the associations between a broader range of lifestyles of young adults and their patterns of food consumption. Design: Cross-sectional. Setting: Brisbane, Australia. Participants: The data set are from a long running birth cohort study which commenced in 1981. Details of dietary intake and sociodemographic and lifestyle factors were from the 21-year follow-up of the Mater-University of Queensland Study of Pregnancy (MUSP) birth cohort. The effective cohort (n 2665, 57 % women) is of young adult offspring. Usual dietary intake was assessed using a Food Frequency Questionnaire (FFQ). Data on sociodemographic and lifestyle variables were obtained from self-reports. Results: Western and prudent dietary patterns were identified for the combined cohort of women and men using principal components analysis. Multivariable linear regression models were used to examine the associations between lifestyle variables and dietary patterns adjusting for potential confounders. Results from multivariable adjusted models showed that physical activity, watching TV and smoking were strongly associated with each dietary pattern; alcohol consumption and BMI showed weaker associations (P < 0·05 for all). Conclusions: Our study describes a clustering of unhealthy lifestyles in young adults. Young adults with unhealthy lifestyles less often adhere to a healthy prudent dietary pattern and more often an unhealthy Western pattern. Dietary preferences are enmeshed in a lifestyle matrix which includes physical activity, sedentary activity, smoking and alcohol consumption of young adults. [ABSTRACT FROM AUTHOR]

Objective: Children with chronic kidney disease (CKD) experience many obstacles to achieving optimal dietary intake. Dietary intake patterns remain unexplored or poorly described. This study compares nutritional intake and diet quality of Australian children with CKD to controls., Methods: A food frequency questionnaire captured intake data and was compared to controls. Nutritional intake was determined using individualized nutrient reference values, and diet quality described using the Australian Guide to Healthy Eating and the Australian Child and Adolescent Recommended Food Score., Results: Children with CKD (n = 36) and controls (n = 82) were studied. Children with CKD had lower weight and height z scores, but higher body mass index (P < .0001 for all parameters). Children with CKD had adequate energy intake, and excessive protein and sodium intake (336% and 569%). They were significantly less likely to meet requirements for vitamin A (P < .001), thiamine (P = .006), folate (P = .01), vitamin C (P = .008), calcium (P < .0001), iron (P = .01), magnesium (P = .0009), and potassium (P = .002). No child met recommended vegetable intake; however, less than half of children with CKD met fruit (44%), grains (31%), and dairy serves (31%). They were also less likely to meet recommended fruit and dairy serves (P = .04 and P = .01, respectively). Non-core foods provided 36% of energy, and although comparable to controls, was contributed more by takeaway foods (P = .01)., Conclusion: Children with CKD have reduced nutritional intake of key nutrients and consume more takeaways than controls. Attention to increasing core foods, limiting sodium intake, and managing restrictions while promoting nutrient density appears necessary., (Copyright © 2023 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)

Dietary carotenoids are associated with lower risk of CHD. Assessment of dietary carotenoid intake using questionnaires can be susceptible to measurement error. Consequently, there is a need to validate data collected from FFQs which measure carotenoid intake. This study aimed to assess the performance of the Cardio-Med Survey Tool (CMST)-FFQ-version 2 (v2) as a measure of dietary carotenoid intake over 12-months against plasma carotenoids biomarkers and 7-Day Food Records (7DFR) in an Australian cardiology cohort. Dietary carotenoid intakes (β- and α-carotene, lycopene, β-cryptoxanthin and lutein/zeaxanthin) were assessed using the 105-item CMST-FFQ-v2 and compared to intakes measured by 7DFR and plasma carotenoid concentrations. Correlation coefficients were calculated between each dietary method, and validity coefficients (VCs) were calculated between each dietary method and theoretical true intake using the 'methods of triads'. Thirty-nine participants aged 37-77 years with CHD participated in the cross-sectional study. The correlation between FFQ and plasma carotenoids were largest and significant for β-carotene (0.39, p =0.01), total carotenoids (0.37, p =0.02) and β-cryptoxanthin (0.33, p =0.04), with weakest correlations observed for α-carotene (0.21, p =0.21) and lycopene (0.21, p =0.21). The FFQ VCs were moderate (0.3-0.6) or larger for all measured carotenoids. The strongest were observed for total carotenoids (0.61) and β-carotene (0.59), while the weakest were observed for α-carotene (0.33) and lycopene (0.37). In conclusion, the CMST-FFQ-v2 measured dietary carotenoids intakes with moderate confidence for most carotenoids, however, there was less confidence in ability to measure α-carotene and lycopene intake, thus further research is warranted using a larger sample., Competing Interests: None., (© The Author(s) 2024.)

