SUMO-3 promotes the ubiquitin-dependent turnover of TRIM55.

Human muscle-specific RING fingers (MURFs) are members of the tripartite motif (TRIM) family of proteins characterized by their C-terminal subgroup one signature domain. MURFs play a role in sarcomere formation and microtubule dynamics. It was previously established that some TRIMs undergo post-translational modification by small ubiquitin-like modifier (SUMO). In this study, we explored the putative SUMOylation of MURF proteins as well as their interactions with SUMO. MURF proteins (TRIM54, TRIM55, and TRIM63) were not found to be SUMOylated. However, TRIM55 turnover by proteasomal and lysosomal degradation was higher upon overexpression of SUMO-3 but not of SUMO-1. Furthermore, it is predicted that TRIM55 contains two potential SUMO-interacting motifs (SIMs). We found that SIM1- and SIM2-mutated TRIM55 were more stable than the wild-type (WT) protein partly due to decreased degradation. Consistently, SIM-mutated TRIM55 was less polyubiquitinated than the WT protein, despite similar monoubiquitination levels. Using IF microscopy, we observed that SIM motifs influenced TRIM55 subcellular localization. In conclusion, our results suggest that SUMO-3 or SUMO-3-modified proteins modulate the localization, stability, and RING ubiquitin ligase activity of TRIM55.

Traditional surveys versus ecological momentary assessments: Digital citizen science approaches to improve ethical physical activity surveillance among youth.

The role of physical activity (PA) in minimizing non-communicable diseases is well established. Measurement bias can be reduced via ecological momentary assessments (EMAs) deployed via citizen-owned smartphones. This study aims to engage citizen scientists to understand how PA reported digitally by retrospective and prospective measures varies within the same cohort. This study used the digital citizen science approach to collaborate with citizen scientists, aged 13-21 years over eight consecutive days via a custom-built app. Citizen scientists were recruited through schools in Regina, Saskatchewan, Canada in 2018 (August 31-December 31). Retrospective PA was assessed through a survey, which was adapted from three validated PA surveys to suit smartphone-based data collection, and prospective PA was assessed through time-triggered EMAs deployed consecutively every day, from day 1 to day 8, including weekdays and weekends. Data analyses included paired t-tests to understand the difference in PA reported retrospectively and prospectively, and linear regressions to assess contextual and demographic factors associated with PA reported retrospectively and prospectively. Findings showed a significant difference between PA reported retrospectively and prospectively (p = 0.001). Ethnicity (visible minorities: ß = - 0.911, 95% C.I. = -1.677, -0.146), parental education (university: ß = 0.978, 95% C.I. = 0.308, 1.649), and strength training (at least one day: ß = 0.932, 95% C.I. = 0.108, 1.755) were associated with PA reported prospectively. In contrast, the number of active friends (at least one friend: ß = 0.741, 95% C.I. = 0.026, 1.458) was associated with retrospective PA. Physical inactivity is the fourth leading cause of mortality globally, which requires accurate monitoring to inform population health interventions. In this digital age, where ubiquitous devices provide real-time engagement capabilities, digital citizen science can transform how we measure behaviours using citizen-owned ubiquitous digital tools to support prevention and treatment of non-communicable diseases.

Is excessive smartphone use associated with weight status and self-rated health among youth? A smart platform study.

BACKGROUND: In Canada, it is recommended that youth limit screen time to less than two hours per day, yet, the majority of youth are reportedly spending a significantly higher amount of time in front of a screen. This is particularly concerning given that these recommendations do not take into account smartphone devices, which is the most common screen time technology of choice for the younger generations. This study implements an innovative approach to understanding screen time behavior and aims to investigate the unique relationship between smartphone specific screen time and physical health outcomes. METHODS: This cross-sectional study is part of the Smart Platform, a digital epidemiological and citizen science initiative. 436 youth citizen scientists, aged 13-21 years, provided all data via their own smartphones using a custom-built smartphone application. Participants completed a 124-item baseline questionnaire which included validated self-report surveys adapted to collect data specifically on smartphone use (internet use, gaming, and texting), demographic characteristics, and physical health outcomes such as weight status and self-rated health. Binary regression models determined the relationship between smartphone use and physical health outcomes. RESULTS: Overall participants reported excessive smartphone use in all categories. 11.4% and 12% of the 436 youth participants reported using their smartphone excessively (greater than 2 h per day) during the week and weekend respectively for gaming and were over 2 times more likely than their peers to fall within an overweight/obese BMI status. Excessive weekend gaming was also associated with self-rated health where participants were over 2 times more likely than their peers to report poor self-rated health. CONCLUSIONS: The results indicate that excessive screen time on smartphones does have complex associations with youth health. Further investigation with more robust study designs is needed to inform smartphone-specific screen time guidelines for youth.

