Comparison of an Australian food-frequency questionnaire with diet records: implications for nutrition surveillance

AbstractObjectives:To compare a widely used Australian food-frequency questionnaire (FFQ) with diet records and consider the results in relation to its use in nutrition surveillance.Design:Inter-method reliability study.Setting:A randomised trial in subjects with past asbestos exposure.Subjects:Seventy-two adults living in Western Australia.Methods:A semi-quantitative FFQ developed by the Commonwealth Scientific Industrial Research Organisation in South Australia was administered after the completion of four 7-day diet records (DRs).Results:Mean agreement between methods was not significantly different from 100% for many nutrients, but the limits of agreement indicated that, at the individual level, the FFQ over- or underestimated the DR by at least 50%. Mean agreement between methods decreased significantly with increasing intakes for the majority of nutrients. Pearson's correlation coefficients were less informative indicators of agreement compared with the limits of agreement.Conclusions:These results indicate poor agreement between the FFQ and DR when estimating absolute intakes. Therefore, comparing intakes collected using this FFQ with specific cut-off points such as Recommended Dietary Intakes for nutrition surveillance may lead to seriously flawed conclusions about population intakes.

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Agreement between a brief food frequency questionnaire and diet records using two statistical methods

Public Health Nutrition ◽

10.1079/phn200062 ◽

2001 ◽

Vol 4 (2) ◽

pp. 255-264 ◽

Cited By ~ 23

Author(s):

GL Ambrosini ◽

NH de Klerk ◽

AW Musk ◽

D Mackerras

Keyword(s):

Food Frequency Questionnaire ◽

Asbestos Exposure ◽

Reliability And Validity ◽

Correlation Coefficients ◽

Beta Carotene ◽

Cross Sectional Study ◽

Limits Of Agreement ◽

Cross Sectional ◽

Food Frequency ◽

Diet Records

AbstractObjectiveTo compare intra- and inter-method reliability of a semi-quantitative food frequency questionnaire (FFQ) designed specifically to measure beta carotene (BC) and retinol intake, using two methods – the limits of agreement (LOA) and the correlation coefficient.DesignA cross-sectional study of dietary intake.SettingA randomized trial of vitamin A supplements in 2769 subjects with past asbestos exposure.SubjectsData from 57 men and 26 women, aged 28–72 years, living in Western Australia.MethodsThe FFQ was administered at baseline (FFQ1) and repeated 1 year later (FFQ2). Four 1-week diet records (DRs) were completed during the year.ResultsMean agreement between FFQ2 and FFQ1 was 120% for BC and 98% for retinol. LOA were 47–306% and 21–459%, respectively. Mean agreement between FFQ2 and the DR was 149% for BC and 63% for retinol; LOA were 50–447% and 11–349%, respectively. Mean agreement and LOA varied across energy intakes. Between the DR and FFQ2, correlation coefficients were 0.36 for BC and 0.51 for retinol. These varied considerably across age, gender and energy intakes and were not in accordance with limits of agreement findings.ConclusionAlthough correlation coefficients were positive and significant, there was less than ideal intra-method and inter-method reliability shown by the limits of agreement method. Bias was uneven across the range of intakes, the LOA were wide and, compared with the DR, the FFQ significantly over-estimated BC and under-estimated retinol. This shows the limitations of calculating correlation coefficients alone, for assessing reliability and validity.

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Relative Validity and Reproducibility of a Short Food Frequency Questionnaire to Assess Nutrient Intakes of New Zealand Adults

Nutrients ◽

10.3390/nu12030619 ◽

2020 ◽

Vol 12 (3) ◽

pp. 619 ◽

Cited By ~ 2

Author(s):

Cecilia Ho Yan Sam ◽

Paula Skidmore ◽

Sheila Skeaff ◽

Sherly Parackal ◽

Clare Wall ◽

...

