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Background: Dietary assessment methods have limitations in capturing real-time eating behaviour accurately. Equipped with automated dietary-data-collection capabilities, the "intelligent ordering system" (IOS) has potential applicability in obtaining long-term consecutive, relatively detailed on-campus dietary records among university students with little resource consumption. We investigated (1) the relative validity of IOS-derived nutrient/food intakes compared to those from the 7-day food diary (7DFD); (2) whether including a supplemental food frequency questionnaire (SFFQ) improves IOS accuracy; and (3) sex differences in IOS dietary intake estimation. Methods: Medical students (n = 221; age = 22.2 ± 2.4 years; 38.5% male and 61.5% female) completed the 7DFD and SFFQ. During the consecutive 7-day survey period, students weighed and photographed each meal before and after consumption. Then, students reviewed their 3-month diet and completed the SFFQ, which includes eight underprovided school-canteen food items (e.g., dairy, fruits, nuts). Meanwhile, 9385 IOS dietary data entries were collected. We used Spearman coefficients and linear regression models to estimate the associations among the different dietary intake assessment methods. Individual- and group-level agreement was assessed using the Wilcoxon signed-rank test, cross-classification, and Bland‒Altman analysis. Results: IOS mean daily energy, protein, fat, and carbohydrate intake estimations were significantly lower (-15-20%) than those of the 7DFD. The correlation coefficients varied from 0.52 (for added sugar) to 0.88 (for soybeans and nuts), with fruits (0.37) and dairy products (0.29) showing weaker correlations. Sixty-two (milk and dairy products) to 97% (soybeans and nuts) of participants were classified into the same or adjacent dietary intake distribution quartile using both methods. The energy and macronutrient intake differences between the IOS + SFFQ and 7DFD groups decreased substantially. The separate fruit intake measurements from each assessment method did not significantly differ from each other (p > 0.05). IOS and IOS + SFFQ regression models generally yielded higher R2 values for males than for females. Conclusion: Despite estimation differences, the IOS can be reliable for medical student dietary habit assessment. The SFFQ is useful for measuring consumption of foods that are typically unavailable in school cafeterias, improving the overall dietary evaluation accuracy. The IOS assessment was more accurate for males than for females. [ABSTRACT FROM AUTHOR]

Background: The dietary nutritional status of pregnant women is critical for maintaining the health of both mothers and infants. Food exchange systems have been employed in the nutritional guidance of patients in China, although their application in the dietary guidance of healthy pregnant women is quite limited. This study aimed to develop a novel food exchange system for Chinese pregnant women (NFES-CPW) and evaluate the relative validation of its application. Methods: NFES-CPW covers approximately 500 types of food from ten categories and has more elaborate food portion sizes. It established a recommendation index for guiding food selection and used energy, water content, and protein as the exchange basis to balance the supply of energy and important nutrients throughout pregnancy. Furthermore, dietitians used the NFES-CPW and traditional food exchange system to generate new recipes based on the sample recipe. There were 40 derived recipes for each of the two food exchange methods. The food consumption, energy, and key nutrients of each recipe were calculated, and the differences between the two food exchange systems were compared using the Wilcoxon rank sum test or the Chi-square test. Results: The results revealed that compared to those derived from traditional food exchange system, the NFES-CPW derived recipes had a better dietary structure, as evidenced by the intakes of whole-grain cereals, beans excluding soybeans, potatoes, fruits, fish, shrimp and shellfish, as well as eggs (P < 0.05), which were more conducive to reaching the recommended range of balanced dietary pagoda. After calculating energy and nutrients, although these two food exchange systems have similar effects on the dietary energy and macronutrient intake of pregnant women, the intake of micronutrients in NFES-CPW derived recipes was significantly higher than that from the traditional food exchange system, which was more conducive to meeting the dietary requirements of pregnant women. The outstanding improvement are primarily vitamin A, vitamin B2, folic acid, vitamin B12, vitamin C, calcium, iron, and iodine (P < 0.05). Moreover, when compared to recipes obtained from the traditional food exchange system, the error ranges of energy and most nutrients were significantly reduced after employing the NFES-CPW. Conclusions: Therefore, NFES-CPW is an appropriate tool that adheres to Chinese dietary characteristics and can provide suitable dietary guidance to pregnant women. [ABSTRACT FROM AUTHOR]

Background: The dietary nutritional status of the lactating mothers is related to maternal health and has a significant impact on the growth and development of infants through the secretion of breast milk. The food frequency questionnaire (FFQ) is the most cost-effective dietary assessment method that can help obtain information on the usual dietary pattern of participants. Until now, the FFQs have been used for different populations in China, but there are few FFQs available for the lactating mothers. We aimed to develop a semi-quantitative, 156-item FFQ for the Chinese lactating mothers, and evaluate its reproducibility and relative validity.Methods: A total of 112 lactating mothers completed two FFQs and one 3-d dietary record (3DR). The first FFQ (FFQ1) was conducted during postpartum at 60-65 days and the second FFQ (FFQ2) during subsequent follow-up at 5 weeks. The 3DR was completed with portion sizes assessed using photographs taken by the respondent before and after eating (instant photography) 1 week after FFQ1.Results: For reproducibility, the Spearman's correlation coefficients for food ranged from 0.34 to 0.68, and for nutrients from 0.25 to 0.61. Meanwhile, the intra-class correlation coefficients for food ranged from 0.48 to 0.87, and for nutrients from 0.27 to 0.70. For relative validity, the Spearman's correlation coefficients for food ranged from 0.32 to 0.56, and for nutrients from 0.23 to 0.72. The energy-adjusted coefficients for food ranged from 0.26 to 0.55, and for nutrients from 0.22 to 0.47. Moreover, the de-attenuation coefficients for food ranged from 0.34 to 0.67, and for nutrients from 0.28 to 0.77. The Bland-Altman plots also showed reasonably acceptable agreement between the two methods.Conclusions: This FFQ is a reasonably reproducible and a relative valid tool for assessing dietary intake of the Chinese lactating mothers. [ABSTRACT FROM AUTHOR]

