Nutrition knowledge and bone health: development and validation of the 'NutriBone' questionnaire for Italian adult women

Public Health Nutr. 2026 Apr 10;29(1):e94. doi: 10.1017/S1368980026102444.

Abstract

Objective: This study aimed to develop and validate a questionnaire assessing the nutrition knowledge (NK) of Italian adult women regarding the relationship between diet, lifestyle and bone health.

Design: A thirty-item questionnaire in Italian was developed by experts based on a literature review. Participants completed the questionnaire twice, with a 2-4 week gap between the two administrations. During the initial administration, weight and height were recorded using a mechanical scale and a stadiometer, while bone mineral density (BMD) of the lumbar spine (L1-L4), femoral neck and total femur were assessed via dual-energy X-ray absorptiometry (DXA).

Setting: Centre for Metabolic Bone Diseases at the Parma University Hospital, from January 2022 to June 2024.

Participants: Women aged 45-75 years old, native Italian speakers, undergoing DXA at the Centre participated.

Results: The sample included 295 women with a median age of 63 years (interquartile range 11·5). The questionnaire demonstrated good internal consistency (Cronbach's alpha = 0·698) and high temporal stability (R = 0·810, P = 0·002), effectively differentiating between individuals with and without a nutritional background. Regression analysis indicated negative associations between NK score and age (β1 = -0·130, P < 0·001) and BMI (β1 = -0·193, P < 0·001).

Conclusions: The NutriBone questionnaire is a valid and reliable tool for evaluating NK related to bone health in Italian adult women undergoing DXA, with potential for future research applications.

Keywords: Bone health; Health literacy; Nutrition knowledge; Osteoporosis; Questionnaire; Woman.

Publication types

  • Validation Study

MeSH terms

  • Absorptiometry, Photon
  • Aged
  • Bone Density* / physiology
  • Diet* / statistics & numerical data
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Italy
  • Life Style
  • Middle Aged
  • Nutritional Status
  • Reproducibility of Results
  • Surveys and Questionnaires / standards