Background Recent reviews have proposed a causal relationship between prolonged breastfeeding and early childhood caries (ECC), but the evidence to date is inconsistent, with few cohort studies and limited investigation of key confounders. Objective This study aimed to investigate the relationship between dietary practices and early childhood caries in a birth cohort of Australian preschoolers. Methods Participants underwent a standardized dental examination at 2–3 y of age to determine the prevalence of ECC (based on the presence of decayed, missing, or filled tooth surfaces). Breastfeeding practices were reported at 3, 6, 12, and 24 mo of age. Intakes of free sugars were assessed at 1 and 2 y of age. Multivariable regression models generated prevalence ratios (PR) for the association between ECC and breastfeeding duration, and between ECC and sleep feeding practices at 1 y, controlling for sociodemographic factors and free sugars intake. Results There was no independent association between breastfeeding beyond 1 y of age and ECC (PR 1.42, 95% CI: 0.85, 2.38), or between breastfeeding to sleep and ECC (PR 1.12, 95% CI: 0.67, 1.88), although the direction of effect was suggestive of an association. The only factors independently associated with ECC were high free sugars intakes (PR 1.97, 95% CI: 1.13, 3.44), and greater socioeconomic disadvantage (PR 2.15, 95% CI: 1.08, 4.28). Most participants who were breastfed at 1 y of age had ceased by 18 mo or 2 y. Conclusions Breastfeeding practices were not associated with ECC. Given the wide-ranging benefits of breastfeeding, and the low prevalence of sustained breastfeeding in this study and Australia in general, recommendations to limit breastfeeding are unwarranted, and breastfeeding should be promoted in line with global and national recommendations. To reduce the prevalence of early childhood caries, improved efforts are needed to limit foods high in free sugars. [ABSTRACT FROM AUTHOR]

Nutrition-related chronic diseases are a major problem among Indigenous populations. Appropriate dietary intake assessment tools are needed for nutritional surveillance and intervention; however, tools designed to measure the habitual dietary intake of Indigenous persons are largely lacking. We developed a digital food frequency questionnaire (FFQ) to measure habitual consumption among Australian Aboriginal adults and support personalized nutrition counseling. The primary contributors to energy, select nutrients, and inter-person variation (83 food groups) were identified from nationally representative 24 h recall (24HR) data, and they accounted for >80% of the total intake and inter-person variation of the nutrients of interest. Based on community input, a meal-based FFQ format was adopted, with a main food/beverage list of 81 items and the capacity to report on >300 additional items via the digital platform. The nutrient database was based on the Australian Food and Nutrient Database. Data for the first 60 study participants (70% female; median age: 48 years) were used to assess the FFQ's utility. The participants' median [IQR] reported energy intake (10,042 [6968-12,175] kJ/day) was similar to their median [IQR] estimated energy expenditure (10,197 [8636-11,551] kJ/day). Foods/beverages on the main FFQ list accounted for between 66% and 90% of the participants' reported energy and nutrient intakes; the remainder came from participant-selected extra items. The digital FFQ platform provides a potentially valuable resource for monitoring habitual dietary intake among Aboriginal adults and supporting chronic disease prevention and management interventions.

