dietary assessment tool network (diet@net) mrc … · dietary assessment. the delphi techniques...
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DIETary Assessment Tool NETwork(DIET@NET) MRC Partnership Grant. Nutritools (www.nutritools.org)
Dr Marisol Warthon-Medina, QIB
Paul Finglas, Mark Roe, Janet Cade, Barrie Margetts, Sian
Robinson, Andy Ness, Nisreen Alwan, Neil Hancock on
behalf of the DIET@NET Consortium. Tunisia 8th November, 2018.
Outline
• DIET@NET project (Nutritools)
• Best Practice Guidelines (BPG)
• Tool library development – Systematic Review of Reviews
• Nutritools website overview
Partnership Expertise
MWM
Aim
Improve the quality, consistency and comparability of dietary data
collected in epidemiological & clinical studies by:
Producing best practice guidelines (BPG) around the collection and analysis of dietary intake data to help raise standards;
Providing access to high-quality, online tools to measure food and nutrient intakes.
DIET@NET Partnership Structure - Groups and Group Chairs
DIET@NET members - Acknowledgements
Steering Group (SG): Janet Cade, Barrie Margetts, Sian Robinson, Nisreen Alwan,
Andrew Ness, Petra Wark, Toni Steer, Polly Page, Paul Finglas,
Tim Key.
Advisory Group (AG): Barrie Margetts, Amy Subar, Gilliam
Swan, Andrea de Silva Sanigorski, Nadia Slimani, Mark
Lawrence, Simon Wheeler.
Working Groups: Laura Johnson, Linda Harvey, Mark Roe,
Katharine Roberts, Victoria Burley, Darren Greenwood,
Birdem Amoutzopoulous, Darren Cole, Hermione Lawson,
‘SG’.
Project team: Janet Cade, Marisol Warthon-Medina, Neil
Hancock, Jayne Hutchinson, Lauren Gibson, Linda Bush, Elisa
Vargas-Garcia, Jozef Hooson.
DIET@NET – Strands of work
IBest Practice
Guidelines for dietary assessment
II
DAT-eLibrary(interactive website)
III
Online interface between food tables
and tools
Nutritools website work strands
The Nutritools website (www.nutritools.org)
Introduction
➢ Accurate assessment of dietary intake is important for: • Planning and implementation of health promotion
• Evaluating the effectiveness of public health interventions
• Research into links between diet and health.
➢ Measuring dietary intake is one of the most challenging aspects of public health research as no dietary method can measure dietary intake without error.
➢ Strategies which support researchers to choose the most appropriate dietary assessment method are needed.
Aim: Using expert consensus, we aimed to develop Best Practice Guidelines (BPG) to aid researchers carrying out dietary assessment.
Steps for the development of the Best Practice Guidelines (BPG) for dietary assessment
Best Practice Guidelines for dietary assessment
43 Guidelines: Essential (E) & Desirable (D)
Best Practice Guidelines
Cade, J. E., M. Warthon-Medina, S. Albar, N. A. Alwan, A. Ness, M. Roe, P. A. Wark, K. Greathead, V. J. Burley, P. Finglas, L. Johnson, P. Page, K. Roberts, T. Steer, J. Hooson, D. C. Greenwood and S. Robinson (2017). "DIET@NET: Best Practice Guidelines for dietary assessment in health research." BMC Medicine 15(1): 202.https://doi.org/10.1186/s12916
-017-0962-x
131 experts invited.
57 experts were involved in Delphi process
Best Practice Guidelines (BPG) Key message:
➢Using the Best Practice Guidelines will help selection, standardization and quality of dietary assessment.
➢The Delphi techniques allowed us to synthesise experts’ consensus on best practice in choosing a potential Dietary Assessment Tool (DAT) & think through its implementation.
➢The BPG will help researchers to select the most appropriate DAT.
➢These guidelines are included on the Nutritools website (www.nutritools.org).
Best Practice Guidelines Example
Dietary Assessment Tools (DATs) – Strengths and Weaknesses
FFQ – Strengths and Weaknesses
Tool library• The DATe-library provides information on:
-63 UK dietary assessment tools and -64 worldwide tools and validation study characteristics.
