Validation of a food quantification picture book targeting children of 0–10 years of age for pan-European and national dietary surveys

The aim of the present study was to validate thirty-eight picture series of six pictures each developed within the PANCAKE (Pilot study forthe Assessment of Nutrient intake and food Consumption Among Kids in Europe) project for portion size estimation of foods consumed byinfants, toddlers and children for future pan-European and national dietary surveys. Identical validation sessions were conducted in threeEuropean countries. In each country, forty-five foods were evaluated; thirty-eight foods were the same as the depicted foods, and sevenfoods were different, but meant to be quantified by the use of one of the thirty-eight picture series. Each single picture within a pictureseries was evaluated six times by means of predefined portions. Therefore, thirty-six pre-weighed portions of each food were evaluatedby convenience samples of parents having children aged from 3 months to 10 years. The percentages of participants choosing the correctpicture, the picture adjacent to the correct picture or a distant picture were calculated, and the performance of individual pictures withinthe series was assessed. For twenty foods, the picture series performed acceptably (mean difference between the estimated portion numberand the served portion number less than 0·4 (SD ,1·1)). In addition, twelve foods were rated acceptable after adjustment for density differences.Some other series became acceptable after analyses at the country level. In conclusion, all picture series were acceptable forinclusion in the PANCAKE picture book. However, the picture series of baby food, salads and cakes either can only be used for foodsthat are very similar to those depicted or need to be substituted by another quantification tool.</p

What do Danish children eat, and does the diet meet the recommendations?:Baseline data from the OPUS School Meal Study

A child's diet is an important determinant for later health, growth and development. In Denmark, most children in primary school bring their own packed lunch from home and attend an after-school care institution. The aim of the present study was to evaluate the food, energy and nutrient intake of Danish school children in relation to dietary guidelines and nutrient recommendations, and to assess the food intake during and outside school hours. In total, 834 children from nine public schools located in the eastern part of Denmark were included in this cross-sectional study and 798 children (95·7 %) completed the dietary assessment sufficiently (August–November 2011). The whole diet was recorded during seven consecutive days using the Web-based Dietary Assessment Software for Children (WebDASC). Compared with the food-based dietary guidelines and nutrient recommendations, 85 % of the children consumed excess amounts of red meat, 89 % consumed too much saturated fat, and 56 % consumed too much added sugar. Additionally 35 or 91 % of the children (depending on age group) consumed insufficient amounts of fruits and vegetables, 85 % consumed insufficient amounts of fish, 86 % consumed insufficient amounts of dietary fibre, 60 or 84 % had an insufficient Fe intake (depending on age group), and 96 % had an insufficient vitamin D intake. The study also showed that there is a higher intake of fruits and bread during school hours than outside school hours; this is not the case with, for example, fish and vegetables, and future studies should investigate strategies to increase fish and vegetable intake during school hours