Beverage Intake Questionnaire for Latino Children (BIQ-L)

Abstract

The Beverage Intake Questionnaire for Latino Children (BIQ-L), developed by Beck, Fernandez, and Martinez (2023), is a specialized, 13-item instrument designed for the culturally sensitive assessment of dietary beverage intake among young Latino children. The development process was rigorous, incorporating insights from qualitative research involving Latino immigrant parents, extensive literature review, and consultation with pediatricians and nutrition specialists focused on low-income Latino populations.

The BIQ-L covers a wide array of beverage categories, crucially including culturally specific drinks such as agua fresca and horchata, alongside common items like soda, store-bought and homemade fruit juices, sports drinks, flavored milk, and various fat percentages of unflavored milk. The instrument is available in both English and Spanish, making it highly accessible for research in diverse settings. Initial validation studies demonstrated strong associations with objective measures, supporting its utility in clinical and public health research.

Keywords

Beverage Intake, Fruit Juices, Latino Children, Sugar-Sweetened Beverages, Culturally Specific Beverages, Developmental Measures, Drinking Behavior, Health Behavior, Latinos/Latinas, Health Behavior Measures, Child Behavior, Child Health

Authors

Beck, Amy L.; Fernandez, Alicia; Martinez, Suzanna M.

Purpose

The primary objective of the Beverage Intake Questionnaire for Latino Children (BIQ-L) is to provide a comprehensive and accurate assessment of beverage consumption patterns in young Latino children. Recognizing that standard dietary tools often overlook culturally relevant drinks, the BIQ-L was specifically tailored to capture the intake of beverages common in Latino households, thereby ensuring a more sensitive and complete measure of dietary exposure.

This instrument is critical for researchers and clinicians seeking to identify specific dietary risk factors, particularly the consumption of Sugar-Sweetened Beverages (SSBs), which are strongly linked to childhood obesity and poor health outcomes within this demographic.

Construct

The BIQ-L measures the psychological and behavioral construct of habitual dietary intake, specifically focusing on the frequency and quantity of beverage consumption over a defined period (seven days). The scale operationalizes beverage consumption into distinct categories based on sugar content (e.g., soda, fruit-flavored drinks, 100% juice) and cultural relevance (e.g., agua fresca, horchata).

By quantifying intake across these categories, the instrument allows researchers to derive metrics related to overall caloric intake, intake of added sugars, and adherence to nutritional guidelines, serving as a proxy measure for health behavior and nutritional risk within the target population.

Validity

The BIQ-L demonstrates strong psychometric properties, established primarily through Criterion Validity and Predictive Validity analyses. Criterion Validity was confirmed by comparing BIQ-L results against intake data derived from three 24-hour dietary recalls, which served as the gold standard. Significant correlations were observed across key categories:

• Sugar-Sweetened Beverages (SSB): r = 0.52, P < 0.001
• 100% Fruit Juice: r = 0.45, P < 0.001
• Flavored Milk: r = 0.70, P < 0.001
• Unflavored Milk: r = 0.70, P < 0.001

Furthermore, the instrument showed robust Predictive Validity. In a multivariable model, weekly servings of SSBs assessed by the BIQ-L were significantly associated with the child’s body mass index z-score (b = 0.15, P = 0.02). This finding confirms the instrument’s ability to predict clinically relevant health outcomes, underscoring its practical utility in nutritional epidemiology.

Reliability

No reliability data (such as test-retest reliability or internal consistency) has been reported or is currently available for the Beverage Intake Questionnaire for Latino Children (BIQ-L).

Factor Analysis

No factor analysis data (exploratory or confirmatory) has been reported or is currently available for the Beverage Intake Questionnaire for Latino Children (BIQ-L).

Instrument

Test Type: Original Inventory/Questionnaire

Format: The instrument uses a 7-day recall period. For each of the 13 beverage categories, the parent or guardian is asked two sequential questions: “In the past 7 days, how many days did (name of child) drink (beverage category) [e.g., soda]?” followed by: “On the days that (name of child) drank (name of beverage category) [e.g., soda], how many ounces did they drink?”

Language Available: English; Spanish

Population Group: Human (Male; Female)

Age Group: Infancy (2-23 months), Preschool Age (2-5 years), Childhood (birth-12 years). The validation study focused primarily on parents of children aged 1–5 years, aligning the scale with critical early childhood developmental stages.

Population Details: The study participants were parents of Latino children aged 1–5, recruited from a federally qualified health center affiliated with an academic institution in San Francisco, United States.

Test Methodology: The instrument utilizes Test Validity to establish its accuracy, specifically relying on comparisons with 24-hour dietary recalls to establish Criterion Validity and statistical modeling to demonstrate Predictive Validity against BMI z-score.