• Visual presentation of DATs using:-bubble charts and -summary plots, allows easy comparison between the DATs.
MWM
Systematic Review of Systematic Reviews
7 scientific databases
searched for reviews post
2000
51 reviews identified after
full screening
97 UK + 845 non-UK tool
development and
validation papers located
DAT data extraction
Phase 1 – 63 UK DATs
Phase 2 – >400 non-UK
DAT access secured from tool
owner and
inclusion in e-library
Databases Searched
Systematic Review – Search Terms Domain 1 (what DATs are assessing)
1 exp diet/ 2 Nutritional status.mp. 3 diet* adj2 intake*.mp 4 diet* adj2 qualit*.mp. 5 food adj2 intake*.mp. 6 nutri* adj2 intake*.mp. 7 diet* adj2 habit*.mp. 8 food adj2 habit.mp. 9 diet* pattern* or meal pattern*.mp. 10 food group*.mp. 11 nutrient*.mp. 12 macro-nutrient* or macronutrient.mp. 13 micro-nutrient or micronutrient.mp. 14 energy intake*.mp. 15 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14
Domain 2 (different types of DATs)
16 diet* adj2 (method* or tool* or survey* or record* or assess*).mp. 17 diet* adj2 (recall* or questionnaire* or histor* or instrument*).mp. 18 nutrition* adj2 (survey* or assess* or instrument*).mp. (27252) 19 food adj2 (questionnaire* or record* or recall* or diar* or checklist* or screener*).mp 20 24* adj2 recall.mp. 21 multiple pass.mp 22 FFQ*.mp 23 diet* adj2 (measure* or analys*).mp 24 nutri* adj2 measur*.mp 25 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24
Domain 3 (the quality of the DATs)
26 valid*.mp. 27 reliab*.mp. 28 reproduc*.mp. 29 calibrat*.mp. 30 repeatab*.mp 31 feasib*.mp 32 evaluat*.mp 33 26 or 27 or 28 or 29 or 30 or 31
Domain 4 (limiting the results to reviews)
34 review*.mp 35 meta-analy*.mp. 36 search*.mp. 37 systematic* adj2 (approach or analys*).mp. 38 33 or 34 or 35 or 36
Domain 1, 2 ,3 and 4 39 15 and 25 and 32 and 37
Domain 1 (what DATs are assessing)
1 exp diet/ 2 Nutritional status.mp. 3 diet* adj2 intake*.mp 4 diet* adj2 qualit*.mp. 5 food adj2 intake*.mp. 6 nutri* adj2 intake*.mp. 7 diet* adj2 habit*.mp. 8 food adj2 habit.mp. 9 diet* pattern* or meal pattern*.mp. 10 food group*.mp. 11 nutrient*.mp. 12 macro-nutrient* or macronutrient.mp. 13 micro-nutrient or micronutrient.mp. 14 energy intake*.mp. 15 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14
Domain 2 (different types of DATs)
16 diet* adj2 (method* or tool* or survey* or record* or assess*).mp. 17 diet* adj2 (recall* or questionnaire* or histor* or instrument*).mp. 18 nutrition* adj2 (survey* or assess* or instrument*).mp. (27252) 19 food adj2 (questionnaire* or record* or recall* or diar* or checklist* or screener*).mp 20 24* adj2 recall.mp. 21 multiple pass.mp 22 FFQ*.mp 23 diet* adj2 (measure* or analys*).mp 24 nutri* adj2 measur*.mp 25 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24
Domain 3 (the quality of the DATs)
26 valid*.mp. 27 reliab*.mp. 28 reproduc*.mp. 29 calibrat*.mp. 30 repeatab*.mp 31 feasib*.mp 32 evaluat*.mp 33 26 or 27 or 28 or 29 or 30 or 31
Domain 4 (limiting the results to reviews)
34 review*.mp 35 meta-analy*.mp. 36 search*.mp. 37 systematic* adj2 (approach or analys*).mp. 38 33 or 34 or 35 or 36
Domain 1, 2 ,3 and 4 39 15 and 25 and 32 and 37
Domain 1 (what DATs are assessing)
