Browse > Article
http://dx.doi.org/10.4163/jnh.2016.49.5.378

Development of nutrition quotient for Korean preschoolers (NQ-P): Item selection and validation of factor structure  

Lee, Jung-Sug (Department of Food & Nutrition, Kookmin University)
Kang, Myung-Hee (Department of Food & Nutrition, Hannam University)
Kwak, Tong-Kyung (Department of Food & Nutrition, Yonsei University)
Chung, Hae Rang (Nutrition for the Future Inc.)
Kwon, Sehyug (Department of Statistics, Hannam University)
Kim, Hye-Young (Department of Food & Nutrition, Yongin University)
Hwang, Ji-Yun (Department of Foodservice Management and Nutrition, Sangmyung University)
Choi, Young-Sun (Department of Food & Nutrition, Daegu University)
Publication Information
Journal of Nutrition and Health / v.49, no.5, 2016 , pp. 378-394 More about this Journal
Abstract
Purpose: Screening of preschool-age children for nutrition programs to improve dietary intake and behaviors requires cost-effective and easily administered validated assessment tools. The purpose of this study was to develop a parent/caregiver-administered instrument for measuring diet quality and behaviors of preschoolers as a nutrition quotient for preschoolers (NQ-P). Methods: Development of NQ-P was carried out in three steps: item generation, item reduction, and validation. The 24-h dietary record was selected as the gold standard reference tool. The 38 items of the NQ-P checklist were derived from a systematic literature review, expert in-depth interviews, statistical analysis of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. Self-administered questionnaires were delivered to parents who recorded 24-h dietary intakes of 100 responders aged 3~5 yr. Pearson's correlation was used to measure the level of agreement between questionnaires. Item reduction was performed, and 20 items were selected based on survey results, expert reviews, and priorities of national nutrition policy and recommendations. The 412 nationwide subjects sampled through daycare centers completed the 20-item checklist questionnaire. The construct validity of the NQ-P was assessed using confirmatory factor analysis, LISREL. Results: After analyses of exploratory factors, NQ-P items identified three dimensions of diet (balance, moderation, and environment). The three-factor structure accounted for 49.28% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-P and three-factor scores of the subjects were calculated by the obtained weights of the questionnaire items. Conclusion: A food behavior checklist for preschoolers' NQ would be a useful and suitable instrument for evaluating nutrition adequacy and dietary quality of Korean preschoolers.
Keywords
preschoolers' nutrition quotient (NQ-P); food behavior; dietary quality; checklist;
Citations & Related Records
Times Cited By KSCI : 13  (Citation Analysis)
연도 인용수 순위
1 Feskanich D, Rockett HR, Colditz GA. Modifying the healthy eating index to assess diet quality in children and adolescents. J Am Diet Assoc 2004; 104(9): 1375-1383.   DOI
2 Kranz S, Hartman T, Siega-Riz AM, Herring AH. A diet quality index for American preschoolers based on current dietary intake recommendations and an indicator of energy balance. J Am Diet Assoc 2006; 106(10): 1594-1604.   DOI
3 Kranz S, Findeis JL, Shrestha SS. Use of the revised children’s diet quality index to assess preschooler’s diet quality, its sociodemographic predictors, and its association with body weight status. J Pediatr (Rio J) 2008; 84(1): 26-34.   DOI
4 Golley RK, Hendrie GA, McNaughton SA. Scores on the dietary guideline index for children and adolescents are associated with nutrient intake and socio-economic position but not adiposity. J Nutr 2011; 141(7): 1340-1347.   DOI
5 Arimond M, Ruel MT. Dietary diversity is associated with child nutritional status: evidence from 11 demographic and health surveys. J Nutr 2004; 134(10): 2579-2585.   DOI
6 Kang MH, Lee JS, Kim HY, Kwon S, Choi YS, Chung HR, Kwak TK, Cho YH. Selecting items of a food behavior checklist for the development of nutrition quotient (NQ) for children. Korean J Nutr 2012; 45(4): 372-389.   DOI
7 Kim HY, Kwon S, Lee JS, Choi YS, Chung HR, Kwak TK, Park J, Kang MH. Development of a nutrition quotient (NQ) equation modeling for children and the evaluation of its construct validity. Korean J Nutr 2012; 45(4): 390-399.   DOI
8 Yon M, Hyun T. Development of an eating habit checklist for screening elementary school children at high risk of energy overintake. Korean J Nutr 2008; 41(5): 414-427.
