Development and external validation of the “Flower-FFQ”: a food frequency questionnaire designed for the Lifelines Cohort Study

Abstract Objective: Food frequency questionnaires (FFQs) assess habitual dietary intake and are relatively inexpensive to process, but may take up to 60 minutes to complete. This article describes the validation of the Flower-FFQ, which consists of four short FFQs measuring the intake of energy and macronutrients or specific (micro)nutrients/foods that can be merged into one complete daily assessment using predefined algorithms. Design: Participants completed the Flower-FFQ and validated regular-FFQ (n=401). Urinary nitrogen (n=242) and potassium excretions (n=361) were measured. We evaluated: 1) group-level bias, 2) correlations, and 3) cross-classification. Setting: Observational study. Participants: Dutch adults, 54±11(mean±SD) years. Results: Flower-FFQ1, Flower-FFQ2, Flower-FFQ3, and Flower-FFQ4 were completed in ±24, 9, 8 and 9 minutes (±50 minutes total), respectively. The regular-FFQ was completed in ±43 minutes. Mean energy (flower vs. regular: 7953 vs. 8718 kJ/day) and macronutrient intakes (carbohydrates: 204 vs. 222 g/day; protein: 75 vs. 76 g/day; fat: 74 vs. 83 g/day; ethanol: 8 vs. 12 g/day) were comparatively similar. Spearman correlations between Flower-FFQ and regular-FFQ ranged from 0.60-0.80 for macronutrients and from 0.40-0.80 for micronutrients and foods. For all micronutrients and foods, ≥78% of the participants classified in the same/adjacent quartile. The flower-FFQ underestimated urinary nitrogen and potassium excretions by 24% and 18%; 75% and 73% of the participants ranked in the same/adjacent quartile. Conclusion: Completing the Flower-FFQ required 50 minutes with a maximum of 25 minutes per short FFQ. The Flower-FFQ has a moderate to good ranking ability for most nutrients and foods and performs sufficiently to study diet-disease associations.

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Dietary Intake in the Lifelines Cohort Study: Baseline Results from the Flower Food Frequency Questionnaire among 59,982 Participants

Nutrients ◽

10.3390/nu14010048 ◽

2021 ◽

Vol 14 (1) ◽

pp. 48

Author(s):

A. Mireille Baart ◽

Elske M. Brouwer-Brolsma ◽

Corine W. M. Perenboom ◽

Jeanne H. M. de Vries ◽

Edith J. M. Feskens

Keyword(s):

Cohort Study ◽

Dietary Intake ◽

Food Frequency Questionnaire ◽

Healthy Aging ◽

Current Knowledge ◽

Macronutrient Intake ◽

Food Groups ◽

Food Frequency ◽

General Dutch Population ◽

Study Participants

The role of nutrition in health and disease is well established. However, more research on this topic is needed to fill gaps in our current knowledge. The Lifelines cohort study, a large Dutch prospective cohort study, was established as a resource for international researchers, aiming to obtain insight into the aetiology of healthy ageing. The study started with 167,729 participants, covering three generations, aiming to follow them for thirty years. This article describes the habitual dietary intake, assessed using the Flower Food Frequency Questionnaire (FFQ), among Lifelines cohort study participants at baseline, stratified by sex and different categories of age, socioeconomic status (SES) and body mass index (BMI). A total of 59,982 adults (23,703 men and 36,279 women), who completed the Flower FFQ and reported plausible habitual dietary intake, were included in the analyses. Median daily energy intake was higher in men (2368 kcal) than in women (1848 kcal), as well as macronutrient intake. Energy and macronutrient intake decreased with increasing age and BMI categories; no differences were observed between SES categories. Intake of most micronutrients was higher in men than in women. Differences were observed between age categories, but not between SES and BMI categories. Food groups were consumed in different amounts by men and women; differences between age, SES and BMI categories were observed as well. The Lifelines cohort study provides extensive dietary intake data, which are generalisable to the general Dutch population. As such, highly valuable dietary intake data are available to study associations between dietary intake and the development of chronic diseases and healthy aging.

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Evaluation of a food frequency questionnaire to determine dietary intake in a large cohort: The SAPALDIA study

Aktuelle Ernährungsmedizin ◽

10.1055/s-0032-1312542 ◽

2012 ◽

Vol 37 (03) ◽

Cited By ~ 1

Author(s):

N Steinemann ◽

IU Leonhäuser ◽

N Probst-Hensch ◽

L Grize ◽

C Brombach

Keyword(s):

Dietary Intake ◽

Food Frequency Questionnaire ◽

Large Cohort ◽

Food Frequency

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Development and validation of a food frequency questionnaire for Japanese athletes (FFQJA)

Journal of the International Society of Sports Nutrition ◽

10.1186/s12970-021-00433-5 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Kazuko Ishikawa-Takata ◽

Kaori Okamoto ◽

Motoko Taguchi

Keyword(s):

Dietary Intake ◽

Food Frequency Questionnaire ◽

Kappa Statistic ◽

Portion Size ◽

Vitamin B ◽

Kappa Index ◽

Food Frequency ◽

Supplement Use ◽

Food Items ◽

Dietary Records

Abstract Background Food frequency questionnaires are considered an effective method for assessing habitual dietary intake, but they must be developed or validated with the target population. Portion size, supplement use and food choice are thought to be especially important methodological considerations for assessing athletes’ dietary intake. This study aimed to develop and validate a food frequency questionnaire for Japanese athletes using data from this population. Methods We used dietary records from 440 Japanese athletes involved in our previous projects. Food items were analyzed using cumulative percentage contributions and multiple regression analysis, to give a selection of 62 basic food items and four supplemental items. The validity of the questionnaire was evaluated among another 77 Japanese athletes by comparing nutrient intakes assessed using the questionnaire with dietary records. Reproducibility was evaluated by comparing a second questionnaire completed 2–3 weeks later by 36 of the athletes in the validation study. Validity was assessed using crude Spearman’s correlation coefficients (CCs), energy-adjusted CCs, intraclass CCs (ICCs), and Kappa index values. Reproducibility was assessed by CCs, energy-adjusted CCs, and ICCs. Results In the validation analysis, the median crude CC for all of the nutrients was 0.407, ranging from 0.222 for dietary fiber to 0.550 for carbohydrate. The median energy-adjusted CC was 0.478, and the median ICC was 0.369. When we divided the athletes into quartiles, 65% (vitamin B1) to 86% (iron) of athletes were classified into the same or adjacent categories using the questionnaire and dietary records, with a median Kappa statistic of 0.32. In the reproducibility analysis, the median crude CC between the two completed questionnaires was 0.654, ranging from 0.582 (carbohydrate) to 0.743 (vitamin B2). The median energy-adjusted CC was 0.643, and the median ICC was 0.647. Conclusions The new 62-item food frequency questionnaire is both reliable and valid and may be useful for assessing food intake in Japanese athletes.

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