Reliability and Validity of a Brief Questionnaire to Assess Calcium Intake in Female Collegiate Athletes


Calcium intake often is inadequate in female collegiate athletes, increasing the risk for training injuries and future osteoporosis. Thus, a brief and accurate assessment tool to quickly measure calcium intake in athletes is needed. We evaluated the reliability and validity, compared to 6 days of diet records (DRs), of the Rapid Assessment Method (RAM), a self-administered calcium checklist (14). Seventy-six female collegiate athletes (mean age = 18.8 yrs, range = 17-21; 97% Caucasian) were recruited from basketball, cross-country, field hockey, soccer, and volleyball teams. Athletes completed a RAM at the start of the training season to assess calcium intake during the past week. Two weeks later, a second RAM was completed to assess reliability, and athletes began 6 days of diet records (DRs) collection. At completion of DRs, athletes completed a final RAM, corresponding to the same time period as DRs, to assess agreement between the 2 instruments. The RAM demonstrated adequate test-retest reliability over 2 weeks (n = 56; Intraclass correlation [ICC] = .54, p < .0001) and adequate agreement with DRs (n = 34; ICC = .41, p = .0067). Calcium intake was below recommended levels, and mean estimates did not differ significantly on the RAM (823 ± 387 mg/d) and DRs (822 ± 330 mg/d;p = .988). Adequacy of calcium intake from both DRs and the RAM was classified as "inadequate" (<1000 mg/d) and "adequate" (≥1000 mg/d). Agreement between the RAM and DRs for adequacy classification was fair (ICC = .30, p = .042), with the RAM identifying 84% of athletes judged to have inadequate calcium intake based on DRs. The RAM briefly and accurately estimates calcium intake in female collegiate athletes compared to DRs.

Publication Title

International Journal of Sport Nutrition and Exercise Metabolism