Socioeconomic Differences in the Association Between Bullying Behaviors and Mental Health in Canadian Adolescents.

BACKGROUND: Bullying and poverty are each associated with poor health in adolescents. We examined socioeconomic differences in the association of bullying and health. METHODS: The 2017/2018 Canadian Health Behaviour of School-aged Children study surveyed 21,750 youth (9-18 years). We used linear regression models to investigate interactive effects of bullying involvement (traditional and cyberbullying) and socioeconomic position (SEP) on self-reported life satisfaction, psychological symptoms, and physical symptoms. RESULTS: Involvement in either form of bullying, as a perpetrator or a target, was associated with worse health and well-being compared to uninvolved youths. Associations of victimization via conventional bullying with low life satisfaction (b = -.33 [-.61, .05]), more psychological symptoms (b = .83 [.27, 1.38]), and more somatic symptoms (b = .56 [.14, .98]) were stronger at lower SEP. CONCLUSION: Socioeconomic disadvantage intensifies the association between bullying victimization and poor health. The intersections of victimization and poverty pose a significant health risk to adolescents.

Do associations between suicide ideation and its correlates (substance use, anxiety, and depression) differ according to victimization type among youth? A Smart platform study.

The issues associated with mental health, substance misuse, and suicide ideation are complex and sensitive among youth. We sought to investigate the role that subjective health, internalizing and externalizing risk factors play in the association between victimization and suicide ideation among youth in Canada via used a custom-built digital epidemiological smartphone application (Smart Platform) on their personal smartphones. A sample of 818 youth citizen scientists in Saskatchewan, Canada downloaded the app to provide information on victimization, subjective health, internalizing problems (symptoms of stress, anxiety, and depression), externalizing behaviours (cannabis use, alcohol, smoking), and suicide ideation. Binary regression models were used to estimate associations and controlled for gender, age, perpetration, and ethnicity. From our sample, 23% of youth reported suicide ideation (i.e., thoughts) in the past year. Three types of victimization (cyberbullied, made fun or teased, or bullied via being left out) are associated with a two-times higher risk of suicide ideation. Although certain risk factors (anxiety, poor subjective health, and cannabis use) were associated with higher suicide ideation risk, they did not moderate the association between victimization and suicide ideation. Symptoms of depression were found to be protective against suicide ideation. Suicide ideation is high among this sample of youth in Canada. Certain types of victimization, internalizing and externalizing risk factors, and poor subjective health are associated with a higher risk of suicide ideation. However, our findings confirm that the pathway from victimization to suicide ideation is complex and is potentially moderated by factors other than the ones explored here.

Socioeconomic inequalities in adolescent health complaints: A multilevel latent class analysis in 45 countries.

Our study evaluated the relationship between adolescent health complaints and socioeconomic position in 45 countries. Data are from the 2017/2018 international Health Behaviour in School-aged Children survey which used proportionate sampling among adolescents aged 11 to 15 years old (n=228,979). Multilevel, multinomial regression analysis assessed the association between the multilevel latent classes with socioeconomic status (SES; at the household and country level). Three distinct latent classes were identified: No Complaints, Psychological Complaints, and a Physical and Psychological Complaints class; where, low household SES was highest for the physical and psychological complaints class. The findings suggest that health promotion policies and interventions among adolescents should consider the specific needs of adolescents living with low household SES as they report more subjective health complaints.

Socioeconomic Position Mediates the Relationship between Family Social Benefits and Adolescent Life Satisfaction in 25 countries.