Aim: To describe the study protocol of the MEDiterranean ISlands‐Australia (MEDIS‐Australia) Study modelled on the MEDIS Study conducted in Greece. The present study aims to explore adherence to the traditional Mediterranean diet pattern, determine enablers and barriers to adherence, explore the definition of Greek cuisine, and associations between adherence to the diet pattern and risk factors for cardiovascular disease (CVD) and metabolic syndrome in older Greek Australians originally from Greek islands and Cyprus. Now long‐term immigrants, with at least 50 years in Australia, characteristics and risk factor profiles of older Greek islander‐born Australians will be compared and contrasted to their counterparts living on Greek islands to evaluate the influence of migration on adherence. Methods: The present study is an observational study of cross‐sectional design using a modified lifestyle and semi‐quantitative food frequency questionnaire to capture sociodemographic, health, psychosocial and dietary characteristics, including cuisine, of 150 older Greek islander‐born Australians. Anthropometric measures and medical history will be collected. Participants will be aged over 65 years, live independently, are originally from a Greek island and are free from CVD. Results: Data collection is underway. Conclusions: Characteristics and behaviours associated with adherence, if identified, could be evaluated in future studies. For example, exploration of enablers or barriers to adherence to a Mediterranean dietary pattern in an Australian population. [ABSTRACT FROM AUTHOR]

Background The present study aimed to develop a food frequency questionnaire ( FFQ) assessing dietary omega-3 long chain polyunsaturated fatty acid ( n-3 LCPUFA) intake in Australian children and to validate the FFQ against a 7-day food diary. Methods The investigation comprised a cross-sectional and validation study. The study setting was two private primary schools in the in the Illawarra region of New South Wales. Twenty-two Australian children, aged 9-13 years, who were not on a special diet or receiving medical care that limited their food choice in the 3 months prior to recruitment, were recruited into the study. Results A total of 131 items, classified according to seven food group categories, was included in the n-3 LCPUFA FFQ, as identified from published dietary surveys and a supermarket survey. Good correlations between the FFQ and the 7-day food diary were observed for eicosapentaenoic acid ( EPA) [ r = 0.691, 95% confidence interval (CI) = 0.51-0.83, P < 0.001], docosahexaenoic acid ( DHA) ( r = 0.684, 95% CI = 0.45-0.84, P < 0.001) and total n-3 LCPUFA ( r = 0.687, 95% CI = 0.48-0.85, P < 0.001). Bland-Altman plots showed an acceptable limit of agreement between the FFQ and the average 7-day food diary. However, the mean EPA, DHA and total n-3 LCPUFA intakes estimated from the FFQ were significantly higher than those from the average 7-day food diary estimates ( P < 0.001). Conclusions A novel n-3 LCPUFA FFQ that has been developed to estimate dietary n-3 LCPUFA intakes in Australian children has been shown to have relative validity. The FFQ provides a useful contribution to dietary assessment methodology in this age group; however, reproducibility remains to be demonstrated. [ABSTRACT FROM AUTHOR]

The aim of this study was to measure validity and reproducibility of a caffeine food frequency questionnaire (C-FFQ) developed for the Australian population. The C-FFQ was designed to assess average daily caffeine consumption using four categories of food and beverages including; energy drinks; soft drinks/soda; coffee and tea and chocolate (food and drink). Participants completed a seven-day food diary immediately followed by the C-FFQ on two consecutive days. The questionnaire was first piloted in 20 adults, and then, a validity/reproducibility study was conducted (n = 90 adults). The C-FFQ showed moderate correlations (r = .60), fair agreement (mean difference 63 mg) and reasonable quintile rankings indicating fair to moderate agreement with the seven-day food diary. To test reproducibility, the C-FFQ was compared to itself and showed strong correlations (r = .90), good quintile rankings and strong kappa values (κ = 0.65), indicating strong reproducibility. The C-FFQ shows adequate validity and reproducibility and will aid researchers in Australia to quantify caffeine consumption. [ABSTRACT FROM PUBLISHER]

