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Capturing health and eating status through a nutritional perception screening questionnaire (NPSQ9) in a randomised internet-based personalised nutrition intervention: the Food4Me study

  • San-Cristobal, Rodrigo1
  • Navas-Carretero, Santiago1, 2
  • Celis-Morales, Carlos3
  • Livingstone, Katherine M.3
  • Stewart-Knox, Barbara4
  • Rankin, Audrey5
  • Macready, Anna L.6
  • Fallaize, Rosalind6
  • O’Donovan, Clare B.7
  • Forster, Hannah7
  • Woolhead, Clara7
  • Walsh, Marianne C.7
  • Lambrinou, Christina P.8
  • Moschonis, George8
  • Manios, Yannis8
  • Jarosz, Miroslaw9
  • Daniel, Hannelore10
  • Gibney, Eileen R.7
  • Brennan, Lorraine7
  • Gundersen, Thomas E.11
  • And 8 more
  • 1 University of Navarra, Centre for Nutrition Research, Department of Nutrition, Food Science and Physiology, C/Irunlarrea, 1, Pamplona, 31008, Spain , Pamplona (Spain)
  • 2 CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, 28023, Spain , Madrid (Spain)
  • 3 Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, NE1 7RU, UK , Newcastle Upon Tyne (United Kingdom)
  • 4 School of Psychology, University of Bradford, West Yorkshire, BD71DP, UK , West Yorkshire (United Kingdom)
  • 5 University of Ulster, Northern Ireland Centre for Food and Health, Coleraine, BT52 1SA, UK , Coleraine (United Kingdom)
  • 6 University of Reading, Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, Reading, RG6 6AA, UK , Reading (United Kingdom)
  • 7 UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, 4, Republic of Ireland , Dublin (Ireland)
  • 8 Harokopio University of Athens, Department of Nutrition and Dietetics, Athens, 17671, Greece , Athens (Greece)
  • 9 Institute of Food and Nutrition (IZZ), Warsaw, 02-903, Poland , Warsaw (Poland)
  • 10 Technische Universität München, ZIEL Research Center of Nutrition and Food Sciences, Biochemistry Unit, Munich, 85354, Germany , Munich (Germany)
  • 11 Vitas Ltd., Oslo Science Park, Gaustadalléen 21, Oslo, 0349, Norway , Oslo (Norway)
  • 12 Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Department of Nutrition, Oslo, 0317, Norway , Oslo (Norway)
  • 13 NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Department of Human Biology, Maastricht, 6200 MD, The Netherlands , Maastricht (Netherlands)
  • 14 Food and Society Group, Newcastle University, Newcastle Upon Tyne, NE1 7RU, UK , Newcastle Upon Tyne (United Kingdom)
  • 15 Instituto de Investigaciones Sanitarias de Navarra (IDisNa), Pamplona, 31008, Spain , Pamplona (Spain)
  • 16 Instituto Madrileño de Estudios Avanzados (IMDEA) Alimentacion, Madrid, Spain , Madrid (Spain)
Published Article
International Journal of Behavioral Nutrition and Physical Activity
BioMed Central
Publication Date
Dec 11, 2017
DOI: 10.1186/s12966-017-0624-6
Springer Nature


BackgroundNational guidelines emphasize healthy eating to promote wellbeing and prevention of non-communicable diseases. The perceived healthiness of food is determined by many factors affecting food intake. A positive perception of healthy eating has been shown to be associated with greater diet quality. Internet-based methodologies allow contact with large populations. Our present study aims to design and evaluate a short nutritional perception questionnaire, to be used as a screening tool for assessing nutritional status, and to predict an optimal level of personalisation in nutritional advice delivered via the Internet.MethodsData from all participants who were screened and then enrolled into the Food4Me proof-of-principle study (n = 2369) were used to determine the optimal items for inclusion in a novel screening tool, the Nutritional Perception Screening Questionnaire-9 (NPSQ9). Exploratory and confirmatory factor analyses were performed on anthropometric and biochemical data and on dietary indices acquired from participants who had completed the Food4Me dietary intervention (n = 1153). Baseline and intervention data were analysed using linear regression and linear mixed regression, respectively.ResultsA final model with 9 NPSQ items was validated against the dietary intervention data. NPSQ9 scores were inversely associated with BMI (β = −0.181, p < 0.001) and waist circumference (Β = −0.155, p < 0.001), and positively associated with total carotenoids (β = 0.198, p < 0.001), omega-3 fatty acid index (β = 0.155, p < 0.001), Healthy Eating Index (HEI) (β = 0.299, p < 0.001) and Mediterranean Diet Score (MDS) (β = 0. 279, p < 0.001). Findings from the longitudinal intervention study showed a greater reduction in BMI and improved dietary indices among participants with lower NPSQ9 scores.ConclusionsHealthy eating perceptions and dietary habits captured by the NPSQ9 score, based on nine questionnaire items, were associated with reduced body weight and improved diet quality. Likewise, participants with a lower score achieved greater health improvements than those with higher scores, in response to personalised advice, suggesting that NPSQ9 may be used for early evaluation of nutritional status and to tailor nutritional advice.Trial registrationNCT01530139.

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