The aims of this study were to assess the mediating role of household socioeconomic position (SEP) in the associations between the country-level factors: family social benefits, and public income support to single parent households (SPH), with the individual-level factor adolescent life satisfaction. Our sample consisted of adolescent (11, 13, and 15 years old) participants in the Health Behaviour in School-aged Children study (2013/2014) across Canada and 24 countries in Europe. We used World Bank data on country wealth from OECD data on social benefits for families and public income support to SPH. Multilevel linear regressions assessed mediated (indirect) associations of these country-level predictors, through SEP, with life satisfaction. Family social benefits ranged between 1.1% and 3.7% of country wealth. The direct association showed that family social benefits were associated with lower adolescent life satisfaction (ß = -0.244, 95% Confidence Intervals [C.I.] = -0.306, -0.182, p < 0.0001) among all adolescents and for adolescents in SPH (ß = -0.118, 95% C.I. = -0.161, -0.074, p < 0.0001). However, the mediated (indirect) association showed that family social benefits were associated with higher life satisfaction which is partially mediated by SEP (ß = 0.087, 95% C.I. = 0.065, 0.109, p < 0.0001) among all adolescents and for adolescents in SPH as well (ß = 0.041, 95% C.I. = 0.030, 0.052, p < 0.0001). Country policies may support the wellbeing of adolescents by reducing poverty and improving their socioeconomic position in society.

Trends in gender and socioeconomic inequalities in adolescent health over 16 years (2002-2018): findings from the Canadian Health Behaviour in School-aged Children study. / Évolution des inégalités en santé chez les adolescents selon le genre et le statut socioéconomique sur 16 ans (2002 à 2018) : résultats de l'Enquête sur les comportements de santé des jeunes d'âge scolaire.

INTRODUCTION: Monitoring health inequalities in adolescents informs policy approaches to reducing these inequalities early in the life course. The purpose of this study was to investigate trends in gender and socioeconomic inequalities in six health domains. METHODS: Data were from five quadrennial survey cycles of the Health Behaviour in School-aged Children (HBSC) study in Canada (pooled n = 94 887 participants). Differences in health between socioeconomic groups (based on material deprivation) and between genders were assessed using slope and relative indices of inequality in six health domains: daily physical activity, excess body weight, frequent physical symptoms, frequent psychological symptoms, low life satisfaction, and fair or poor self-rated health. RESULTS: Over a 16-year period, adolescents in Canada reported progressively worse health in four health domains, with those at the lowest socioeconomic position showing the steepest declines. Socioeconomic differences increased in excess body weight, physical symptoms, low life satisfaction, and fair or poor health. Gender differences also increased. Females showed poorer health than males in all domains except excess body weight, and gender differences increased over time in physical symptoms, psychological symptoms and low life satisfaction. CONCLUSION: Socioeconomic and gender inequalities in health are persistent and widening among adolescents in Canada. Policies that address material and social factors that contribute to health disparities in adolescence are warranted.

Examining the role that weight perception and social influences have on mental health among youth in the COMPASS study.

PURPOSE: We investigated whether social health mitigates the association between weight perception and anxiety and depression 1 year later in a large sample of Canadian youth in a prospective, gender-specific analysis. METHODS: We used 2 years of linked survey data from 20,485 grade 9-11 students who participated in wave 6 (2017/18) and 7 (2018/19) of the COMPASS study. Mental health outcomes included the Generalized Anxiety Disorder-7 item (GAD-7) scale and the 10-item Centre for Epidemiological Studies Depression Scale Revised (CESD-10-R). Social health encompassed students' perceived relationships with friends, family, teachers, and within schools. Multilevel, prospective, linear models regressed mental health (at wave 7) on social health (at wave 6) and weight perception (at wave 6) while controlling for weight status, ethnicity, and grade (at wave 6). Interaction terms were used to test social health factors as moderators in the association between weight perception and mental health. RESULTS: Overweight perceptions were associated with higher anxiety and depression scores among youth; this was more pronounced among females. Social health was associated with lower anxiety and depression scores. Among females only, an overweight perception had the highest predicted scores for significant depressive symptoms. Among males only, underweight perceptions were associated with higher anxiety scores. No social health factors had moderating effects in females, and only two interactions were significant among males: feeling safe at school had protective associations with anxiety scores among those with underweight perceptions while those with overweight perceptions had higher depression scores when they reported rewarding social relationships. CONCLUSION: Overweight perceptions in all youth, and underweight perceptions in males, predicted anxiety and depression symptoms 1 year later. The role of social health should not be discounted as a means of preventing anxiety and depression in youth, although this study suggests it is not sufficient to protect against adverse associations with overweight perceptions for all youth, and underweight perceptions for males.