The aim of this article is to report on the validity and internal consistency of a short food frequency questionnaire (FFQ) to measure dietary intake in Australian adults. A total of 407 individuals completed the short FFQ. The Cronbach’s alpha of 0.66 indicated acceptable internal consistency for the FFQ. Content validity was measured using factor analysis showed that 35% of total variance was explained by factor analysis. The FFQ was also validated against 31 3-day food records (FR). No significant difference between average intake of energy, most macronutrients, and some micronutrients between two instruments was identified. An acceptable levels of correlation (0.39–0.69) was observed between the two instruments. Bland and Altman’s plots showed relative agreement in both instruments with potential bias in measuring iron and iodine. The current FFQ can be an acceptable tool to quickly measuring dietary intake in Australian adults. [ABSTRACT FROM PUBLISHER]

Excess free sugars intake contributes to dental caries and obesity in children. Food frequency questionnaires (FFQ) that assess free sugars intake in young children are limited. This study evaluated the utility of a 68-item FFQ to assess free sugars intake in Australian young children against three 24-h recalls at ages 1.5, 3.5, and 5.0 years. Free sugars intakes estimated from two methods were compared using group- and individual-level validation tests. Group-level tests revealed that mean free sugars intakes estimated from two methods were similar and Bland-Altman tests revealed no presence of proportional bias at age 1.5 years. For ages 3.5 and 5.0 years, the FFQ underestimated the free sugars intake compared to the recalls, and Bland-Altman tests revealed proportional bias. For individual-level tests, the deattenuated correlation ( R ) between free sugars intakes estimated from two methods exhibited good agreement across three time-points (R: 0.54-0.62), as were the percentage agreement (68.5-73.6%) and weighted kappa (K w : 0.26-0.39). The FFQ showed good validity at age 1.5 years. For ages 3.5 and 5.0 years, the FFQ showed good validity for individual-level tests only. The FFQ provided stronger validity in the ranking of individuals according to free sugars intake than comparing absolute free sugars intake at group level.

Abstract: Objective: To develop and validate a simple non-invasive method that estimates the intakes of omega-3 and omega-6 polyunsaturated fatty acids (PUFA) in a healthy adult population. Methods: A new electronic PUFA food frequency questionnaire (FFQ) was validated by comparison with a 3-d weighed food record and blood biomarkers (erythrocytes and plasma) using the method of triads model and tested for reproducibility. Healthy subjects were recruited from the local Illawarra Region, New South Wales, Australia. Results: The PUFA FFQ adequately estimated intakes for eicosapentaenoic acid, docosahexaenoic acid, total long chain omega-3 PUFA, linoleic acid, total omega-6 PUFA, and total PUFA, which were comparable with results from the 3-d food record. Eicosapentaenoic acid, docosahexaenoic acid, and total long chain omega-3 showed high validity coefficients for erythrocytes (and plasma) 0.92 (0.87), 0.69 (0.64), and 0.78 (0.73) (P < 0.05), respectively. Spearman’s rank correlation coefficients ranged from 0.48 to 0.76 when the PUFA FFQ was tested for reproducibility (P < 0.05). Conclusion: The electronic PUFA questionnaire was found to be reproducible and is a valid tool to assess PUFA intakes in a healthy adult population. [Copyright &y& Elsevier]

