Dietary Screener Questionnaire in the NHANES 2009-10: Background
The National Health and Nutrition Examination Survey (NHANES) assesses the health and nutritional status of adults and children in the U.S. It collects detailed information about food, nutrient, and supplement intake and other dietary behaviors. Before the 2009-10 administration, the NHANES collected this information exclusively through 24-hour recalls, food frequency questionnaires, and survey questionnaires. In certain situations, however, such as when assessment of the total diet is not required or when time is constrained, researchers have found that short dietary assessment instruments, often called screeners, are valuable. For example, screeners can be used for characterizing a population's median intakes or examining interrelationships between diet and other variables.
Recognizing the need for these tools, the Risk Factor Assessment Branch (RFAB), has developed several dietary screeners. One of these is the 26-item Dietary Screener Questionnaire (DSQ), which asks about the frequency of consumption in the past month of selected foods and drinks. The DSQ captures intakes of fruits and vegetables, dairy/calcium, added sugars, whole grains/fiber, red meat, and processed meat.
- Each of the 26 items on the screener was selected because of its relationship to one or more dietary factors of interest in dietary guidance. Learn more about the relationship between dietary factors and food items on the DSQ.
- A SAS program and associated data files are available that process the DSQ data from the interviewer-administered questionnaire. A Web-based version is also available.
Because screeners are shorter and less detailed than a total dietary assessment, some quantitative accuracy is sacrificed. However, calibrating a screener against the more precise 24-hour recall can help ensure that a screener is providing the best and most accurate estimates possible.
The DSQ was included in the NHANES 2009-2010 in order to gather data for use in calibrating screeners. The calibration is carried out using a set of scoring algorithms developed for each component of the DSQ. The scoring algorithms convert screener responses to estimates of dietary intake for fruits and vegetables (cup equivalents), dairy (cup equivalents), added sugars (tsp), whole grains (ounce equivalents), fiber (g), and calcium (mg). Responses to the red meat and processed meat questions may be used as qualitative indicators of intake frequency, but no scoring algorithms will be developed for those particular dietary factors.
The scoring algorithms will enable researchers using the DSQ in their own studies to improve the accuracy of estimates of dietary factors assessed. Researchers also will be able to compare their results to calibrated national estimates from NHANES.
At the time these scoring algorithms were developed, food pattern equivalents information from the NHANES 2009-2010 24-hour recall data had not yet been released. Such information is necessary to perform direct calibration of the screener with these 24-hour recalls. Therefore, RFAB developed alternative scoring algorithms, based on earlier NHANES data, which can be used until algorithms based on direct calibration can be posted on this site. These alternative algorithms are presented in the Data Processing and Scoring Procedures section.
Substantial evaluation work has been done to develop the individual questions on the DSQ and test the performance of subsets of questions.
This work has been led by the National Cancer Institute (NCI) and supported by the Centers for Disease Control and Prevention (CDC), the National Heart, Lung and Blood Institute (NHLBI), NIH's Office of Behavioral and Social Sciences Research (OBSSR), and NIH's Office of Dietary Supplements (ODS).
For more information about screeners and how they are used, including information about other screeners developed by RFAB, please visit Overview of Dietary Screeners.