A randomized community trial to advance digital epidemiological and mHealth citizen scientist compliance: A smart platform study.

BACKGROUND: This study aims to understand how participants' compliance and response rates to both traditional validated surveys and ecological momentary assessments (EMAs) vary across 4 cohorts who participated in the same mHealth study and received the same surveys and EMAs on their smartphones, however with cohort-specific time-triggers that differed across the 4 cohorts. METHODS: As part of the Smart Platform, adult citizen scientists residing in Regina and Saskatoon, Canada, were randomly assigned to 4 cohorts in 2018. Citizen Scientists provided a complex series of subjective and objective data during 8 consecutive days using a custom-built smartphone application. All citizen scientists responded to both validated surveys and EMAs that captured physical activity. However, using Smart Platform, we varied the burden of responding to validated surveys and EMAs across cohorts by using different time-triggered push notifications. Participants in Cohort 1 (n = 10) received the full baseline 209-item validated survey on day 1 of the study; whereas participants in cohorts 2 (n = 26), 3 (n = 10), and 4 (n = 25) received the same survey in varied multiple sections over a period of 4 days. We used weighted One-way Analysis of Variance (ANOVA) tests and weighted, linear regression models to assess for differences in compliance rate across the cohort groups controlling for age, gender, and household income. RESULTS: Compliance to EMAs that captured prospective physical activity varied across cohorts 1 to 4: 50.0% (95% Confidence Interval [C.I.] = 31.4, 68.6), 63.0% (95% C.I. = 50.7, 75.2), 37.5% (95% C.I. = 18.9, 56.1), and 61.2% (95% C.I. = 47.4, 75.0), respectively. The highest completion rate of physical activity validated surveys was observed in Cohort 4 (mean = 97.9%, 95% C.I. = 95.5, 100.0). This was also true after controlling for age, gender, and household income. The regression analyses showed that citizen scientists in Cohorts 2, 3, and 4 had significantly higher compliance with completing the physical activity validated surveys relative to citizen scientists in cohort group 1 who completed the full survey on the first day. CONCLUSIONS & SIGNIFICANCES: The findings show that maximizing the compliance rates of research participants for digital epidemiological and mHealth studies requires a balance between rigour of data collection, minimization of survey burden, and adjustment of time- and user-triggered notifications based on citizen or patient input.

Food insecurity, state fragility and youth mental health: A global perspective.

Youth in fragile settings face disproportionate risks of experiencing food insecurity and poor mental health. Cross-national evidence is lacking on the association between food insecurity and mental health in youth populations, and on state fragility as a social determinant of these experiences. We analysed data from six cycles of the Gallup World Poll (2014-2019), an annual survey that contains multi-item scales of food insecurity, mental health problems and positive wellbeing. The analytic sample included 164,118 youth aged 15-24 years in 160 states. We linked individual responses to state-level data from the Fragile States Index-an aggregate measure of state vulnerability to collapse or conflict (coded: sustainable, stable, warning, or alert) and estimated adjusted relative risk (RR) of food insecurity as a function of state fragility. We then used linear regression to examine associations of state fragility and food insecurity with mental health and wellbeing. The prevalence of moderate or severe food insecurity rose from 22.93% in 2014 to 37.34% in 2019. State fragility (alert vs. sustainable) was related to an increased risk of food insecurity (RR = 2.28 [95% CI 1.30 to 4.01]), more mental health symptoms (b = 6.36 [95% CI 1.79 to 10.93]), and lower wellbeing (b = -4.49 [95% CI -8.28 to -0.70]) after controlling for state wealth and household income. Increased food insecurity (severe vs. none or mild) was uniquely related to more mental health symptoms (b = 18.44 [95% CI 17.24 to 19.64]) and reduced wellbeing (b = -9.85 [95% CI -10.88 to -8.83]) after state fragility was also controlled. Globally, youth experience better mental health where states are more robust and food access is more secure. The findings underscore the importance of strong governance and coordinated policy actions that may improve youth mental health.

Relative food insecurity, mental health and wellbeing in 160 countries.