9 Choi Y, You Y, Go KA, Tserendejid Z, You HJ, Lee JE, Lee S, Park HR. The prevalence of obesity and the level of adherence to the Korean dietary action guides in Korean preschool children. Nutr Res Pract 2013; 7(3): 207-215.   DOI
10 Yon M, Hyun T. Development of an eating habit checklist for screening elementary school children at risk of inadequate micronutrient intake. Korean J Nutr 2009; 42(1): 38-47.
11 Ministry of Health and Welfare (KR). The 2009 dietary guidelines for Koreans. Seoul: Ministry of Health and Welfare; 2009.
12 Ministry of Food and Drug Safety (KR). Guidelines of child-care foodservice management. Cheongju: Ministry of Food and Drug Safety; 2015.
13 Hanley JA, McNeil BJ. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology 1982; 143(1): 29-36.   DOI
14 Swets JA. Measuring the accuracy of diagnostic systems. Science 1988; 240(4857): 1285-1293.   DOI
15 Story M, Kaphingst KM, Robinson-O'Brien R, Glanz K. Creating healthy food and eating environments: policy and environmental approaches. Annu Rev Public Health 2008; 29(1): 253-272.   DOI
16 Shim JE, Kim J, Mathai RA; STRONG Kids Research Team. Associations of infant feeding practices and picky eating behaviors of preschool children. J Am Diet Assoc 2011; 111(9): 1363-1368.   DOI
17 Yoo JS, Choi YS. Evaluation of items for the food behavior checklist and nutrition quotient score on children in rural areas of Gyeongbuk. J Nutr Health 2013; 46(5): 427-439.   DOI
18 Kim JH, Jung YH. Evaluation of food behavior and nutritional status of preschool children in Nowon-gu of Seoul by using nutrition quotient (NQ). Korean J Community Nutr 2014; 19(1): 1-11.   DOI
19 Kennedy ET, Ohls J, Carlson S, Fleming K. The healthy eating index: design and applications. J Am Diet Assoc 1995; 95(10): 1103-1108.   DOI
20 Kleiser C, Mensink GB, Scheidt-Nave C, Kurth BM. HuSKY: a healthy nutrition score based on food intake of children and adolescents in Germany. Br J Nutr 2009; 102(4): 610-618.   DOI
21 Kim YK, Song IH. Factors affecting the physical growth and eating habits of children at daycare centers located in Yangyang-gun in Gangwon province. J Korean Soc Matern Child Health 2011; 15(2): 141-151.   DOI
22 Seo SJ, Shin HS. A study on eating behavior, developmental outcomes of young children, and nutritional attitude and knowledge levels of mothers. J East Asian Soc Diet Life 2009; 19(6): 839-845.
23 Bae JW, Oh MS. Parental perception and dietary behaviors of preschool children with environment-friendly food service in kindergarten. Korean J Food Cult 2012; 27(6): 646-658.   DOI
24 McCurdy K, Gorman KS. Measuring family food environments in diverse families with young children. Appetite 2010; 54(3): 615-618.   DOI
25 Seo JY, Lee IS, Choi BS. Study of food intakes and eating patterns among preschool children in Daegu area. Nutrient intakes and dietary habits associated with body weight status. Korean J Community Nutr 2009; 14(6): 710-721.
26 Kourlaba G, Kondaki K, Grammatikaki E, Roma-Giannikou E, Manios Y. Diet quality of preschool children and maternal perceptions/misperceptions: the GENESIS study. Public Health 2009; 123(11): 738-742.   DOI
27 Shim JE, Yoon JH, Kim K, Paik HY. Association between picky eating behaviors and growth in preschool children. J Nutr Health 2013; 46(5): 418-426.   DOI
28 Kwon JY, Park H, Whang EM. The effects of milk group intake to dietary diversity score and nutrient adequacy ratio among toddler. Korean J Nutr 2001; 34(1): 30-38.
