Lotte GP Peters1, Iris M de Hoogh2, Arjan HJ Huizing3, Desiree A Lucassen4, Edith JM Feskens4, Wilrike J Pasman3, Anouk Middelweerd1, Suzan Wopereis3
1EEMCS, University of Twente, Enschede, the Netherlands; 2Human Performance, TNO, Soesterberg, the Netherlands; 3Health & Work, TNO, Leiden, the Netherlands; 4Human Nutrition & Health, WUR, Wageningen, the Netherlands
Background: Lifestyle is an increasingly important part of type 2 diabetes (T2D) treatment, with nutrition playing a key role. However, accurate dietary assessment methods are often burdensome, time-consuming or fail to capture habitual dietary intake. The web-based Nutri+ questionnaire was developed to quickly and easily evaluate habitual dietary intake. This study evaluated Nutri+ validity and reproducibility for Dutch habitual dietary intake at the food group level, using web-based 24-hour recalls administered via Compl-eat™ as reference.
Methods: The Nutri+ questionnaire assessed intake of 21 food groups (17 quantitative and 4 qualitative) and was validated in a cross-over study with 312 healthy Dutch adults (≥35 years). Participants completed the Nutri+ questionnaire on one randomly selected day and Compl-eat™ on four randomly selected, non-consecutive days, both repeated in two waves in reverse order.
Results: When comparing the mean intakes of the Nutri+ questionnaire with Compl-eat™, the Spearman correlation coefficients for 14 out of 17 quantitative food groups (0.43 to 0.90 (p =0.00)) indicated acceptable (r =0.20-0.49) to good (r ≥0.50) agreement with the reference method. The three remaining quantitative food groups had poor to acceptable agreement (r =0.16-0.30, p =0.00-0.02). For the four qualitative food groups, the kappa values were low (κ <0.20), showing no to low agreement. The Nutri+ questionnaire showed good consistency between wave 1 and wave 2, with intra-class correlation coefficients ranging from 0.51 to 0.87 (p <0.001). This indicates strong agreement across all quantitative food groups.
Discussion/Conclusion: After refinement, particularly with regard to the qualitative food groups, the Nutri+ questionnaire is an appropriate tool for assessing habitual dietary intake. The mean intakes of the Nutri+ questionnaire compared to Compl-eat™ showed an acceptable to good agreement for most food groups, and it showed a good reproducibility. Next, this web-based tool will be made more accessible and engaging, and developed into a chatbot. This will then be tested with people living with T2D as part of personalized lifestyle strategies.