title: NutricheQ Questionnaire assesses the risk of dietary imbalances in toddlers from 1 through 3 years of age.
abstract: BACKGROUND
  Although a nutrient-poor diet may affect children's growth, especially early in life, few tools to assess dietary imbalances in 1- to 3-year-old children have been developed.
  
  
  OBJECTIVE
  To investigate the accuracy and test-retest reliability of the NutricheQ Questionnaire in the identification of toddlers with the risk of inadequate intake of micro- and macronutrients in a sample of Italian toddlers.
  
  
  METHODS
  A 3-day weighed food record was performed, and results were compared with outcomes of the NutricheQ Questionnaire in 201 toddlers (training set: 1-3 years old). The accuracy of NutricheQ in the identification of categories of nutritional risk was evaluated using the receiver operating characteristic (ROC) curves. Test-retest of the tool was estimated using the intraclass correlation coefficient (ICC) and the Cronbach's alpha statistic, in a validation set of 50 toddlers.
  
  
  RESULTS
  The NutricheQ Questionnaire is a valid tool for the identification of toddlers at risk for dietary imbalances. Significant differences in nutrient intake (p<0.005) were found among the three groups of risk identified by the questionnaire: toddlers included in the high-risk group had a lower intake of key nutrients such as iron, vitamin D and other vitamins, and fibre compared to those included in the low-risk group. NutricheQ is also reliable between administrations, as demonstrated by its test-retest reliability. ICC and Cronbach's alpha were 0.73 and 0.83, respectively, for Section 1 of NutricheQ, and 0.55 and 0.70 for Section 2.
  
  
  CONCLUSIONS
  The NutricheQ Questionnaire is a reliable and consistent tool for the assessment of possible dietary risk factors in Italian toddlers. It consistently identifies toddlers with a high probability of having poor iron and vitamin D intake, and other dietary imbalances.
authors.affiliation: Research Area for Multifactorial Diseases and Nutritional Department, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Giuseppe S
authors.initials: GS
authors.lastname: Morino
authors.affiliation: Research Area for Multifactorial Diseases and Nutritional Department, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Cinelli
authors.affiliation: Research Area for Multifactorial Diseases and Nutritional Department, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Di Pietro
authors.affiliation: Research Area for Multifactorial Diseases and Nutritional Department, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Vittoria
authors.initials: V
authors.lastname: Papa
authors.affiliation: Research Area for Multifactorial Diseases and Nutritional Department, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Spreghini
authors.affiliation: Research Area for Multifactorial Diseases and Nutritional Department, Bambino Gesù Children's Hospital, Rome, Italy; melania.manco@opbg.net.
authors.forename: Melania
authors.initials: M
authors.lastname: Manco
keywords: diet; dietary deficiency; iron; micronutrient intake; nutritional questionnaire; preschooler; vitamin D deficiency