1 exp diet/ 2 Nutritional status.mp. 3 diet* adj2 intake*.mp 4 diet* adj2 qualit*.mp. 5 food adj2 intake*.mp. 6 nutri* adj2 intake*.mp. 7 diet* adj2 habit*.mp. 8 food adj2 habit.mp. 9 diet* pattern* or meal pattern*.mp. 10 food group*.mp. 11 nutrient*.mp. 12 macro-nutrient* or macronutrient.mp. 13 micro-nutrient or micronutrient.mp. 14 energy intake*.mp. 15 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14
Domain 2 (different types of DATs)
16 diet* adj2 (method* or tool* or survey* or record* or assess*).mp. 17 diet* adj2 (recall* or questionnaire* or histor* or instrument*).mp. 18 nutrition* adj2 (survey* or assess* or instrument*).mp. (27252) 19 food adj2 (questionnaire* or record* or recall* or diar* or checklist* or screener*).mp 20 24* adj2 recall.mp. 21 multiple pass.mp 22 FFQ*.mp 23 diet* adj2 (measure* or analys*).mp 24 nutri* adj2 measur*.mp 25 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24
Domain 3 (the quality of the DATs)
26 valid*.mp. 27 reliab*.mp. 28 reproduc*.mp. 29 calibrat*.mp. 30 repeatab*.mp 31 feasib*.mp 32 evaluat*.mp 33 26 or 27 or 28 or 29 or 30 or 31
Domain 4 (limiting the results to reviews)
34 review*.mp 35 meta-analy*.mp. 36 search*.mp. 37 systematic* adj2 (approach or analys*).mp. 38 33 or 34 or 35 or 36
Domain 1, 2 ,3 and 4 39 15 and 25 and 32 and 37
Domain 1 (what DATs are assessing)
1 exp diet/ 2 Nutritional status.mp. 3 diet* adj2 intake*.mp 4 diet* adj2 qualit*.mp. 5 food adj2 intake*.mp. 6 nutri* adj2 intake*.mp. 7 diet* adj2 habit*.mp. 8 food adj2 habit.mp. 9 diet* pattern* or meal pattern*.mp. 10 food group*.mp. 11 nutrient*.mp. 12 macro-nutrient* or macronutrient.mp. 13 micro-nutrient or micronutrient.mp. 14 energy intake*.mp. 15 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14
Domain 2 (different types of DATs)
16 diet* adj2 (method* or tool* or survey* or record* or assess*).mp. 17 diet* adj2 (recall* or questionnaire* or histor* or instrument*).mp. 18 nutrition* adj2 (survey* or assess* or instrument*).mp. (27252) 19 food adj2 (questionnaire* or record* or recall* or diar* or checklist* or screener*).mp 20 24* adj2 recall.mp. 21 multiple pass.mp 22 FFQ*.mp 23 diet* adj2 (measure* or analys*).mp 24 nutri* adj2 measur*.mp 25 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24
Domain 3 (the quality of the DATs)
26 valid*.mp. 27 reliab*.mp. 28 reproduc*.mp. 29 calibrat*.mp. 30 repeatab*.mp 31 feasib*.mp 32 evaluat*.mp 33 26 or 27 or 28 or 29 or 30 or 31
Domain 4 (limiting the results to reviews)
34 review*.mp 35 meta-analy*.mp. 36 search*.mp. 37 systematic* adj2 (approach or analys*).mp. 38 33 or 34 or 35 or 36
Domain 1, 2 ,3 and 4 39 15 and 25 and 32 and 37
Domain 1 (What are the DATs measuring)
Domain 2 (Different type of DATs)
Domain 3 (Quality of the DATs)
Domain 4 (Limiting results to reviews)
• Reviews which evaluate/complete a comparative analysis on validated DATs which measure full nutrient intake, macro or micro nutrient intake, food groups, or non-nutrients e.g. flavonoids.
• Reviews which include DATs validated against a biomarker or another self-reported measure of dietary intake.
• Reviews that include DATs which have been validated in any population.
Inclusion Criteria
Exclusion Criteria
• Only assess DATS which measures:
➢ Eating Behaviour
➢ Food Preference
➢ Feeding Practices
➢ Eating Disorders
➢ Malnutrition
• Only assess DATS which cannot be implemented on Nutritools.org - e.g. PDAs.