Food insecurity contributes to various stress-related health problems and previous research found that its association with mental illness is stronger in more affluent countries. We hypothesised that this pattern is a function of relative deprivation whereby the severity of individual food insecurity relative to others in a reference group determines its associations with mental health and wellbeing after differences in absolute food insecurity are controlled for. Using survey data from the Gallup World Poll collected in 160 countries and a measure of relative deprivation (Yitzhaki index), we found that relative food insecurity-based on national or regional reference groups-related to more mental health symptoms, lower positive wellbeing and lower life satisfaction after controlling for absolute food insecurity, household income, and country differences. Our analysis also found that relative food insecurity was more strongly related to mental health and wellbeing where the prevalence of food insecurity was lower. The findings underscore the negative health consequences of material deprivation and unfavourable social comparisons. Consistent with relative deprivation theory, individuals who live with constant worries about not getting enough food, have to skip meals, or face chronic hunger are deprived of material and social resources that support mental health and wellbeing, especially in settings where food insecurity is less common and potentially more stigmatised. The implications of these findings for global food policy and surveillance efforts are discussed.

Does social support moderate the association between hunger and mental health in youth? A gender-specific investigation from the Canadian Health Behaviour in School-aged Children study.

BACKGROUND: Youth who go hungry have poorer mental health than their counterparts - there are gender differences in this relationship. This study investigated the role of social support in the association between hunger and mental health among a nationally representative sample of youth in Canada in gender-specific analyses. METHODS: We used a probability-based sample of 21,750 youth in grades 6-10 who participated in the 2017-2018 Canadian Health Behaviour in School-aged Children. Self-report data were gathered on hunger, mental health (measured via the World Health Organization-5 well-being index) and five sources of support - peer, family and teacher support as well as the school climate and neighborhood support. We conducted adjusted, gender-specific, multilevel regression analyses assessing the association between mental health, social support and hunger. RESULTS: We found that youth who reported lower support were more likely to experience going to bed hungry (relative to never hungry) across all support factors. As for the social support factors, all the social support factors were associated with a higher mental health score, even after controlling for hunger. Despite these results our final set of models showed that our measures of social support did not alleviate the negative association between hunger and mental health. As for gender-specific findings, the negative association between hunger and a mental health was more pronounced among females relative to their male counterparts. We also found that certain social support factors (i.e., family, teacher and neighborhood support) were associated with a higher mental health score among females relative to males while controlling for hunger status. CONCLUSIONS: We find that five social support factors are associated with a higher mental health score among ever hungry youth; however, social support did not overpower the negative association between hunger and mental health. Food insecurity is a challenge to address holistically; however, hungry youth who have high social support have higher odds of better mental health.

Gender differences in the longitudinal association between multilevel latent classes of chronic disease risk behaviours and body mass index in adolescents. / Différences entre les sexes quant à l'association longitudinale entre classes latentes multiniveaux de comportements à risque associés aux maladies chroniques et indice de masse corporelle chez les adolescents.

INTRODUCTION: Few studies have assessed the relationship between chronic disease risk behaviours and body mass index (BMI) in a longitudinal, sex/gender-specific context. This study used gender-specific analyses to assess the extent to which chronic disease risk behaviour latent classes are associated with BMI and weight status at follow-up. METHODS: Longitudinal data from 4510 students in Grades 9 to 12, tracked from 2013- 2015, who participated in the COMPASS study were used to assess gender differences in the lagged association between previously determined latent classes (of physical activity and substance use) with BMI using multilevel mixed-effects models. Our multilevel regression models assessed the association between two latent classes, active experimenters and inactive non-using youth, with BMI when stratified by gender. RESULTS: Male inactive non-substance-using youth were associated with a 0.29 higher continuous BMI (95% CI: 0.057, 0.53) and odds of overweight/obesity increased by 72% (OR = 1.72, 95% CI: 1.2, 2.4) for binary BMI at follow-up relative to active youth who experiment with substance use. No significant associations were detected in females. CONCLUSION: Over time, physical activity has a protective role on BMI in male youth. Both substance use and physical inactivity should be addressed in obesity prevention efforts. Gender stratification in analyses is also important since females and males have different contributing factors to increases in BMI.

Exploring gender differences in the longitudinal association between bullying and risk behaviours with Body Mass Index among COMPASS youth in Canada.

