Food Frequency Questionnaire (FFQ) For Toddlers

Food frequency questionnaires (FFQ) are dietary assessment tools which are designed with the benefit of hindsight evaluation of routine dietary intake over a specific reference period¹. It has progressively more been used for dietary assessment in epidemiological research due to its realistic advantages such as; relatively low cost and respondent burden, along with a relative ease of administration and data analyses².

Toddler-hood is an important period of life when growth is rapid and organ, motor and cognitive abilities are still under development. Energy and nutrient requirements of these children are relatively higher to their body size. In addition, nutritional deficiencies at this age might have long-lasting effects on health³.

Eating habits are also being developed during this stage and it may be a challenging task to maintain a balanced diet for toddlers while transitioning from an infant diet to family food. Insights into dietary patterns and food intake during toddler-hood may be used for the development of healthy eating habits. A robust dietary assessment tools such as an FFQ could be used to provide these insights⁴.

In this context a new study was carried out through a literature review, to provide an evidence-based review of the principal elements and steps required to develop an FFQ for this particular age group⁵. Information on the methodological considerations for designing an FFQ especially for toddlers was investigated.

The stages of developing an FFQ were identified as: conducting assessment based on study’s objective, constructing its elements which include food and beverage list, frequency of consumption categories, portion size estimation and cultural considerations, testing for its validity and reliability.

The process of constructing an FFQ included; an assessment stage of characteristics of population and time interval, followed by selecting and developing the elements such as; food lists, frequency of consumption and portion sizes. The final stages of the FFQ development involve testing for validity and repeatability of the draft questionnaire to avoid biased results and inappropriate associations⁶.

Keywords:

Methodology, food frequency questionnaire, food and beverage list, toddlers, dietary data collection, dietary assessment tools, eating habits, balanced diet.

References:

1. Bell, L.K., R.K. Golley and A.M. Magarey, 2014. A short food-group-based dietary questionnaire is reliable and valid for assessing toddler’s dietary risk in relatively advantaged samples. Br. J. Nutr., 112: 627-637.
2. Shim, J.S., K. Oh and H.C. Kim, 2014. Dietary assessment methods in epidemiologic studies. Epidemiol. Health, Vol. 36. 10.4178/epih/e2014009
3. Simeon, D.T. and S.M. Grantham-McGregor, 1990. Nutritional deficiencies and children’s behaviour and mental development. Nutr. Res. Rev., 3: 1-24.
4. Burrows, T., M. Hutchesson, L.K. Chai, M. Rollo, G. Skinner and C. Collins, 2015. Nutrition interventions for prevention and management of childhood obesity: What do parents want from an eHealth program? Nutrients, 7: 10469-10479.
5. Mubarik, F., Warren, J., Abrahamse, M., Brown, J.E. and Muhardi, L., 2018. Methodological Considerations for the Design of Food Frequency Questionnaires for Toddlers. Pak. J. Nutri., 17: 102-115.
6.  Cade, J.E., V.J. Burley, D.L. Warm, R.L. Thompson and B.M. Margetts, 2004. Food-frequency questionnaires: A review of their design, validation and utilisation. Nutr. Res. Rev., 17: 5-22.