• Only assess lifestyle questionnaires (diet plus physical activity) where diet questions are minimal.
• All of the DATs and papers identified from the systematic reviews were downloaded and reviewed to determine eligibility for the Nutritools website.
• To be eligible for inclusion the DATs had to be valid, measure dietary intake and be able to be added onto the website.
• No date restrictions was imposed on the selection of DATs
• DATs were split up into UK and non-UK, as UK DATs would only be added onto the website.
Identifying DATs from the Systematic Reviews
Library of validated DATs
DAT in the UK: Child and Diet Evaluation Tool (CADET) - Food checklist
DAT in the UK: Myfood24 (https://www.myfood24.org)spinout company : Dietary Assessment Ltd
DAT in France
DATs for African countries• Tool available from Botswana:
FFQ1 year
• Tool available from South Africa:
Tool visualisation
Bubble chart Summary plot
Food Questionnaire Creator
FQC – CADET example of finalised questionnaire
Links to useful resources
Nutritools glossary
Help / FAQ
References• Lachat C, Hawwash D, Ocké MC, Berg C, Forsum E, et al. (2016) Strengthening the Reporting of
Observational Studies in Epidemiology—Nutritional Epidemiology (STROBE-nut): An Extension of the STROBE Statement. PLoS Med 13: e1002036.
• Bland JM, Altman DG (1995) Comparing methods of measurement: why plotting difference against standard method is misleading. The Lancet 346: 1085-1087.
• Moher D, Schulz KF, Simera I, Altman DG (2010) Guidance for developers of health research reporting guidelines. PLoS medicine 7: e1000217.
• Carter MC, Albar SA, Morris MA, Mulla UZ, Hancock N, et al. (2015) Development of a UK Online 24-h Dietary Assessment Tool: myfood24. Nutrients 7: 4016-4032.
• Diet, Anthropometry and Physical Activity (DAPA) Measurement Toolkit:http://dapa-toolkit.mrc.ac.uk/
• National Cancer institute Dietary Assessment Primer:https://dietassessmentprimer.cancer.gov/concepts/
Principle Investigator: Prof Janet Cade
Project Manager: Dr Marisol Warthon-Medina
Research Support Assistant: Mr. Jozef Hooson
Database Manager: Mr. Neil Hancock
Dr Salwa Albar Dr Nisreen Alwan Prof Andy Ness Mr Mark Roe Prof Petra Wark Dr Katharine GreatheadDr Victoria Burley Mr Paul Finglas
Dr Laura Johnson Ms Polly Page Dr Katharine Roberts
Dr Toni SteerDr Darren Greenwood Prof Sian Robinson
Contact Nutritools –[email protected]
www.nutritools.ac.uk
@Nutritools_org
Acknowledgements: DIET@NET Consortium –Project team
Acknowledgements:
• Paul Finglas, Head of FDNC [email protected]
• Mark Roe [email protected]
• Dr Marisol Warthon-Medina [email protected]
• Jenny Plumb [email protected]
• Hannah Pinchen [email protected]
• Rachel Berry [email protected]
• Olivia Shaw [email protected]
• Daniela Segovia-Lizano [email protected]
• Pete Metcalf [email protected]
Food Databanks National Capability (FDNC) https://fdnc.quadram.ac.uk/Quadram Institute Bioscience (QIB) & EuroFIRhttp://www.eurofir.org/:
Feedback from Nutritools website users: – Agreed Quotations
“The website looks great and easy to use and such a resource was long
overdue.” Dr Angeliki Papadaki, Senior Lecturer in Nutrition, School for Policy Studies, University of Bristol.
“I think that it is an excellent site and could be very useful to people
wishing to conduct dietary surveys. It is very intuitive to navigate” Dr Helen
Moore, Knowledge Exchange Manager (EPSRC IAA) in the Research and Innovation Services, Durham University.
“Nutritools is an exciting and very worthwhile initiative” Associate Professor Anne-
Louise Heath in the Department of Human Nutrition at the University of Otago, New Zealand.