Evaluation of Three Short Dietary Instruments to Assess Fruit and Vegetable Intake: The National Cancer Institute's Food Attitudes and Behaviors Survey

BackgroundFruit and vegetable (F/V) intake assessment tools that are valid, reliable, brief, and easy to administer and code are vital to the field of public health nutrition.ObjectiveTo evaluate three short F/V intake screeners (ie, a 2-item serving tool, a 2-item cup tool, and a 16-item F/V intake screener) among adults using multiple 24-hour dietary recalls (24-hour recalls) as the reference instrument and evaluate test–retest reliability of the screeners across a 2- to 3-week time period.DesignValidity and reliability study.Participants/settingTwo hundred forty-four adults for the validity study and 335 adults for test–retest reliability.Statistical analyses performedMedian values for F/V intakes were calculated for the screeners and 24-hour recalls. The Wilcoxon signed rank test was used to compare screeners with the 24-hour recalls. Deattenuated Pearson correlations were reported for validity and intraclass correlation coefficient used for reliability.ResultsThe estimated median daily servings/cups of F/V for the 2-item serving screener was lower, for the 2-item cup screener was equivalent for men but higher for women, and for the 16-item F/V intake screener were about the same when compared with 24-hour recall values. The deattenuated correlations comparing the 24-hour recalls with the screeners were positive but weak for the 2-item serving screener, and were positive and moderate in strength for the 2-item cup and 16-item F/V intake screeners. The test–retest intraclass correlation coefficients were all positive and fairly strong for all of the screeners.ConclusionsAlthough dietary screeners offer a more cost-effective, less burdensome way to obtain gross estimates to rank individuals with regard to F/V intake, these methods are not recommended for assessing precise intake levels.