Validation of a food frequency questionnaire: VioScreen-Allergy

Authors: PICKETT-NAIRNE, KACI - University Of Colorado; GLUECK, DEBORAH - University Of Colorado; Thomson, Jessica; WEISS, RICK - Viocare, Inc; FULLMEYER, KELLY - Viocare, Inc; SCHULTZ, CLAIRE - Denver Health; SCHAEFER, CLAUDIA - Merck Research Laboratories; EVANS, COURTNEY - Children’s Hospital Colorado; BOWHAY, EMILY - Children’s Hospital Colorado; MARTINEZ, MONICA - Adams State College; MOORE, WENDY - Children’s Hospital Colorado; FLEISCHER, DAVID - Children’s Hospital Colorado; VENTER, CARINA - University Of Colorado

Submitted to: Nutrients
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/29/2024
Publication Date: 11/2/2024
Citation: Pickett-Nairne, K., Glueck, D., Thomson, J.L., Weiss, R., Fullmeyer, K., Schultz, C., Schaefer, C., Evans, C., Bowhay, E., Martinez, M., Moore, W., Fleischer, D., Venter, C. 2024. Validation of a food frequency questionnaire: VioScreen-Allergy. Nutrients. 16(21):3772. https://DOI.org/10.3390/nu16213772.
DOI: https://doi.org/10.3390/nu16213772

Interpretive Summary: The prevalence of eczema and food allergies are rising dramatically, negatively affecting the quality of life of many Americans. Measuring intake of food allergens is necessary to capture associations between maternal dietary intake during pregnancy and subsequent allergy outcomes in children. Yet current food frequency questionnaires do not distinguish among specific groups of food allergens, such as nuts and seeds. Thus, to address questionnaire limits for capturing specific food allergens, the objective of this work was to validate a new questionnaire, VioScreen-Allergy, specifically designed to measure intake of food allergens. Based on a sample of females of childbearing age, intake amounts of macronutrients, micronutrients, and allergens compared favorably between VioScreen-Allergy and 24-hour dietary recalls with few exceptions (Vitamin C, niacin, and cashew protein). Additionally, beta-carotene and orange vegetable servings were positively associated with skin carotenoid measures (biomarker of fruit and vegetable intake). This study provides evidence supporting the use of VioScreen-Allergy for measuring overall dietary intake as well as food allergen intake, particularly for determining associations between maternal dietary intake during pregnancy and development of eczema and food allergies in children.

Technical Abstract: Background/Objectives: An adapted version of an online pictorial food frequency questionnaire (FFQ), VioScreen-Allergy, assesses total dietary intake, intake of allergens and foods in the maternal diet index (MDI) linked to offspring allergy. This study assessed intermethod reliability, test-retest reliability, and external validity of the VioScreen-Allergy. Methods: Females of childbearing age were recruited at Denver Health and Children’s Hospital, Colorado, USA and during a month were asked to complete four 24-hour recalls and two VioScreen-Allergy FFQs. All those with at least two 24-hour recalls and both VioScreen-Allergy assessments were analyzed. Energy-adjusted and non-adjusted linear mixed models 1) compared MDI scores and intake of nutrients and allergens as measures of intermethod reliability; 2) evaluated VioScreen-Allergy test-retest reliability as differences between repeated measurements, and 3) assessed external validity by modeling associations between VioScreen-Allergy derived intake of beta-carotene and orange vegetables and Veggie Meter®-assessed skin carotenoids. Bonferroni corrections controlled multiple comparisons within assessment. Results: Of 53 participants enrolled, 25 demographically dissimilar participants were included in the analysis. There were no significant differences between 24-hour recall and VioScreen-Allergy mean intakes of macronutrients, micronutrients, allergens, or MDI, except for Vitamin C, niacin, and cashew protein. There were no significant differences between repeated measurements of VioScreen-Allergy, either energy-adjusted or unadjusted. Both beta-carotene and orange vegetable servings were significantly associated with Veggie Meter®. Conclusions: Although non-significance could have been due to low power, clinical as well as statistical assessments of intermethod reliability, test-retest reliability, and external validity suggest that VioScreen-Allergy has reasonable utility for trials assessing allergens and MDI in the context of overall intake.