Objective: To examine the test-retest reliabilities and relative validities of the Chinese version of short International Physical Activity Questionnaire (IPAQ-S-C), the Global Physical Activity Questionnaire (GPAQ-C), and the Total Energy Expenditure Questionnaire (TEEQ-C) in a population-based prospective study, the Taizhou Longitudinal Study (TZLS). Study design: A longitudinal comparative study. Methods: A total of 205 participants (male: 38.54%) aged 30-70 years completed three questionnaires twice (day one and day nine) and physical activity log (PA-log) over seven consecutive days. The test-retest reliabilities were evaluated using intra-class correlation coefficients (ICCs) and the relative validities were estimated by comparing the data from physical activity questionnaires (PAQs) and PA-log. Results: Good reliabilities were observed between the repeated PAQs. The ICCs ranged from 0.51 to 0.80 for IPAQ-C, 0.67 to 0.85 for GPAQ-C, and 0.74 to 0.94 for TEEQ-C, respectively. Energy expenditure of most PA domains estimated by the three PAQs correlated moderately with the results recorded by PA-log except the walking domain of IPAQ-S-C. The partial correlation coefficients between the PAQs and PA-log ranged from 0.44 to 0.58 for IPAQ-S-C, 0.26 to 0.52 for GPAQ-C, and 0.41 to 0.72 for TEEQ-C, respectively. Bland-Altman plots showed acceptable agreement between the three PAQs and PA-log. Conclusion: The three PAQs, especially TEEQ-C, were relatively reliable and valid for assessment of physical activity and could be used in TZLS. [ABSTRACT FROM AUTHOR]

Objective Food frequency questionnaires are relatively inexpensive, easy and quick to administer, but the construction of a food frequency questionnaire that can capture Chinese food habits is challenging given the diverse lifestyle and eating habits in different parts of the country. The aim of this study was to assess the validity and reproducibility of a self-administered food frequency questionnaire against a 3-day dietary recall in a rural region of western China. Design Prospective cohort study. Setting Chinese maternal and child healthcare hospital. Population A total of 168 healthy pregnant women. Methods Pregnant women completed a food frequency questionnaire at 16-24 weeks gestation, and again at 29-31 weeks; during weeks 26-27 they completed a 3-day dietary recall. Results In general, mean intake was higher when assessed with food frequency questionnaires compared with dietary recall. Spearman and intra-class correlation coefficients between the two food frequency questionnaires ranged from 0.31 to 0.69 and from 0.27 to 0.79, respectively. For the second food frequency questionnaire and the dietary recall, the crude and de-attenuated Spearman correlations ranged from 0.12 to 0.55 and 0.14 to 0.58, respectively. The correlation both between the two food frequency questionnaires and between the second food frequency questionnaire and the dietary recall decreased after adjustment for energy. Ranking women, 31-57% and 1-8% were classified into the same and the opposite quartile, respectively, by both food frequency questionnaires; 30-45% and 1-11% were classified into the same and the opposite quartile respectively for the second food frequency questionnaire and dietary recall. Conclusion The food frequency questionnaire showed good reproducibility and correlations with dietary recall; it is useful for ranking study participants according to dietary intake, which is of great importance to future etiological studies in this cohort. [ABSTRACT FROM AUTHOR]

As an important part of antenatal care for pregnant women in China, dietary assessment plays a positive role in maternal and fetal health. Shortcomings in the associated methodologies require improvement. Our purpose was to develop a novel WeChat Applet for image-based dietary assessment (WAIDA) and evaluate its relative validity among pregnant women in China. Data on 251 lunch meals of pregnant women in their second trimester were analyzed. The differences in food weight, energy, and nutrient estimates by the dietary recall or WAIDA method with the weighing method were compared using paired t-tests. Pearson correlation coefficients were used to analyze the correlation between food weight, energy, and nutrient intake obtained from the recall or WAIDA method and those obtained from the weighing method. The Bland-Altman analysis was used to examine the agreement between the recall or WAIDA method and the weighing method for energy and nutrients. Compared with the weighing method, the variation range of food weight, energy and nutrients estimated by the WAIDA method was smaller and more stable than that estimated by the recall method. Compared with the recall method, the correlations suggested a better relationship between the energy and nutrient intakes from the weighing method and those estimated by the WAIDA method (0.752-0.970 vs. 0.480-0.887), which were similar to those of food weight (0.332-0.973 vs. -0.019-0.794). The Bland-Altman analysis showed that the mean differences of the energy and nutrients estimated from the recall method were further away from zero relative to the weighing method compared to the WAIDA method and with numerically wider 95% confidence intervals. The spans between the upper and lower 95% limit of agreement (LOAs) of the energy and nutrients obtained by the WAIDA method were narrower than those obtained by the recall method, and the majority of the data points obtained by the WAIDA method lay between the LOAs, closer to the middle horizontal line. Compared with the recall method, the WAIDA method is consistent with the weighing method, close to the real value of dietary data, and expected to be suitable for dietary assessment in antenatal care.