BACKGROUND: Valid assessment tools are needed when investigating adherence to national dietary and lifestyle guidelines.
OBJECTIVE: The relative validity of the new digital food frequency questionnaire, the DIGIKOST-FFQ, against 7-day weighed food records and activity sensors was investigated.
METHODS: In total, 77 participants were included in the validation study and completed the DIGIKOST-FFQ and the weighed food record, and of these, 56 (73%) also used the activity sensors. The DIGIKOST-FFQ estimates the intake of foods according to the Norwegian food-based dietary guidelines (FBDGs) in addition to lifestyle factors.
RESULTS: At the group level, the DIGIKOST-FFQ showed good validity in estimating intakes according to the Norwegian FBDG. The median differences were small and well below portion sizes for all foods except \"water\" (median difference 230 g/day). The DIGIKOST-FFQ was able to rank individual intakes for all foods (r=0.2-0.7). However, ranking estimates of vegetable intakes should be interpreted with caution. Between 69% and 88% of the participants were classified into the same or adjacent quartile for foods and between 71% and 82% for different activity intensities. The Bland-Altman plots showed acceptable agreements between DIGIKOST-FFQ and the reference methods. The absolute amount of time in \"moderate to vigorous intensity\" was underestimated with the DIGIKOST-FFQ. However, estimated time in \"moderate to vigorous intensity,\" \"vigorous intensity,\" and \"sedentary time\" showed acceptable correlations and good agreement between the methods. The DIGIKOST-FFQ was able to identify adherence to the Norwegian FBDG and physical activity recommendations.
CONCLUSIONS: The DIGIKOST-FFQ gave valid estimates of dietary intakes and was able to identify individuals with different degrees of adherence to the Norwegian FBDG and physical activity recommendations. Moderate physical activity was underreported, water was overreported, and vegetables showed poor correlation, which are important to consider when interpreting the data. Good agreement was observed between the methods in estimating dietary intakes and time in \"moderate to vigorous physical activity,\" \"sedentary time,\" and \"sleep.\"

Chronic kidney disease (CKD) is a major public health problem with significant clinical, societal, and psychosocial burdens. Nutrition therapy has been an integral part of the medical management of patients with CKD for more than a century, with the main goals of preserving kidney function and preventing complications. Nutrition abnormalities may emerge well before dialysis therapy is initiated and are associated with poor outcomes. It is therefore important to revisit nutrition management in the advanced stages of CKD to gain a broader insight into its role and effect on patient outcomes. Traditionally, nutrition recommendations have focused on the prescription of energy (calories) and macro- and micronutrients. Today, dietary modeling also focuses on the evidence for food consumption on health. This review argues that advanced non-dialysis-dependent CKD nutrition requirements to a large extent align with healthy eating guidelines for the general population and should not be based on deprivation or be unusually restrictive. The best currently available evidence for the CKD diet is likely to be derived from CKD nutrition prescriptions in conjunction with evidence underpinning national dietary guidelines and evidence of healthy dietary patterns, such as Mediterranean-style and Dietary Approaches to Stop Hypertension (DASH)-style eating. Positive messages from these dietary patterns should improve acceptance of CKD dietary interventions among patients.

Dietary guidelines provide evidence-based statements on food choices to meet nutritional requirements and reduce the risk of prevailing chronic disease. They involve a substantial amount of research translation, and their implementation has important health consequences. Foods, however, are complex combinations of nutrients and other compounds that act synergistically within the food and across food combinations. In addition, the evidence base underpinning dietary guidelines accesses research that reflects different study designs, with inherent strengths and limitations. We propose a systematic approach for the review of evidence that begins with research on dietary patterns. This research will identify the combinations of foods that best protect, or appear deleterious to, health. Next, we suggest that evidence be sought from research that focuses on the effects of individual foods. Finally, nutrient-based research should be considered to explain the mechanisms by which these foods and dietary patterns exert their effects, take into account the effects of ingredients added to the food supply, and enable assessments of dietary sufficiency. The consideration of individual nutrients and food components (e.g., upper limits for saturated fat, added sugar, and sodium) provides important benchmarks for evaluating overall diet quality. The concepts of core and discretionary foods (nutrient-rich and nutrient-poor foods, respectively) enable distinctions between foods, and this has implications for the relation between food policy and food manufacturing. In summary, evidence supporting healthy dietary patterns provides the foundation for the development of dietary guidelines. Further reference to individual foods and nutrients follows from the foundation of healthy dietary patterns.