Validation of a short food group questionnaire to determine intakes from healthy and unhealthy food groups in 5-9-year-old South African children

BackgroundReliable dietary data for children are necessary to investigate associations with health outcomes. The present study aimed to develop and validate a questionnaire to determine the frequency of intakes of specific healthy and unhealthy food groups in young children.MethodsParticipants were 5-9-year-old South African children (n = 920) from 10 urban schools. Their parents completed a demographic questionnaire and the food intake questionnaire with food pictures. Based on the literature, four healthy food groups (fruits, vegetables, milk, meat/fish/poultry/eggs) and six unhealthy food groups (hot and cold sugar-sweetened beverages, candy, salty snacks, cakes and fast foods) were included, with five different frequency responses. Six experienced nutritionists assessed the face validity and content validity. After pilot testing, construct validity and homogeneity were determined in the participants. Convergent validity was determined using urinary sodium and potassium concentrations as biological intake markers.ResultsNutritionists confirmed face and content validity. Caregivers confirmed understanding of the questionnaire. Three factors explained 50.2% of the variance, with most unhealthy food groups as factor 1, fruits and vegetables as factor 2, and animal source protein and milk groups clustered with sugar-sweetened beverages as factor 3. The frequency of milk group, fruits and vegetables intake correlated negatively, whereas the frequency of salty snacks and fast foods intakes correlated positively with the urinary sodium:potassium ratio.ConclusionsThe healthy and unhealthy food group questionnaire has advantages of low respondent burden, as well as acceptable content and convergent validity in South African children. The questionnaire may be used to investigate associations between food intakes and health outcomes. The study aimed to develop and validate a questionnaire to determine the frequency of intake of healthy and unhealthy foods in young South African children. The food group questionnaire had low respondent burden, acceptable content and convergent validity and can be used to study associations between food intakes and health outcomes.image Simplified methods to collect data on the food consumption of children are required in epidemiological studies.Intakes from specific food groups, namely fruits, vegetables, sugar-sweetened beverages and snacks, salty snacks, and fast foods, are important.A healthy and unhealthy food group questionnaire was validated and showed acceptable content and convergent validity in South African children.The food group questionnaire has a low respondent burden.