Keyword(s):

New Zealand ◽

Blood Sample ◽

Food Frequency Questionnaire ◽

Correlation Coefficients ◽

Future Research ◽

Dietary Intakes ◽

Food Frequency ◽

Relative Validity ◽

Diet Records ◽

Diet Record

There is no recent validated short food frequency questionnaire (FFQ) for use in New Zealand (NZ) adults. This study aimed to evaluate the relative validity and reproducibility of a short FFQ in free-living NZ adults aged 30–59 years. A 57-item, semi-quantitative FFQ was developed and pre-tested. During a 12-month study period the FFQ was administrated twice with a 9-month interval between administrations. Four two-day diet records were collected at months 0, 3, 6, and 9 and a blood sample was taken at month 9. Spearman correlations were used to evaluate the validity of the FFQ with the eight-day diet records and selected biomarkers. Cross-classification analysis and the Bland–Altman method were used to assess the agreement between the FFQ and the diet record. Reproducibility over nine months was assessed using intra-class correlations. A total of 132 males and females completed both FFQs, the eight-day diet record, and provided a blood sample. The highest energy-adjusted correlation coefficients were observed for alcohol (0.81), cholesterol (0.61), and carbohydrate (0.61), with the lowest for sodium (0.29), thiamin (0.33), and niacin equivalents (0.34). More than three quarters of the participants were correctly classified into the same or adjacent quartile for most nutrients, with a low proportion of participants being grossly misclassified (<10%). For most nutrients, the limits of agreement from the Bland–Altman analyses were between 50% and 250%. A positive correlation was observed between dietary intakes and plasma biomarkers for all selected nutrients. The FFQ showed moderate to good reproducibility, with almost all reliability coefficients ranging from 0.60 to 0.80. This short FFQ was shown to validly and reliably rank individuals by their habitual intake of most major nutrients, indicating that the FFQ will offer a time-efficient way to assess the nutrient intake of NZ adults in future research.

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Development and Relative Validity of a Semiquantitative Food Frequency Questionnaire to Estimate Dietary Intake among a Multi-Ethnic Population in the Malaysian Cohort Project

Nutrients ◽

10.3390/nu13041163 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1163

Author(s):

Suzana Shahar ◽

Mohd Razif Shahril ◽

Noraidatulakma Abdullah ◽

Boekhtiar Borhanuddin ◽

Mohd Arman Kamaruddin ◽

...

Keyword(s):

Vitamin C ◽

Correlation Coefficient ◽

Food Frequency Questionnaire ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Weighted Kappa ◽

Dietary Intakes ◽

Food Frequency ◽

Relative Validity ◽

Spearman’S Correlation

Measuring dietary intakes in a multi-ethnic and multicultural setting, such as Malaysia, remains a challenge due to its diversity. This study aims to develop and evaluate the relative validity of an interviewer-administered food frequency questionnaire (FFQ) in assessing the habitual dietary exposure of The Malaysian Cohort (TMC) participants. We developed a nutrient database (with 203 items) based on various food consumption tables, and 803 participants were involved in this study. The output of the FFQ was then validated against three-day 24-h dietary recalls (n = 64). We assessed the relative validity and its agreement using various methods, such as Spearman’s correlation, weighed Kappa, intraclass correlation coefficient (ICC), and Bland–Altman analysis. Spearman’s correlation coefficient ranged from 0.24 (vitamin C) to 0.46 (carbohydrate), and almost all nutrients had correlation coefficients above 0.3, except for vitamin C and sodium. Intraclass correlation coefficients ranged from −0.01 (calcium) to 0.59 (carbohydrates), and weighted Kappa exceeded 0.4 for 50% of nutrients. In short, TMC’s FFQ appears to have good relative validity for the assessment of nutrient intake among its participants, as compared to the three-day 24-h dietary recalls. However, estimates for iron, vitamin A, and vitamin C should be interpreted with caution.