Objective: To examine the utility of a shorter FFQ compared with a longer FFQ, both of which are commonly used in Australia. Design: Comparative study. Setting: Community setting. Subjects: One hundred and fifty-nine men (mean 55 (SEM 7) years) screened for participation in an intervention study completed both the Commonwealth Scientific and Industrial Research Organisation FFQ and the Cancer Council of Victoria FFQ. Agreement between both questionnaires was assessed according to Bland-Altman plots and limits of agreement (LOA) and ordinary least products regression to test for the presence of fixed and proportional bias. Results: There was good relative agreement between the methods for energy and macronutrients (Pearson's correlation coefficients: energy r=0·7, protein r=0·6, fat r=0·8, carbohydrate r50·7, alcohol r=0·8; P<0·01). Mean group-level agreement for the majority of nutrients (70 %) fell between 80% and 110 %. According to the criteria used (maximum LOA was 50-200% and no significant proportional bias), there was acceptable agreement between the FFQ for energy and total saturated and monounsaturated fat, but not for protein, carbohydrate and fibre. Micronutrients that did not meet the agreement criteria including calcium, iron, thiamin, niacin, riboflavin and folate. When the data were analysed according to quintiles, the majority of subjects were either in exactly the same quintile or within one quintile for most nutrients, and 1-2% were grossly misclassified by three or four quintiles. Conclusions: We conclude that there is sufficient agreement between the instruments for group-level comparisons in men, but they are not interchangeable for estimation of individual intakes. [ABSTRACT FROM AUTHOR]

Objective:The aim of this study was to assess the major dietary patterns of two age cohorts of women, to determine to the extent to which the dietary patterns differ between the cohorts and to assess whether they vary according to sociodemographic and behavioural characteristics and patterns of nutrient intake.Method:Dietary intake was assessed using an 80-item food frequency questionnaire for women aged 50-55 years (n=10 150; 'middle age') in 2001 and aged 25-30 years (n=7371; 'young') in 2003, from the Australian Longitudinal Study on Women's Health. Factor analysis using principal component extraction was used to identify dietary patterns, and a pattern score was calculated from the consumption of the food items identified with each dietary pattern. Associations between the dietary pattern scores and sociodemographic and behavioural characteristics and nutrient intakes were investigated using regression analysis.Results:Six dietary patterns were identified and were labelled: cooked vegetables; fruit; Mediterranean-style; processed meat, meat and takeaway; reduced fat dairy; and high-fat and sugar foods. Regression analysis revealed that healthier dietary patterns were significantly associated with other favourable health-related behaviours, higher socioeconomic status and living in urban areas (P-values <0.05).Conclusions:In spite of differences in the level of consumption of individual food items, the similarity in dietary patterns across two generations of women suggests that policies and interventions to improve diet should focus on social and economic factors and general health-related behaviour rather than different age groups. [ABSTRACT FROM AUTHOR]

Background & Aims: A brief assessment tool on frequency and variety of fruit and vegetable intake could provide a cost-effective and sustainable approach to improving diet. The primary aim was to evaluate the comparative validity of a brief index of Fruit And Vegetable VAriety (FAVVA) relative to food and nutrient intakes derived from a comprehensive food frequency questionnaire (FFQ). The secondary aim was to evaluate the FAVVA index in relation to fasting plasma carotenoid concentrations., Methods: Dietary intakes and fasting plasma carotenoid concentrations of 99 overweight and obese adults (49.5% female; 44.6 ± 9.9 years) were assessed at baseline and 3-months. Food and nutrient intakes were assessed using the Australian Eating Survey (AES) FFQ. The FAVVA index was derived from a sub-set of 35 AES questions related to fruit and vegetable intake frequency and variety. Associations were assessed using Spearman's correlation coefficients and linear regression analysis, and agreement using weighted kappa (K w )., Results: Total FAVVA score demonstrated moderate to strong, significant (all p < 0.01) correlations with total daily intakes of vegetables (r = 0.75), vitamin C (r = 0.71), fruit (r = 0.66), vitamin A (r = 0.49), fibre (r = 0.49), potassium (r = 0.46), magnesium (r = 0.39), iron (r = 0.26), riboflavin (r = 0.24), calcium (r = 0.23), zinc (r = 0.20) and niacin equivalent (r = 0.20). These associations remained significant in the adjusted regression analyses and agreement testing. Total FAVVA was significantly correlated with plasma carotenoid concentrations (μg/dL) of α-carotene (r = 0.22, p < 0.01), β-carotene (r = 0.26, p < 0.001), β-cryptoxanthin (r = 0.22, p < 0.01) and total carotenoids (r = 0.18, p < 0.05). The associations with α-carotene (β = 0.09, p < 0.001), β-carotene (β = 0.42, p < 0.05) and total plasma carotenoids (β = 0.85, p < 0.05) remained significant in the adjusted regression analyses and for agreement testing., Conclusions: FAVVA is suitable as a brief tool to rank frequency and variety of fruit and vegetable intake., (Copyright © 2018 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

