Tugault-Lafleur Claire N, Black Jennifer L, Barr Susan I
Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, Vancouver, British Columbia, Canada
Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, Vancouver, British Columbia, Canada.
Adv Nutr. 2017 Jan 17;8(1):63-79. doi: 10.3945/an.116.013144. Print 2017 Jan.
To evaluate the impact of school-based nutrition interventions, accurate and reliable methods are needed to assess what children eat at school. The primary objective of this study was to systematically review methodological evidence on the relative accuracy and reliability of dietary assessment methods used in the school context. The secondary objective was to assess the frequency of methods and analytical approaches used in studies reporting in-school dietary outcomes. Three health databases were searched for full-text English-language studies. Twenty-two methodological studies were reviewed. For school meal recalls, the majority of studies (n = 8 of 12) reported poor accuracy when accuracy was measured by using frequencies of misreported foods. However, when energy report rates were used as a measure of accuracy, studies suggested that children were able to accurately report energy intake as a group. Results regarding the accuracy of food-frequency questionnaires (FFQs) and food records (FRs) were promising but limited to a single study each. Meal observations offered consistently good interrater reliability across all studies reviewed (n = 11). Studies reporting in-school dietary outcomes (n = 47) used a broad range of methods, but the most frequently used methods included weighed FRs (n = 12), school meal recalls (n = 10), meal observations by trained raters (n = 8), and estimated FRs (n = 7). The range of dietary components was greater among studies relying on school meal recalls and FRs than among studies using FFQs. Overall, few studies have measured the accuracy of dietary assessment methods in the school context. Understanding the methodological characteristics associated with dietary instruments is vital for improving the quality of the evidence used to inform and evaluate the impact of school-based nutrition policies and programs.
为评估以学校为基础的营养干预措施的影响，需要准确可靠的方法来评估儿童在学校的饮食情况。本研究的主要目的是系统回顾关于学校环境中使用的膳食评估方法相对准确性和可靠性的方法学证据。次要目的是评估报告校内饮食结果的研究中所使用方法和分析方法的频率。检索了三个健康数据库中的全文英文研究。对22项方法学研究进行了综述。对于学校膳食回忆法，大多数研究（12项中的8项）报告称，当用误报食物的频率来衡量准确性时，准确性较差。然而，当用能量报告率作为准确性的衡量指标时，研究表明儿童作为一个群体能够准确报告能量摄入量。关于食物频率问卷（FFQ）和食物记录（FR）准确性的结果很有前景，但每项都仅限于一项研究。在所有综述的研究（n = 11）中，膳食观察的评分者间信度一直良好。报告校内饮食结果的研究（n = 47）使用了广泛的方法，但最常用的方法包括称重食物记录（n = 12）、学校膳食回忆法（n = 10）、由经过培训的评分者进行的膳食观察（n = 8）和估计食物记录（n = 7）。依赖学校膳食回忆法和食物记录的研究中膳食成分的范围比使用食物频率问卷的研究更大。总体而言，很少有研究在学校环境中测量膳食评估方法的准确性。了解与膳食工具相关的方法学特征对于提高用于为以学校为基础的营养政策和计划提供信息并评估其影响的证据质量至关重要。