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Relative validity of a food-frequency questionnaire developed to assess food intake of schoolchildren living in the Brazilian Western Amazon

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2011001100013 ◽

2011 ◽

Vol 27 (11) ◽

pp. 2197-2206 ◽

Cited By ~ 13

Author(s):

Fernanda Baeza Scagliusi ◽

Mariana Tarricone Garcia ◽

Ana Luiza Coutinho Indiani ◽

Marly Augusto Cardoso

Keyword(s):

Food Intake ◽

Food Frequency Questionnaire ◽

Correlation Coefficients ◽

Dietary Intakes ◽

Food Frequency ◽

Relative Validity ◽

Vitamins A And C ◽

The Mean ◽

Almost All ◽

Good Agreement

This study aimed to assess the relative validity of a food frequency questionnaire (FFQ) developed to assess food intake of schoolchildren from the Brazilian Western Amazon. The dietary intakes of 61 schoolchildren, aged between six and nine 9 years, were measured using two 24-hour dietary recalls and one FFQ, conducted with the children's, mother or guardians. Validity of the FFQ compared to the mean of the two dietary recalls was assessed using Pearson's correlation coefficient adjusted for attenuation and energy intake, Bland & Altman plots and evaluation of agreement levels between the two assessment methods. Energy-adjusted and deattenuated correlation coefficients ranged from -0.03 for vitamin C, to 0.93 for calcium. The mean coefficient was 0.46. The mean proportion of subjects classified within one quintile by the two methods was 66%. The Bland & Altman plots indicated good agreement for almost all nutrients, with a mean limit of agreement of 108%. These results indicate that, although there was a lack of accuracy for certain nutrients, such as vitamins A and C, the FFQ ensures reliable estimates of intake of most nutrients.

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Validation of a quantitative food-frequency questionnaire for use in Western Mali

Public Health Nutrition ◽

10.1079/phn2001181 ◽

2001 ◽

Vol 4 (6) ◽

pp. 1267-1277 ◽

Cited By ~ 35

Author(s):

Liv E Torheim ◽

Ingrid Barikmo ◽

Anne Hatløy ◽

Moro Diakité ◽

Kari Solvoll ◽

...

Keyword(s):

Food Intake ◽

Food Frequency Questionnaire ◽

Correlation Coefficients ◽

Vulnerable Groups ◽

Food Groups ◽

Food Frequency ◽

Diet Records ◽

Median Correlation ◽

Study Population ◽

Diet Record

AbstractObjective:The purpose of this study was to validate a quantitative food-frequency questionnaire (QFFQ) created for assessing the usual intake of foods and nutrients in the prevailing season in Western Mali.Design:Intake of foods and nutrients over the week preceding the interview was measured with a 69-item QFFQ. Intakes were compared with intakes as measured with 2-day combined weighed and recalled diet records.Setting:A rural village in Western Mali, West Africa.Subjects:Twenty-seven men and 48 women (15–59 years of age) representing 18 households.Results:Spearman rank correlations between intake of food groups from the QFFQ and the diet record ranged from 0.09 (meat/fish) to 0.58 (tea/coffee). Median coefficient was 0.37. Median Spearman correlation coefficient for nutrient intake was 0.40. Men had higher median correlation coefficients than did women. The proportion of subjects being classified into the same quartile of food intake was on median 33%, while a median of 7% was misclassified into extreme quartiles. Correct classification into the same quartile for intake of nutrients was on median 34% while a median of 4% was grossly misclassified. Intakes of most food groups and nutrients as measured by the QFFQ were higher than those measured by the diet records. However, while men had higher estimated intakes for foods eaten in-between meals, women in general had higher intake of foods eaten in the main meals.Conclusion:This QFFQ can be used for comparing the intake of foods and nutrients between groups within this study population. It therefore represents a useful tool in the surveillance of food intake in the population, both in identifying vulnerable groups and for tracking food intake over time. The differences between men and women in overestimating food intake need to be taken into account when using the method.

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Improvement in dietary intake estimates through the combined use of different approaches

Revista de Nutrição ◽

10.1590/1678-9865201932e180137 ◽

2019 ◽

Vol 32 ◽

Author(s):

Raíssa do Vale Cardoso LOPES ◽

Juliana Araújo TEIXEIRA ◽

Dirce Maria MARCHIONI ◽

Luisa Lina VILLA ◽

Anna Regina GIULIANO ◽

...