In the first 2 years of life, it is important to limit exposure to foods high in free sugars, in order to lay foundations for lifelong eating patterns associated with a reduced risk of chronic disease. Intake data at this age is limited, so compliance with recommendations is not known. This analysis describes free sugars intakes, food sources and determinants of high consumption among Australian children at 2 years of age. Free sugars intakes were estimated using a customized Food Frequency Questionnaire, and median usual free sugars intake at 2 years was 22.5 (Interquartile Range (IQR) 12.8⁻37.7) g/day, contributing a median 8% of the estimated energy requirement (EER). Based on the EER, most children (71.1%) exceeded the World Health Organization recommendation that <5% of energy should come from free sugars, with 38% of participants exceeding the <10% recommendation. Children from households with the greatest socioeconomic disadvantage were more likely to exceed the 10% recommendation (Prevalence Ratio (PR) 1.44, 95% Confidence Interval (95% CI) 1.13⁻1.84), and be in the top tertile for free sugars intake (PR 1.58, 95% CI 1.19⁻2.10) than the least disadvantaged. Main sources of free sugars were non-core foods, such as fruit juice, biscuits, cakes, desserts and confectionery; with yogurt and non-dairy milk alternatives the two notable exceptions. Improved efforts to reduce free sugars are needed from the introduction of solid food, with a particular focus on fruit juice and non-core foods.

Aim: To develop and assess the validity and reproducibility of a food frequency questionnaire (FFQ) to measure total flavonoid intake, and individual flavonoid subclasses, in older adults., Methods: Retrospective analysis of flavonoid intake in older adults informed the development of a FFQ to measure flavonoid intake and determine the flavonoid subclasses consumed (anthocyanins, flavan-3-ols, flavones, flavonols and flavanones). Older adults (n = 42, mean age 75.3 ± 8.6 years) attended two interviews 1 month apart where anthropometrics (height and weight), blood pressure (BP), demographic data and a 93-item self-administered FFQ were collected. A 4-day food record (FR) was randomly administered between the two interview dates, and each food item was assigned a flavonoid and flavonoid subclass content using the United States Department of Agriculture flavonoid database. The criterion validity and reproducibility of the FFQ was assessed against a 4-day FR using the Wilcoxon signed-rank sum test, Spearman's correlation coefficient (r), Bland-Altman Plots and Cohen's kappa., Results: Total flavonoid intake was determined (median intake FFQ = 919.3 mg/day, FR = 781.4 mg/day). Tests of validity indicated that the FFQ consistently overestimated total flavonoid intake compared with the 4-day FR. There was a significant difference in estimates between the FFQ and the 4-day FR for total flavonoid intake (Wilcoxon signed-rank sum P < 0.001; Bland-Altman plots indicated large bias and wide limits of agreement), but they were well correlated (Spearman's r 0.93, P < 0.001; Cohen's kappa κ = 0.619, P < 0.001). For individual flavonoid subclasses, the tests of validity indicated greater discrepancy compared with 4-day FR. The FFQ showed high reproducibility for estimating total flavonoid intake (FFQ1vsFFQ2: Wilcoxon signed-rank sum test, P > 0.05; Spearman's r 0.91, P < 0.001; Bland-Altman plots visually showed small, non-significant bias and wide limits of agreement; and Cohen's kappa κ = 0.619, P < 0.001), with a small mean percentage difference (6.7%). For individual flavonoid subclasses, the tests of reproducibility between FFQ1 and FFQ2 showed similarly high reproducibility., Conclusions: The developed FFQ appears suitable for satisfactorily ranking individuals according to total flavonoid intake. The FFQ shows limitations for estimating absolute total flavonoid intake and intake of flavonoid subclasses in comparison to a 4-day FR in terms of overestimating intake. Refinement and further validation of this tool may be required., (© 2017 The Authors. Nutrition & Dietetics published by John Wiley & Sons Australia, Ltd on behalf of Dietitians Association of Australia.)

