Reliability and Validity Estimate of the Pro-Inflammatory/Anti-Inflammatory Food Intake Score in South American Pediatric Population: SAYCARE Study

Int J Environ Res Public Health. 2023 Jan 6;20(2):1038. doi: 10.3390/ijerph20021038.

Abstract

Chronic low-grade inflammation may be associated with the development of chronic non-communicable diseases in young populations, often lasting to adulthood. Studies show that the diet is related to chronic inflammation. The Pro-inflammatory/Anti-inflammatory Food Intake Score (PAIFIS) is an indicator that measures the inflammatory potential of the diet, with the help of validated tools that assess food consumption. The validation of tools that assess inflammatory dietary patterns in young populations to produce valid and reliable results is essential to guide disease prevention strategies for adulthood.

Methods: This study aimed to estimate the Pro-inflammatory/Anti-inflammatory Food Intake Score (PAIFIS) in children and adolescents in South America and to test its reliability and validity using a food frequency questionnaire (FFQ) and an inflammatory biomarker. This work consists of a validation study in a sample of children and adolescents conducted in South America (SAYCARE Study). The habitual consumption of food contributing to calculating the PAIFIS was obtained through an FFQ and 24 h Dietary Recall (24HDR). Reliability was tested using the FFQ (FFQ1 × FFQ2), using Spearman's correlation coefficient to estimate the agreement between measurements. The validity of the PAIFIS was tested using 24HDR and the inflammatory biomarker C-reactive protein (CRP) using Spearman's correlation and multilevel linear regression.

Results: For children and adolescents, pro- and anti-inflammatory food groups showed Spearman's correlation coefficients ranging from 0.31 to 0.66, convergent validity ranging from 0.09 to 0.40, and criterion validity for a reliability range from -0.03 to 0.18. The PAIFIS showed Spearman's correlation coefficients for reliability ranging from 0.61 to 0.69, convergent validity from 0.16 to 0.23, and criterion validity from -0.03 to 0.24.

Conclusion: The PAIFIS showed acceptable reliability, weak convergent validity, and weak criterion validity in children and adolescents.

Keywords: dietary inflammatory index; food frequency questionnaire; inflammation; inflammatory biomarker; pediatric; validation study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anti-Inflammatory Agents*
  • Child
  • Diet Records
  • Diet Surveys
  • Diet* / methods
  • Eating
  • Energy Intake
  • Humans
  • Inflammation
  • Reproducibility of Results
  • South America
  • Surveys and Questionnaires

Substances

  • Anti-Inflammatory Agents

Grants and funding

Lívia G. Azevedo-Garcia received a Brazilian Master’s Student scholarship from the São Paulo Research Foundation (FAPESP, pro. 2018/19068-8). Augusto César F. De Moraes received the Start Fund from The University of Texas Health Science Center at Houston and was also awarded the Young Investigator Grant from FAPESP (proc. 2017/20317–0 and 2019/02617–1). Heráclito B Carvalho received a research grant from the São Paulo Research Foundation (FAPESP, proc. 2014/11468-6) and an advanced scientist scholarship from the National Council of Technological and Scientific Development (CNPq; proc. 300951/2015-9). The South American Youth/Child Cardiovascular and Environmental (SAYCARE) study was supported mainly by the Brazilian Government through the National Counsel of Technological and Scientific Development (CNPq; proc. 471266/2013-2) and the São Paulo State Government through the São Paulo Research Foundation (FAPESP; proc. 2014/11468-6). The SAYCARE Study was also co-funded by other agencies in other countries as follows: (1) the Collaborative Projects Fund (R.D. N 501-2015-INSN-DG-OEA) granted by the National Institute of Child Health, Lima, Peru; (2) the Sustainability Strategy at the University of Antioquia from 2014 to 2015, the research group of social and economic determinants of health and nutrition, and Demography and Health Research Group at the University of Antioquia, Medellin, Colombia, and Interuniversity Services Corporation from the University of Antioquia; (3) the Secretary of University Extension and Student Welfare, University of Buenos Aires, Buenos Aires, Argentina.