Keyword(s):

Dietary Intake ◽

Food Frequency Questionnaire ◽

Correlation Coefficients ◽

Reference Method ◽

Weighted Kappa ◽

Target Population ◽

Dietary Intakes ◽

Food Frequency ◽

24 Hour Recall ◽

Calibration Equations

ABSTRACT Objective This study aimed to compare dietary intake estimates using two different methodological approaches: use of new portions obtained with the 24-Hour Diet Recall, which was applied in the current study population, and the application of calibration equations, which were estimated using the same 24h-recalls. Methods Calibration equations were estimated using linear regression. The medians and confidence intervals of energy and nutrient intakes were assessed using all the approaches. The U Mann Whitney test was applied to verify differences among dietary intakes obtained with the 24 Hour Recall and Food Frequency Questionnaire-based methods. The correlation between different measures was assessed with Spearman coefficient. Weighted Kappa was used to verify the capability of the Food Frequency Questionnaire -based methods to classify individuals in the same intake levels of the 24 Hour Recall. Results Nine of the eleven components that were analyzed using the Food Frequency Questionnaire with standard portions and calibrated had medians significantly different from those obtained using the 24 Hour Recall; only the measurements of vitamin E and energy were statistically equal. For the Food Frequency Questionnaire with 24 Hour Recall portions, only the medians of vitamin D and B12 did not significantly differ from the 24 Hour Recall medians. Finally, for the Food Frequency Questionnaire with 24 Hour Recall portions and calibrated, all components, except folate and iron, had medians statistically equal to those obtained using the 24 Hour Recall. Spearman correlation coefficients were higher for the Food Frequency Questionnaire with 24 Hour Recall portions calibrated for all the assessed components, and the values ranged from 0.27 (total fat) to 0.57 (iron). Higher Kappa correlation coefficients were found for the Food Frequency Questionnaire 24 Hour Recall portions calibrated. Conclusion Calibrated FFQ with portions estimated from the own target population obtained better estimates of dietary intake, with values considerably more similar to those obtained with the reference method.

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Validation of the European Prospective Investigation into Cancer (EPIC) Food Frequency Questionnaire for use among Adults in Lebanon

Public Health Nutrition ◽

10.1017/s1368980021002123 ◽

2021 ◽

pp. 1-27

Author(s):

Karim Khaled ◽

Vanora Hundley ◽

Maya Bassil ◽

Mira Bazzi ◽

Fotini Tsofliou

Keyword(s):

Vitamin A ◽

Food Frequency Questionnaire ◽

Correlation Coefficients ◽

Epidemiological Studies ◽

Kappa Statistics ◽

Dietary Intakes ◽

Food Frequency ◽

Dietary Recall ◽

Acceptable Agreement ◽

Good Agreement

Abstract Objective: To validate the EPIC food frequency questionnaire (FFQ) in Lebanon. Design: Validation of the EPIC FFQ was done against three 24-hour recalls. Unadjusted and energy adjusted correlations, Bland Altman plots, and weighed kappa statistics were used to assess the agreement between the two methods. Setting: Lebanon. Participants: 119 adults (staff and students) at a Lebanese University. Results: Good unadjusted and energy-adjusted correlation coefficients were found between data from the two methods which ranged from −0.002 (vitamin A) to 0.337 (carbohydrates) and were all statistically significant except for vitamin D, vitamin E, vitamin A, selenium, and niacin. Slight/fair agreement was reported through weighed kappa estimates for unadjusted data ranging from −0.05 (vitamin C) to 0.248 (magnesium) and for energy-adjusted data ranging from −0.034 (vitamin A) to 0.203 (phosphorus). Individuals were categorised into exact and adjacent quartiles with an average of 78% for unadjusted data and 70% for energy-adjusted data, indicating a very good agreement between the EPIC FFQ and the average of the 24-HRs data. The visual inspection of the Bland-Altman plots revealed an over-estimation of energy, carbohydrates, protein, and fat intakes by the FFQ method. Conclusion: Overall, when all tests were taken into consideration, this study demonstrated an acceptable agreement of the EPIC FFQ with the 24-hour dietary recall method and significantly good correlations between dietary intakes. Therefore, the EPIC FFQ can be considered a valid tool for assessing diet in epidemiological studies among Lebanese adults.