Diet quality indices can predict nutritional adequacy of usual intake, but validity should be determined. The aim was to assess the validity of total and sub-scale score within the Australian Recommended Food Score (ARFS), in relation to fasting plasma carotenoid concentrations. Diet quality and fasting plasma carotenoid concentrations were assessed in 99 overweight and obese adults (49.5% female, aged 44.6 ± 9.9 years) at baseline and after three months (198 paired observations). Associations were assessed using Spearman's correlation coefficients and regression analysis, and agreement using weighted kappa (K w ). Small, significantly positive correlations were found between total ARFS and plasma concentrations of total carotenoids ( r = 0.17, p < 0.05), β-cryptoxanthin ( r = 0.18, p < 0.05), β-carotene ( r = 0.20, p < 0.01), and α-carotene ( r = 0.19, p < 0.01). Significant agreement between ARFS categories and plasma carotenoid concentrations was found for total carotenoids (K w 0.12, p = 0.02), β-carotene (K w 0.14, p < 0.01), and α-carotene (K w 0.13, p < 0.01). In fully-adjusted regression models the only signification association with ARFS total score was for α-carotene (β = 0.19, p < 0.01), while ARFS meat and fruit sub-scales demonstrated significant relationships with α-carotene, β-carotene, and total carotenoids ( p < 0.05). The weak associations highlight the issues with self-reporting dietary intakes in overweight and obese populations. Further research is required to evaluate the use of the ARFS in more diverse populations., Competing Interests: The authors declare no conflict of interest.

Objectives: The aims of the current study were to comprehensively assess the dietary intakes and diet quality of a sample of Australian competitive adolescent rugby union players and compare these intakes with National and Sports Dietitians Association (SDA) Recommendations for adolescent athletes. A secondary aim investigated applying different physical activity level (PAL) coefficients to determine total energy expenditure (TEE) in order to more effectively evaluate the adequacy of energy intakes., Design: Cross-sectional., Methods: Anthropometrics and dietary intakes were assessed in 25 competitive adolescent male rugby union players (14 to 18 years old). Diet was assessed using the validated Australian Eating Survey (AES) food frequency questionnaire and diet quality was assessed through the Australian Recommended Food Score., Results: The median dietary intakes of participants met national recommendations for percent energy (% E) from carbohydrate, protein and total fat, but not carbohydrate intake when evaluated as g/day as proposed in SDA guidelines. Median intakes of fibre and micronutrients including calcium and iron also met national recommendations. Overall diet quality was classified as 'good' with a median diet quality score of 34 (out of a possible 73); however, there was a lack of variety within key food groups including carbohydrates and proteins. Non-core food consumption exceeded recommended levels at 38% of the daily total energy intake, with substantial contributions from takeaway foods and sweetened beverages. A PAL coefficient of 1.2-1.4 was found to best balance the energy intakes of these players in their pre-season., Conclusions: Adolescent rugby players met the percent energy recommendations for macronutrients and attained an overall 'good' diet quality score. However, it was identified that when compared to specific recommendations for athletes, carbohydrate intakes were below recommendations and these players in their pre-season reported high consumption of non-core foods, particularly sugar sweetened drinks and low intakes of vegetables., Competing Interests: The authors have no competing interests relating to the content of this manuscript. There were no other contributors to this manuscript.

