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Dietary Screener Questionnaire in the NHIS Cancer Control Supplement (CCS) 2010


The NHIS CCS is administered every five years and focuses on knowledge, attitudes, and practices in cancer-related health behaviors, screening, and risk assessment. The NHIS CCS covers a variety of topics, including diet and nutrition.

Diet can be assessed using a variety of tools. Food records and 24-hour dietary recalls assess the total diet over one or more days, and they are considered the most accurate instruments. In certain situations, however, such as when time is constrained or assessment of the total diet is not required, researchers have found that short dietary assessment instruments, often called screeners, are valuable. For example, screeners can be used for characterizing a population's median intakes or examining interrelationships between diet and other variables. Recognizing the need for these tools, the Risk Factor Monitoring and Methods Branch (RFMMB) has developed several dietary screeners. One of these is the 26-item Dietary Screener Questionnaire (DSQ), which asks about the frequency of consumption in the past month of selected foods and drinks. The DSQ captures intakes of fruits and vegetables, dairy/calcium, added sugars, whole grains/fiber, red meat, and processed meat.

The DSQ was included in both the National Health and Nutrition Examination Survey (NHANES) 2009-10 and the National Health Interview Survey Cancer Control Supplement (NHIS CCS) 2010. The DSQ is publicly available.

Because screeners are shorter and less detailed than a total dietary assessment, some quantitative accuracy is sacrificed. However, calibrating a screener against the more precise 24-hour recall can help ensure that a screener is providing the best and most accurate estimates possible.

The NHANES 2009-10 collected two non-consecutive 24-hour recalls, in addition to the DSQ. The DSQ will be calibrated to the more precise recalls, by developing scoring algorithms for each component of the DSQ. The scoring algorithms convert screener responses to estimates of dietary intake for fruits and vegetables (cup equivalents), dairy (cup equivalents), added sugars (tsp), whole grains (ounce equivalents), fiber (g), and calcium (mg). Responses to the red meat and processed meat questions may be used as qualitative indicators of intake frequency, but no scoring algorithms will be developed for those particular dietary factors.

The DSQ administered in the NHIS CCS 2010 [English (PDF) | Spanish (PDF)] was nearly identical to the DSQ administered in the NHANES 2009-10 [English (PDF. 163 KB) | Spanish (PDF, 196 KB)]. The only difference is that in the NHIS CCS 2010, two questions were asked to capture intakes of sports drinks, energy drinks, and fruitades, whereas only one question was asked in the NHANES 2009-10 DSQ.

Questions Asked
How often did you drink sweetened fruit drinks, sports or energy drinks, such as Kool-aid, lemonade, Hi-C, cranberry drink, Gatorade, Red Bull or Vitamin Water? Include fruit juices you made at home and added sugar to. Do not include diet drinks or artificially sweetened drinks. How often did you drink SPORTS and ENERGY drinks such as Gatorade, Red Bull, and Vitamin water?
  How often did you drink sweetened fruit drinks, such as Kool-aid, cranberry and lemonade? Include fruit drinks you made at home and added sugar to.

The scoring algorithms for the NHANES 2009-10 DSQ have been applied to the NHIS CCS 2010 DSQ. At the time these scoring algorithms were developed, food pattern equivalents information from the NHANES 2009-10 24-hour recall data had not yet been released. Such information is necessary to perform direct calibration of the screener with the 24-hour recalls. Therefore, RFMMB developed alternative scoring algorithms, based on earlier NHANES data, which can be used until algorithms based on direct calibration can be posted on this site. These algorithms are presented in the Data Processing and Scoring Procedures section. That section also describes in detail the procedures used to develop the algorithms. For those interested only in accessing the NHIS variables, please visit the Computed Variables page.

For more information about screeners and how they are used, including information about other screeners developed by RFMMB, please visit Overview of Dietary Screeners.

Last Modified: 11 Apr 2014