The validity and reliability of the Dietary Index for a Child's Eating in 2-8-year old children living in New Zealand

This study aimed to examine the validity and reliability of the Dietary Index for a Child's Eating (DICE) in children living in New Zealand (NZ). Caregivers of healthy children aged 2-8 years completed a 4-day estimated food record (4DFR) for their child and completed the DICE online on two separate occasions, 8 weeks apart. Relative validity was assessed by comparing the DICE and 4DFR total score and component subscores using the Wilcoxon test, Spearman rank correlation coefficients, cross-classification, and weighted kappa () statistic. For evaluating construct validity, the DICE total score was compared with energy and nutrient intake from the 4DFR using linear contrast analysis. Intraclass correlation coefficients (Cronbach's alpha) and Bland-Altman plots were used to assess the reliability of DICE. From a possible score of 100, the mean +/- standard deviation of DICE was 78.2 +/- 11.5 and from the 4DFR, was 73.8 +/- 10.8, with a positive correlation (r = 0.72; p < 0.001) and moderate agreement ( = 0.49). Cross-classification showed 61.9% were correctly categorised into the same tertile group from DICE and the 4DFR. Participants in the highest tertile of DICE had higher intakes of fibre, vitamin C, vitamin A, vitamin D, folate, and calcium. Good agreement (alpha = 0.87) was found for reliability. DICE is a valid and reliable tool for the assessment of children's adherence to a healthy diet, as recommended by the NZ Ministry of Health Food and Nutrition guidelines.