Diet Tips:Monash University Comprehensive Nutrition Assessment Questionnaire (CNAQ)

Dr Jaci Barrett (Accredited Practising Dietitian)

In 2009, we published a journal article detailing the production and validation of a food frequency questionnaire (FFQ). This FFQ was a component of my PhD. The aim was to develop a FFQ able to provide analysis of FODMAP intake, amongst other nutritional factors, so that we could use it in our research and avoid the need to have our patients complete lengthy food diaries for long periods of time.

The FFQ was validated and due to the broad range of nutritional factors that it was able to assess, we named it the Comprehensive Nutrition Assessment Questionnaire (CNAQ). The FFQ can adequately assess intake of the following:

Macronutrients	Vitamins	Sugars & fermentable carbohydrates	Minerals
Energy	Vitamin A	Total Sugars	Calcium
Carbohydrate	Thiamin	Glucose	Iron
Protein	Vitamin C	Fructose	Magnesium
Fat	Folate	Excess fructose	Phosphorus
Saturated fat	Niacin	Sucrose	Potassium
Polyunsaturated fat	Riboflavin	Lactose	Sodium
Monounsaturated fat	Thiamin	Total OS	Zinc
Cholesterol	b carotene equivalents	Fructans
Alcohol		Total GOS
Starch		Raffinose
Dietary fibre		Stachyose
Resistant starch		Sorbitol
Glycaemic index		Mannitol
Glycaemic load

This extensive list makes the CNAQ useful to a wide range of researchers and health professionals including those involved in gastroenterology, endocrinology, cardiac, renal and nutritional medicine.

Due to the broad appeal of the CNAQ, we then arranged for the CNAQ to be produced into an online tool, so that it could be easily accessed by researchers and other interested parties around the world. Organisations are provided with an account, participant email addresses are uploaded into the secure site, and participants are then sent a personal login to complete the online CNAQ. Completed responses can then be viewed by the organisation and the nutrient analysis can be automatically exported into excel.

This is a fantastic tool, particularly in the research setting. There is an extraordinary time saving by utilising this online tool compared with manual entry of daily food diaries.

For more information please see the original validation paper http://www.sciencedirect.com/science/article/pii/S0002822310011909. 

You can also read more about the online CNAQ or download an order form here www.cnaq.com.au.

 

Diet Tips:NEW US RESEARCH: The Low FODMAP diet superior for the relief of abdominal pain and bloating

The Low FODMAP Diet & mNICE Diet Compared

By Dr Jane Varney

 

An interesting study was published by our colleagues at the University of Michigan this week (1). The US study compared the effect of two dietary interventions on IBS symptoms in people with diarrhoea predominant IBS (IBS-D). The interventions in question were the low FODMAP diet and a more traditional dietary approach, known as mNICE (modified guidance from the National Institute for Health and Care Excellence).

Ninety-two eligible subjects were recruited into the study, all of whom had IBS-D and most of whom were female (71%). Participants were randomised to either a low FODMAP diet or the mNICE diet for 4 weeks. Because this was also not a feeding study, a dietitian taught participants how to follow their respective diets, but participants were required to put this advice into practice and prepare their own meals. Resources developed at Monash and Michigan Universities were used to teach participants how to follow the low FODMAP diet. Guidance given to the mNICE group included to eat small frequent meals, to avoid trigger foods and to avoid excess alcohol and caffeine. This guidance was considered ‘modified’, because high FODMAP foods were not specifically excluded as would typically be the case on this diet.

 

 The study revealed a number of interesting findings:

·         The diets were equally effective at providing ‘adequate relief’ of overall IBS symptoms, with improvements experienced in 41% of participants in the mNICE group and 52% of participants in the low FODMAP group.

·         More participants in the low FODMAP group experienced an improvement in abdominal pain, 51% versus 23%, p=0.008.

·         The greatest benefit of the low FODMAP diet was for relief of abdominal pain and bloating, with improvements in stool consistency, stool frequency and urgency also observed in this group.

Take home messages:

·         The low FODMAP and mNICE diets improve symptom control in roughly half of all people with IBS-D.

·         The low FODMAP diet may be a superior choice for the relief of some symptoms, namely abdominal pain and bloating

 

1. Eswaran SL, Chey WD, Han-Markey T, Ball S, Jackson K. A Randomized Controlled Trial Comparing the Low FODMAP Diet vs. Modified NICE Guidelines in US Adults with IBS-D. Am J Gastroenterol. 2016.

Link to full research article: http://www.nature.com/ajg/journal/vaop/ncurrent/full/ajg2016434a.html