Keywords

Beverage Intake, Fruit Juices, Latino Children, Sugar-Sweetened Beverages, Culturally Specific Beverages, Developmental Measures, Drinking Behavior, Health Behavior, Latinos/Latinas, Health Behavior Measures, Child Behavior, Child Health

Authors

Author ORCID Identifier (Amy L. Beck): orcid.org/0000-0002-4567-8857

Affiliation Email addresses (Amy L. Beck): [email protected]

Correspondence Address (Amy L. Beck): University of California San Francisco, School of Medicine, Department of Pediatrics, 550 16th St, San Francisco, California, United States, 94158

Permissions & Fee and Test Year

Permissions: May use for Research/Teaching

Commercial: No

Fee: No

Test Year: 2023

References

Beck, A. L., Fernandez, A., & Martinez, S. M. (2023). The 7-day Beverage Intake Questionnaire for Latino children: Validation of a culturally tailored tool. Journal of Nutrition Education and Behavior, 55(8), 544–552. doi.org/10.1016/j.jneb.2023.05.248

Items of the Beverage Intake Questionnaire for Latino Children (BIQ-L)

The BIQ-L consists of 13 primary items designed to assess the child’s consumption frequency and quantity over the past seven days across the following beverage categories:

• Soda

• Store-bought fruit-flavored drinks with added sugar

• Sports drinks

• Agua fresca

• Horchata (a sweetened rice-based drink)

• Homemade lemonade

• Store-bought 100% fruit juice

• Homemade 100% fruit juice

• Flavored milk

• Unflavored milk (with individual questions for whole, 2%, 1%, and nonfat milk)

The full text of the test items, organized by category, is provided below:

1. Soda Consumption:

   • In the past 7 days, how many days did [name of child] drink soda, such as Coke, Pepsi, or Sprite, not including diet soda? (range, 0–7)

   • How many ounces did they drink on the days that [name of child] drank soda?

2. Store-Bought Fruit-Flavored Drinks with Added Sugar:

   • In the past 7 days, how many days did [name of child] drink store-bought fruit-flavored drinks with added sugar such as Capri Sun, Sunny Delight, Hawaiian Punch, Kool-Aid, or lemonade? (range, 0–7)

   • How many ounces did they drink on the days that [name of child] drank store-bought fruit-flavored drinks with added sugar?

3. Sports Drink Consumption:

   • In the past 7 days, how many days did [name of child] drink a sports drink such as Gatorade? (range, 0–7)

   • How many ounces did they drink on the days that [name of child] drank sports drinks?

4. Store-Bought 100% Fruit Juice Consumption (including 100% from WIC):

   • In the past 7 days, how many days did [name of child] drink store-bought 100% fruit juice (including 100% from WIC)? (range, 0–7)

   • How many ounces did they drink on the days that [name of child] drank store-bought 100% fruit juice?

5. Horchata Consumption:

   • In the past 7 days, how many days did your [name of child] drink horchata? (range, 0–7)

   • How many ounces did they drink on the days that [name of child] drank horchata?

6. Agua Fresca Consumption:

   • In the past 7 days, how many days did [name of child] drink agua fresca? (range, 0–7)

   • How many ounces did they drink on the days that [name of child] drank agua fresca?

7. Homemade Freshly Squeezed Fruit Juice Consumption:

   • In the past 7 days, how many days did [name of child] drink homemade freshly squeezed fruit juice? (range, 0–7)

   • How many ounces did they drink on the days that [name of child] drank homemade freshly squeezed fruit juice?

8. Homemade Lemonade Consumption:

   • In the past 7 days, how many days did [name of child] drink homemade lemonade? (range, 0–7)

   • How many ounces did they drink on the days that [name of child] drank homemade lemonade?

9. Flavored Milk Consumption (e.g., Chocolate or Strawberry Milk):

   • In the past 7 days, how many days did [name of child] drink flavored milk such as chocolate or strawberry milk? (range, 0–7)

   • How many ounces did they drink on the days that [name of child] drank flavored milk?

10. Plain Whole Milk Consumption:

    • In the past 7 days, how many days did [name of child] drink plain whole milk? (range, 0–7)

    • How many ounces did they drink on the days that [name of child] drank plain whole milk?

11. Plain 2% Milk Consumption:

    • In the past 7 days, how many days did [name of child] drink plain 2% milk? (range, 0–7)

    • How many ounces did they drink on the days that [name of child] drank plain 2% milk?

12. Plain 1% Milk Consumption:

    • In the past 7 days, how many days did [name of child] drink plain 1% milk? (range, 0–7)

    • How many ounces did they drink on the days that [name of child] drank plain 1% milk?

13. Plain Skim (Nonfat) Milk Consumption:

    • In the past 7 days, how many days did [name of child] drink plain skim (nonfat) milk? (range, 0–7)

    • How many ounces did they drink on the days that [name of child] drank plain skim milk?

WIC indicates Special Supplemental Nutrition Program for Women, Infants, and Children.