Food habits and alcohol consumption assessment

Participants completed a twenty-five-item Dietary Habits Questionnaire (DHQ). This questionnaire comprises questions on key dietary habits associated with diet quality and nutritional status. The DHQ was assessed for face validity using cognitive interviewing before use in the 2008/09 NZANS⁽²⁷⁾. The DHQ comprises frequency questions focusing on previous 4-week intakes of breakfast and selected foods and food groups, questions on daily intake of fruit and vegetable servings, and qualitative information on food preparation and cooking practices and the use of low-fat and low-sodium foods. A validated Healthy Dietary Habits Index (HDHI) was calculated from the DHQ. This HDHI comprises fifteen items where a score between 0 (least healthy) and 4 (most healthy) was allocated to each item based on the frequency of consumption (red meat, chicken, low-fat foods, fries, soft drinks, breakfast, fast foods, added salt, low-salt foods), the amount consumed (fruit, vegetables) or the type of item consumed (fish, milks, spreads, bread)⁽³⁰⁾. Participants were categorized into tertiles of HDHI score (low, medium and high).

The DHQ also contained the following questions on alcohol consumption:

If the participant answered ‘yes’, the DHQ then asked:

In order to describe alcohol consumption patterns, five groups were derived based on answers to the three questions (Fig. ​(Fig.1).1). (i) Participants who answered ‘no’ to question 1 were coded as ‘abstainers’. Using the NZ Ministry of Health guidelines for women on alcohol consumption to lower the risk of injury⁽³¹⁾, data from questions 2 and 3 were combined to form four new categories of drinking patterns, namely: (ii) ‘more frequent heavy drinker’ (>4 drinks on a typical drinking day four times per month (interpreted as once per week) or more); (iii) ‘more frequent moderate/light drinker’ (≤4 drinks on a typical drinking day four times per month (interpreted as once per week) or more); (iv) ‘infrequent heavy drinker’ (>4 drinks on a typical drinking day drinking monthly or less); and (v) ‘infrequent moderate/light drinker’ (≤4 drinks on a typical drinking day drinking monthly or less).

Schematic representation of the drinking patterns among women of childbearing age (18–45 years; n 1124) derived from the 2008/09 Adult National Nutrition Survey in New Zealand