The self-administered FFQ "What do you eat" was developed at the Robert Koch Institute to assess the usual intake of several food groups in the KiGGS core survey (2003-2006). The food groups most often consumed by children and adolescents were selected based on data from previous surveys and the advice of nutrition survey experts [17 (link)]. Questions on the frequency and the amount of 45 food items consumed "during the last few weeks" were included. Additional questions related to specific nutritional demands (multivitamin tablets, convenience foods, light products). The frequency of consumption was assessed using ten response categories: never, once a month, two to three times a month, once or twice a week, three to four times a week, five to six times a week, once a day, two to three times a day, four to five times a day, more than five times a day. In addition, participants were asked to indicate the portion size of the food items, which was given in five item-specific categories. Several pictures were used to illustrate portion sizes. The time frame "during the last few weeks" for the FFQ was based on pre-test experience, since some participants reported that it was difficult to give an answer for exactly "the last four weeks". However, the predefined answer categories for the frequency of consumption imply a time frame of about four weeks, since the lowest frequencies relate to a frequency per month (once a month, two to three times a month). The FFQ and a covering letter were sent to the respondents by postal mail three to four weeks prior to the visit. The first page of the FFQ provides instructions on completing the questionnaire. During the survey period a telephone hotline offered support with completing the questionnaire. Furthermore, support was offered when questionnaires were collected on local visit for the DISHES interview. The development process and design are described in detail elsewhere [17 (link)].
The DISHES interview is a modified diet history interview for assessing the usual dietary intake, with a reference period of the last four weeks. This was used as reference instrument. The DISHES software facilitates a standardized, structured and interviewer-guided assessment. The procedure has a meal-based structure similar to many 24-hour recall instruments. It is standardized, but still open-ended and allows the assessment of all possible food items in detail. The DISHES interview was conducted by trained nutritionists at the residence of the participants. First, usual meal patterns were obtained. In the next step, food intakes consumed during each meal were assessed by a check list. Subsequently, the frequency and portion size of each food consumed at the different meals was determined in detail. Additional food items could be chosen by searching the food code database. In general, estimation of portion sizes was facilitated using standardized tableware models. In addition, a picture book adapted from the EPIC-SOFT Picture Book [18 ] could be used to determine the portion size of selected food items. The DISHES software codes food items and connects the codes with the German Food Code and Nutrient Database (BLS II.3), which includes 10,654 food codes [19 (link)]. For the EsKiMo study, the software was adapted for the target group of adolescents (DISHES Junior). Additional foods (1,225 food codes), not yet available in the BLS but often consumed by adolescents, were incorporated into the database. The average duration of an interview in the EsKiMo Study was 49 minutes. The instrument had been previously validated for adults [13 (link)] and used in several national nutrition surveys [16 (link),20 (link),21 (link)].
In the KiGGS study (2003-2006), the parents were asked about their income, occupational status and education. This information was used to calculate a family socio-economic status index, developed for the survey. The index was categorized into low (3-8 points), medium (9-14 points) and high (15-21 points) [22 ]. According to this index, 27.5% of the KiGGS participants were allocated to the low, 45.4% to the medium, and 27.1% to the high socio-economic status group [23 (link)]. Furthermore, the body weight and height of the adolescents was assessed by standardized measurement. The body mass index (BMI) was calculated from body height and weight. According to the Kromeyer-Hauschild method, participants with a BMI above the 90th percentile of the age- and gender-specific reference values were categorized as overweight [24 ].
The DISHES interview is a modified diet history interview for assessing the usual dietary intake, with a reference period of the last four weeks. This was used as reference instrument. The DISHES software facilitates a standardized, structured and interviewer-guided assessment. The procedure has a meal-based structure similar to many 24-hour recall instruments. It is standardized, but still open-ended and allows the assessment of all possible food items in detail. The DISHES interview was conducted by trained nutritionists at the residence of the participants. First, usual meal patterns were obtained. In the next step, food intakes consumed during each meal were assessed by a check list. Subsequently, the frequency and portion size of each food consumed at the different meals was determined in detail. Additional food items could be chosen by searching the food code database. In general, estimation of portion sizes was facilitated using standardized tableware models. In addition, a picture book adapted from the EPIC-SOFT Picture Book [18 ] could be used to determine the portion size of selected food items. The DISHES software codes food items and connects the codes with the German Food Code and Nutrient Database (BLS II.3), which includes 10,654 food codes [19 (link)]. For the EsKiMo study, the software was adapted for the target group of adolescents (DISHES Junior). Additional foods (1,225 food codes), not yet available in the BLS but often consumed by adolescents, were incorporated into the database. The average duration of an interview in the EsKiMo Study was 49 minutes. The instrument had been previously validated for adults [13 (link)] and used in several national nutrition surveys [16 (link),20 (link),21 (link)].
In the KiGGS study (2003-2006), the parents were asked about their income, occupational status and education. This information was used to calculate a family socio-economic status index, developed for the survey. The index was categorized into low (3-8 points), medium (9-14 points) and high (15-21 points) [22 ]. According to this index, 27.5% of the KiGGS participants were allocated to the low, 45.4% to the medium, and 27.1% to the high socio-economic status group [23 (link)]. Furthermore, the body weight and height of the adolescents was assessed by standardized measurement. The body mass index (BMI) was calculated from body height and weight. According to the Kromeyer-Hauschild method, participants with a BMI above the 90th percentile of the age- and gender-specific reference values were categorized as overweight [24 ].
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