The purpose of this study was to identify gender differences in the association between bullying and Body Mass Index (BMI) longitudinally. Longitudinal data (2013-2015) from 4510 youth (Ontario, Canada) were used to model BMI with consecutive bullying status prospectively, adjusting for previously identified gender-specific health risk behaviour latent classes. To assess for gender differences, these mixed-effects models were stratified by gender. Youth who were victims of bullying (VoB) were more active, engaged in more substance use and reported higher BMI than their non-victim of bullying (NVoB) peers. The gender-specific mixed-models showed that there are gender differences in the association between bullying and BMI. Among females, repeated bullying was associated with higher odds of having overweight/obesity [by 51% (95% C.I. = 1.03, 2.23)] at follow-up. Among male youth, being a VoB at the previous wave only, was associated with higher odds of having overweight/obesity [by 60% (95% C.I. = 1.11, 2.29)] at follow-up. In contrast with previous literature that measured BMI during adulthood (i.e., years after school victimization), our study adds a unique contribution to the literature that across one year (while youth are still in secondary school), bullying is associated with higher odds of weight status and BMI among female and male youth. Since this increase occurs during secondary school, school-based programs aimed at decreasing youth bullying behaviours and addressing increases in BMI before youth leave school are of paramount importance.

A gender-stratified, multilevel latent class assessment of chronic disease risk behaviours' association with Body Mass Index among youth in the COMPASS study.

This paper sought to examine chronic disease risk behaviour latent classes and their association with Body Mass Index (BMI), assessing for gender differences. Participants were youth (n = 116,086; grades 9-12) enrolled in the COMPASS study (Ontario, Canada) during 2013, 2014, 2015. Multilevel latent class analysis was used to identify underlying, homogenous classes of youths' engagement in physical activity, smoking, binge drinking and marijuana use. Adjusted multilevel models regressed BMI on the latent classes controlling for ethnicity and grade. Three latent classes were identified: active experimenters (ACE), inactive clean youth (INC) and inactive substance users (INSU). This study found that gender differences are apparent in chronic disease risk behaviour latent classes and their association with BMI. INC males (OR = 0.85, 95% CI = 0.78, 0.93) were associated with a lower odds of overweight/obesity relative to active males who experimented with substance use. As for females, the class with the highest proportion of youth using substances were associated with higher odds (Females: OR = 1.2, 95% CI = 1.1, 1.4) of overweight/obesity relative to their active experimenting peers. As such, youth in latent classes with substance use are associated with higher BMI and weight status. Successful interventions may include school policies/programs that limit screen time use, as they were seen to have a positive effect on PA engagement and including social-influences approaches for substance use. Future research and interventions should be gender-specific as our results show that different latent classes are associated with obesity across genders.

Validity and reliability of a food frequency questionnaire to estimate dietary intake among Lebanese children.

BACKGROUND: Nutritional status during childhood is critical given its effect on growth and development as well as its association with disease risk later in life. The Middle East and North Africa (MENA) region is experiencing alarming rates of childhood malnutrition, both over- and under-nutrition. Hence, there is a need for valid tools to assess dietary intake for children in this region. To date, there are no validated dietary assessment tools for children in any country of the MENA region. The main objective of this study was to examine the validity and reliability of a Food Frequency Questionnaire (FFQ) for the assessment of dietary intake among Lebanese children. METHODS: Children, aged 5 to 10 years (n = 111), were recruited from public and private schools of Beirut, Lebanon. Mothers (proxies to report their children's dietary intake) completed two FFQs, four weeks apart. Four 24-hour recalls (24-HRs) were collected weekly during the duration of the study. Spearman correlations and Bland-Altman plots were used to assess validity. Linear regression models were used to derive calibration factors for boys and girls. Reproducibility statistics included Intraclass Correlation Coefficient (ICC) and percent agreement. RESULTS: Correlation coefficients between dietary intake estimates derived from FFQ and 24-HRs were significant at p < 0.001 with the highest correlation observed for energy (0.54) and the lowest for monounsaturated fatty acids (0.26). The majority of data points in the Bland-Altman plots lied between the limits of agreement, closer to the middle horizontal line. After applying the calibration factors for boys and girls, the mean energy and nutrient intakes estimated by the FFQ were similar to those obtained by the mean 24-HRs. As for reproducibility, ICC ranged between 0.31 for trans-fatty acids and 0.73 for calcium intakes. Over 80 % of study participants were classified in the same or adjacent quartile of energy and nutrients intake. CONCLUSIONS: Findings of this study showed that the developed FFQ is reliable and is also valid, when used with calibration factors. This FFQ is a useful tool in dietary assessment and evaluation of diet-disease relationship in this age group.