Institute for Human Nutrition and Departments of Emergency Medicine and Pediatrics, Columbia University Medical Center, 3959 Broadway, CHN-1-116, New York, NY, 10032, USA.
Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, USA.
Nutr J. 2018 Nov 22;17(1):108. doi: 10.1186/s12937-018-0411-5.
Although animal and human studies have demonstrated interactions between dietary choline and fetal alcohol spectrum disorders, dietary choline deficiency in pregnancy is common in the US and worldwide. We sought to develop and validate a quantitative food frequency questionnaire (QFFQ) to estimate usual daily choline intake in pregnant mothers.
A panel of nutrition experts developed a Choline-QFFQ food item list, including sources with high choline content and the most commonly consumed choline-containing foods in the target population. A data base for choline content of each item was compiled. For reliability and validity testing in a prospective longitudinal cohort, 123 heavy drinking Cape Coloured pregnant women and 83 abstaining/light-drinking controls were recruited at their first antenatal clinic visit. At 3 prenatal study visits, each gravida was interviewed about alcohol, smoking, and drug use, and administered a 24-hour recall interview and the Choline-QFFQ.
Across all visits and assessments, > 78% of heavy drinkers and controls reported choline intake below the Dietary Reference Intakes adequate intake level (450 mg/day). Women reported a decrease in choline intake over time on the QFFQ. Reliability of the QFFQ across visits was good-to-acceptable for 2 of 4 group-level tests and 4 of 5 individual-level tests for both drinkers and controls. When compared with 24-hr recall data, validity of the QFFQ was good-to-acceptable for 3 of 4 individual-level tests and 3 of 5 group-level tests. For controls, validity was good-to-acceptable for all 4 individual-level tests and all 5 group-level tests.
To our knowledge, this is the first quantitative choline food frequency screening questionnaire to be developed and validated for use with both heavy and non-drinking pregnant women and the first to be used in the Cape Coloured community in South Africa. Given the high prevalence of inadequate choline intake and the growing evidence that maternal choline supplementation can mitigate some of the adverse effects of prenatal alcohol exposure, this tool may be useful for both research and future clinical outreach programs.
尽管动物和人体研究已经证明了饮食胆碱与胎儿酒精谱系障碍之间的相互作用，但在怀孕期，饮食胆碱缺乏在美国乃至全球都很常见。我们试图开发并验证一种定量食物频率问卷（QFFQ），以评估孕妇的日常胆碱摄入量。
一组营养专家制定了一份胆碱 QFFQ 食物项目清单，包括高胆碱含量的来源以及目标人群中最常食用的含胆碱食物。为每个项目编制了胆碱含量数据库。为了在一项前瞻性纵向队列中进行可靠性和有效性测试，招募了 123 名重度饮酒的海角有色人种孕妇和 83 名不饮酒/轻度饮酒的对照组在她们的第一次产前诊所就诊时。在 3 次产前研究访视中，每位孕妇都接受了关于酒精、吸烟和药物使用的访谈，并进行了 24 小时回顾性访谈和胆碱 QFFQ 调查。
在所有的访问和评估中，超过 78%的重度饮酒者和对照组报告说他们的胆碱摄入量低于膳食参考摄入量（450 毫克/天）的充足摄入量水平。女性在 QFFQ 上报告了随着时间的推移胆碱摄入量的减少。对于 2 个组级测试中的 4 个和 5 个个体级测试中的 4 个，无论饮酒者还是对照组，QFFQ 的跨访可靠性都很好到可以接受。与 24 小时回顾数据相比，QFFQ 的有效性在 4 个个体级测试中的 3 个和 5 个组级测试中的 3 个中都很好到可以接受。对于对照组，所有 4 个个体级测试和所有 5 个组级测试的有效性都很好到可以接受。
据我们所知，这是第一个为重度和非饮酒孕妇开发和验证的定量胆碱食物频率筛查问卷，也是第一个在南非海角有色人社区使用的问卷。鉴于饮食胆碱摄入不足的高患病率以及越来越多的证据表明，母体胆碱补充可以减轻产前酒精暴露的一些不良影响，因此，该工具可能对研究和未来的临床推广计划都有用。
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