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A rapid food screener to assess fat and fruit and vegetable intake

https://doi.org/10.1016/S0749-3797(00)00119-7Get rights and content

Abstract

Background: The U.S. Preventive Services Task Force recommends that Americans lower dietary fat and cholesterol intake and increase fiber and fruit/vegetables to reduce prevalence of heart disease, cancer, stroke, hypertension, obesity, and non–insulin-dependent diabetes mellitus in the United States. To provide preventive services to all, a rapid, inexpensive, and valid method of assessing dietary intake is needed.

Methods: We used a one-page food intake screener based on national nutrition data. Respondents can complete and score the screener in a few minutes and can receive immediate, brief feedback. Two hundred adults self-administered the food screener. We compared fat, fiber, and fruit/vegetable intake estimates derived from the screener with estimates from a full-length, 100-item validated questionnaire.

Results: The screener was effective in identifying persons with high-fat intake, or low–fruit/vegetable intake. We found correlations of 0.6–0.7 (p<0.0001) for total fat, saturated fat, cholesterol, and fruit/vegetable intake. The screener could identify persons with high percentages of calories from fat, total fat, saturated fat, or cholesterol, and persons with low intakes of vitamin C, fiber, or potassium.

Conclusions: This screener is a useful tool for quickly monitoring patients’ diets. The health care provider can use it as a prelude to brief counseling or as the first stage of triage. Persons who score poorly can be referred for more extensive evaluation by low-cost paper-and-pencil methods. Those who still have poor scores at the second stage ultimately can be referred for in-person counseling .

Section snippets

Methods

We invited employees of a company in the San Francisco Bay area to participate in a Nutrition Education and Research Program, conducted by the University of California. Each employee received the one-page Food Screener and the full-length, eight-page Food Frequency Questionnaire. Patients self-administered both forms. As incentive, we offered an individual nutritional analysis, the results of which were kept confidential from company management. Of the 402 employees invited, 208 chose to

Results

The Food Screener ranked subjects similarly to estimates from the Block full-length Food Frequency Questionnaire, used here as the gold standard, for a number of important nutrients (Table 2). Spearman rank-order correlation coefficient (r>0.60) showed that the Food Screener ranked subjects quite well with respect to dietary intake of total fat, saturated fat, dietary cholesterol, and percent of calories from fat. We also obtained an excellent correlation of the screener with servings of fruits

Discussion

The correlations of the meats/snacks score with fats and cholesterol indicate that the screener can provide estimates of these nutrients similar to rankings obtained from a full-length nutrition questionnaire. If intake of fruits and vegetables is of interest, the fruit/vegetable screener (with the omission of the beans item) produced an excellent estimate of servings of those foods. The correlations of the fruit/vegetables score with associated nutrients as opposed to foods tended to be

Acknowledgements

This work was supported in part by the Harold Dobbs Cancer Research Fund, UCSF/Mt. Zion Cancer Center, and the Shaklee Corporation.

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