Electronic Thesis and Dissertation Repository

Thesis Format

Alternative Format

Degree

Master of Science

Program

Foods and Nutrition

Supervisor

Hartman, Brenda

Abstract

This study evaluated the validity and reproducibility of a Complementary Food Frequency Questionnaire (CFFQ) developed specifically for Canadian infants under one year of age, with the aim to assess the diverse nutrient intake of Canada's multicultural infants. Despite recruitment challenges, the study involved 15 parent-child pairs, with infants averaging 8.2 months old, and 60% of caregivers identifying as Latin American. Over a three-week period, participants completed two administrations of the CFFQ, and a 4-day weighed food record to assess dietary intake. Validity and reproducibility were measured over six statistical tests to assess agreement. Results showed poor validity for 89% of 18 nutrients. While total energy, protein, and fat displayed good reliability, inconsistencies were noted in cross-classification and Bland Altman measures. The CFFQ overestimates nutrient intake among Canadian infants and is not a valid dietary assessment tool. Nevertheless, this research provides preliminary insights for infant nutrition assessment practices in future studies.

Summary for Lay Audience

This study aimed to develop and evaluate a new dietary assessment tool called the Complementary Food Frequency Questionnaire (CFFQ), designed specifically to measure the nutrient intake of Canadian infants under one year of age. Understanding what infants eat is important as they transition from breastmilk or formula to solid foods, ensuring they get the nutrition they need for healthy growth and development. This research study focused on collecting information about the varied diets of Canadian families, reflecting the country’s diverse cultures. Fifteen parent-child pairs took part in the study, with most infants averaging around 8 months old. Most of the caregivers identified as Latin American.

To test how well the CFFQ worked, caregivers completed two rounds of the questionnaire over three weeks, alongside a 4-day weighed food record (4dWFR), which is considered a ‘gold standard’ for tracking what people eat. The 4dWFR required parents to weigh and record all milks and foods before and after their child’s meals, giving a complete picture of the infants' diets during this transition.

The results showed that the CFFQ often reported higher food intake levels than the 4dWFR but still captured the general eating patterns of the infants. However, it struggled to accurately measure 89% of the measured nutrients, indicating that the CFFQ may not be reliable for assessing all aspects of infant nutrition. There were also inconsistencies in the results across the 18 nutrients evaluated, highlighting areas for improvement. A key recommendation for future studies is to explore how the findings can be used by healthcare professionals.

Overall, this research offers valuable insights into what Canadian infants are eating and emphasizes the need to improve the CFFQ. By refining this tool, healthcare providers can better support infant nutrition during this critical stage of development, leading to healthier outcomes for Canadian infants. Future studies should test the CFFQ with larger and more varied groups to ensure that the tool is measuring what it is supposed to measure and has consistent results when used multiple times.

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