Development and Validation of a Questionnaire to Assess Adherence to the Healthy Food Pyramid in Spanish Adults

Andrea Gila-Díaz, Silvia M Arribas, Ángel Luis López de Pablo, Ma Rosario López-Giménez, Sophida Phuthong, David Ramiro-Cortijo, Andrea Gila-Díaz, Silvia M Arribas, Ángel Luis López de Pablo, Ma Rosario López-Giménez, Sophida Phuthong, David Ramiro-Cortijo

Abstract

We aimed to design and validate a new questionnaire of adherence to healthy food pyramid (HFP) (AP-Q), to improve previous instruments. The questionnaire was self-administered and included 28 questions from 10 categories (physical activity, health habits, hydration, grains, fruits, vegetables, oil type, dairy products, animal proteins, and snacks). A population of 130 Spanish adults answered it, obtaining scores from each category and a global score of HFP adherence (AP-Q score). Validation was performed through principal components analysis (PCA) and internal consistency by Cronbach's alpha. AP-Q was also externally validated with Kidmed-test, answered by 45 individuals from the cohort. The global AP-Q score was 5.1 ± 1.3, with an internal consistency of 64%. The PCA analysis extracted seven principal components, which explained 68.5% of the variance. The global AP-Q score was positively associated with Kidmed-test score. Our data suggest that AP-Q is a complete and robust questionnaire to assess HFP adherence, with several advantages: easy to complete, cost-effective, timesaving and has the competency to assess, besides diet, several features affecting health status, lacking in other instruments. We suggest that AP-Q could be useful in epidemiological research, although it requires additional calibration to analyze its reproducibility and validation in other populations.

Keywords: diet; food intake; healthy food pyramid; nutrition; questionnaire design.

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Eigenvalue (A) and scatter plot (B) of the distribution of the principal components for AP-Q categories and dimensions. The plot line shows eigenvalue = 1. The scatter plot shows the three first components.

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