Relative validity of the Children's Eating Habits Questionnaire-food frequency section among young European children: The IDEFICS Study

Silvia Bel-Serrat, Theodora Mouratidou, Valeria Pala, Inge Huybrechts, Claudia Börnhorst, Juan Miguel Fernández-Alvira, Charalampos Hadjigeorgiou, Gabriele Eiben, Antje Hebestreit, Lauren Lissner, Dénes Molnár, Alfonso Siani, Toomas Veidebaum, Vittorio Krogh, Luis A. Moreno

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Abstract Objective To compare, specifically by age group, proxy-reported food group estimates obtained from the food frequency section of the Children's Eating Habits questionnaire (CEHQ-FFQ) against the estimates of two non-consecutive 24 h dietary recalls (24-HDR). Design Estimates of food group intakes assessed via the forty-three-food-group CEHQ-FFQ were compared with those obtained by a computerized 24-HDR. Agreement on frequencies of intakes (equal to the number of portions per recall period) between the two instruments was examined using crude and de-attenuated Pearson's correlation coefficients, cross-classification analyses, weighted kappa statistics (κ w) and Bland-Altman analysis. Setting Kindergartens/schools from eight European countries participating in the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) Study cross-sectional survey (2007-2008). Subjects Children aged 2-9 years (n 2508, 50·4 % boys). Results The CEHQ-FFQ provided higher intake estimates for most of the food groups than the 24-HDR. De-attenuated Pearson correlation coefficients ranged from 0·01 (sweetened fruit) to 0·48 (sweetened milk) in children aged 2-<6 years (mean = 0·25) and from 0·01 (milled cereal) to 0·44 (water) in children aged 6-9 years (mean = 0·23). An average of 32 % and 31 % of food group intakes were assigned to the same quartile in younger and older children, respectively, and classification into extreme opposite quartiles was ≤12 % for all food groups in both age groups. Mean κ w was 0·20 for 2-<6-year-olds and 0·17 for 6-9-year-olds. Conclusions The strength of association estimates assessed by the CEHQ-FFQ and the 24-HDR varied by food group and by age group. Observed level of agreement and CEHQ-FFQ ability to rank children according to intakes of food groups were considered to be low.

Original languageEnglish
Pages (from-to)266-276
Number of pages11
JournalPublic Health Nutrition
Issue number2
Publication statusPublished - Feb 2014



  • 24 h Dietary recall
  • Children
  • FFQ
  • Proxy reports
  • Relative validation

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Public Health, Environmental and Occupational Health

Cite this

Bel-Serrat, S., Mouratidou, T., Pala, V., Huybrechts, I., Börnhorst, C., Fernández-Alvira, J. M., Hadjigeorgiou, C., Eiben, G., Hebestreit, A., Lissner, L., Molnár, D., Siani, A., Veidebaum, T., Krogh, V., & Moreno, L. A. (2014). Relative validity of the Children's Eating Habits Questionnaire-food frequency section among young European children: The IDEFICS Study. Public Health Nutrition, 17(2), 266-276.