29 Shin KO, Chung KH, Park HS. Evaluation of the health status of preschool children stratified based on the weight-length index (WLI). Nutr Res Pract 2010; 4(5): 383-392.   DOI
30 Serdula MK, Alexander MP, Scanlon KS, Bowman BA. What are preschool children eating? A review of dietary assessment. Annu Rev Nutr 2001; 21: 475-498.   DOI
31 United States Department of Agriculture, Food and Nutrition Service. Nutrition and wellness tips for young children: build a healthy plate with whole grains [Internet]. Alexandria (VA): Food and Nutrition Service; 2015 [cited 2015 Apr 8]. Available from: http:// www.teamnutrition.usda.gov/library.html.
32 Dubois L, Farmer AP, Girard M, Peterson K. Preschool children's eating behaviours are related to dietary adequacy and body weight. Eur J Clin Nutr 2007; 61(7): 846-855.   DOI
33 Wright CM, Parkinson KN, Shipton D, Drewett RF. How do toddler eating problems relate to their eating behavior, food preferences, and growth? Pediatrics 2007; 120(4): e1069-e1075.   DOI
34 Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 1997; 337(13): 869-873.   DOI
35 Steyn NP, Nel JH, Nantel G, Kennedy G, Labadarios D. Food variety and dietary diversity scores in children: are they good indicators of dietary adequacy? Public Health Nutr 2006; 9(5): 644-650.   DOI
36 Benjamin SE, Cradock A, Walker EM, Slining M, Gillman MW. Obesity prevention in child care: a review of U.S. state regulations. BMC Public Health 2008; 8: 188.   DOI
37 Marotz LR. Feeding toddlers and young children. In: Marotz LR, editor. Health, Safety, and Nutrition for the Young Child. 7th ed. Clifton Park (NY): Thomson Delmar Learning; 2009. p. 428-447.
38 Ollson S. Obesity in the early childhood years: state of the science and implementation of promising solutions: workshop summary. Washington, D.C. : National Academies Press; 2016.
39 Campbell K, Crawford D. Family food environments as determinants of preschool-aged children's eating behaviours: implications for obesity prevention policy. A review. Aust J Nutr Diet 2001; 58(1): 19-25.
40 Bennett CA, de Silva-Sanigorski AM, Nichols M, Bell AC, Swinburn BA. Assessing the intake of obesity-related foods and beverages in young children: comparison of a simple population survey with 24 hr-recall. Int J Behav Nutr Phys Act 2009; 6: 71.   DOI
41 Chun IA, Han MA, Park J, Choi SW, Ryu SY. The association between parental characteristics and dietary habits of early childhood. J Korean Soc Matern Child Health 2013; 17(1): 150-161.   DOI
42 Do NH, Kim JS, Ha MK. Survey on time use of infants and preschool children: research report 2013-10. Seoul: Korea Institute of Child Care and Education; 2013.
43 Manios Y, Kourlaba G, Grammatikaki E, Androutsos O, Moschonis G, Roma-Giannikou E. Development of a diet-lifestyle quality index for young children and its relation to obesity: the preschoolers diet-lifestyle index. Public Health Nutr 2010; 13(12): 2000-2009.   DOI
44 Smithers LG, Golley RK, Brazionis L, Emmett P, Northstone K, Lynch JW. Dietary patterns of infants and toddlers are associated with nutrient intakes. Nutrients 2012; 4(8): 935-948.   DOI
45 Northstone K, Emmett PM. Are dietary patterns stable throughout early and mid-childhood? A birth cohort study. Br J Nutr 2008; 100(5): 1069-1076.   DOI
46 Mikkilä V, Räsänen L, Raitakari OT, Pietinen P, Viikari J. Consistent dietary patterns dentified from childhood to adulthood: the cardiovascular risk in young Finns study. Br J Nutr 2005; 93(6): 923-931.   DOI
47 Randall Simpson JA, Keller HH, Rysdale LA, Beyers JE. Nutrition screening tool for every preschooler (NutriSTEP): validation and test-retest reliability of a parent-administered questionnaire assessing nutrition risk of preschoolers. Eur J Clin Nutr 2008; 62(6): 770-780.   DOI
48 Randall Simpson J, Gumbley J, Whyte K, Lac J, Morra C, Rysdale L, Turfryer M, McGibbon K, Beyers J, Keller H. Development, reliability, and validity testing of toddler NutriSTEP: a nutrition risk screening questionnaire for children 18-35 months of age. Appl Physiol Nutr Metab 2015; 40(9): 877-886.   DOI