Background: Short food frequency questionnaires (FFQs) are powerful screening instruments for estimating nutrient intakes and play an important role in risk stratification in vulnerable populations. Omega-3 fatty acids are of increasing importance in the prevention of chronic and degenerative disease, especially in older adults who are at higher risk of these chronic conditions. A short FFQ exists to rapidly assess omega-3 intake from marine sources, however it has not previously been validated for agreement with total omega-3 intake and ability to identify suboptimal omega-3 intakes in older adults or for use in Australia., Objective: The aim of the study was to validate a 9-item marine omega-3 FFQ (MFQ) for assessment of omega-3 intake against a validated 74-item semiquantitative FFQ., Methods: One hundred and eight participants (mean age 67 ± 10 years, 47% male) completed the MFQ designed to estimate omega-3 intake from marine sources and the 74-item FFQ designed to estimate usual omega-3 and total energy intake in addition to other nutrients. To test agreement between the two questionnaires for estimating total omega-3 intake, mean bias and 95% limits of agreement (LOA) were calculated. Sensitivity and specificity were assessed using 2 × 2 contingency tables based on whether participants did or did not meet National Heart Foundation (NHF) recommendations for omega-3 intake per day., Results: Mean intake of omega-3 estimated from the MFQ was 210 ± 235 mg/day compared with 295 ± 260 mg/day as estimated by the FFQ. Mean bias (95% LOA) for omega-3 assessed by the two questionnaires was 89 mg/day (-475 mg to 653 mg). The MFQ achieved 98% sensitivity and 31% specificity for the omega-3 cut-off of 500 mg/day. When nutrient composition of the marine products were replaced with Australian data, mean intake of omega-3 was 230 ± 253 mg and the mean bias improved to 64 mg (-681 mg to 553 mg) and achieved 93% sensitivity and 40% specificity., Conclusions: The MFQ shows promise as a rapid screening tool for identifying older adults with intakes of omega-3 fatty acids likely to be below recommendations for chronic and degenerative disease risk reduction. Given the clinically meaningful mean bias and wide LOA, it cannot be recommended as an appropriate tool for the purpose of reporting average intake of individuals. Use of Australian nutrient data improved the mean bias of the tool in estimating total omega-3 intake. The values should be replaced and the MFQ could then be a useful tool for research purposes at the population level.

Background: Food frequency questionnaires (FFQ) are used in epidemiological studies to investigate the relationship between diet and disease. There is a need for a valid and reliable adult FFQ with a contemporary food list in Australia., Aims: To evaluate the reproducibility and comparative validity of the Australian Eating Survey (AES) FFQ in adults compared to weighed food records (WFRs)., Methods: Two rounds of AES and three-day WFRs were conducted in 97 adults (31 males, median age and BMI for males of 44.9 years, 26.2 kg/m(2), females 41.3 years, 24.0 kg/m(2). Reproducibility was assessed over six months using Wilcoxon signed-rank tests and comparative validity was assessed by intraclass correlation coefficients (ICC) estimated by fitting a mixed effects model for each nutrient to account for age, sex and BMI to allow estimation of between and within person variance., Results: Reproducibility was found to be good for both WFR and FFQ since there were no significant differences between round 1 and 2 administrations. For comparative validity, FFQ ICCs were at least as large as those for WFR. The ICC of the WFR-FFQ difference for total energy intake was 0.6 (95% CI 0.43, 0.77) and the median ICC for all nutrients was 0.47, with all ICCs between 0.15 (%E from saturated fat) and 0.7 (g/day sugars)., Conclusions: Compared to WFR the AES FFQ is suitable for reliably estimating the dietary intakes of Australian adults across a wide range of nutrients., (Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)