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Reproducibility of the Online Food4Me Food-Frequency Questionnaire for Estimating Dietary Intakes across Europe

Journal of Nutrition ◽

10.3945/jn.115.225078 ◽

2016 ◽

Vol 146 (5) ◽

pp. 1068-1075 ◽

Cited By ~ 16

Author(s):

◽

Steven J Marshall ◽

Katherine M Livingstone ◽

Carlos Celis-Morales ◽

Hannah Forster ◽

...

Keyword(s):

Total Energy ◽

Energy Intake ◽

Food Frequency Questionnaire ◽

Controlled Trial ◽

Age Groups ◽

Correlation Coefficients ◽

Normal Weight ◽

Total Energy Intake ◽

Dietary Intakes ◽

Food Frequency

Abstract Background: Accurate dietary assessment is key to understanding nutrition-related outcomes and is essential for estimating dietary change in nutrition-based interventions. Objective: The objective of this study was to assess the pan-European reproducibility of the Food4Me food-frequency questionnaire (FFQ) in assessing the habitual diet of adults. Methods: Participants from the Food4Me study, a 6-mo, Internet-based, randomized controlled trial of personalized nutrition conducted in the United Kingdom, Ireland, Spain, Netherlands, Germany, Greece, and Poland, were included. Screening and baseline data (both collected before commencement of the intervention) were used in the present analyses, and participants were included only if they completed FFQs at screening and at baseline within a 1-mo timeframe before the commencement of the intervention. Sociodemographic (e.g., sex and country) and lifestyle [e.g., body mass index (BMI, in kg/m2) and physical activity] characteristics were collected. Linear regression, correlation coefficients, concordance (percentage) in quartile classification, and Bland-Altman plots for daily intakes were used to assess reproducibility. Results: In total, 567 participants (59% female), with a mean ± SD age of 38.7 ± 13.4 y and BMI of 25.4 ± 4.8, completed both FFQs within 1 mo (mean ± SD: 19.2 ± 6.2 d). Exact plus adjacent classification of total energy intake in participants was highest in Ireland (94%) and lowest in Poland (81%). Spearman correlation coefficients (ρ) in total energy intake between FFQs ranged from 0.50 for obese participants to 0.68 and 0.60 in normal-weight and overweight participants, respectively. Bland-Altman plots showed a mean difference between FFQs of 210 kcal/d, with the agreement deteriorating as energy intakes increased. There was little variation in reproducibility of total energy intakes between sex and age groups. Conclusions: The online Food4Me FFQ was shown to be reproducible across 7 European countries when administered within a 1-mo period to a large number of participants. The results support the utility of the online Food4Me FFQ as a reproducible tool across multiple European populations. This trial was registered at clinicaltrials.gov as NCT01530139.

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Validation of a Newly Developed Food Frequency Questionnaire to Assess Dietary Intakes of Magnesium

Nutrients ◽

10.3390/nu11112789 ◽

2019 ◽

Vol 11 (11) ◽

pp. 2789 ◽

Cited By ~ 1

Author(s):

Deeptha Sukumar ◽

Rosemary DeLuccia ◽

May Cheung ◽

Rohit Ramadoss ◽

Tammy Ng ◽

...

Keyword(s):

Food Frequency Questionnaire ◽

Age Groups ◽

Rank Correlation ◽

Correlation Coefficients ◽

Extended Period ◽

Normal Weight ◽

Dietary Intakes ◽

Food Diary ◽

Cross Sectional ◽

Food Frequency

Magnesium (Mg) intake is an important indication of an individual’s Mg status, but no validated food frequency questionnaire (FFQ) to assess intake currently exists. The purpose of this study was to develop and investigate the validity of a semi-quantitative Mg food frequency questionnaire (MgFFQ) against a 14-day food diary to assess average daily Mg intakes. In this cross-sectional study, 135 adults aged 18 to 75 completed the 33-item MgFFQ and a 14-day food diary to assess their Mg intakes. Coefficients of variance, Pearson’s correlation coefficients, and/or Spearman’s rank correlation coefficient tests were used to determine the relationship between the MgFFQ and the average Mg intake from the 14-day food diary among all participants, men, women, age groups, and body mass index (BMI) groups. The correlation between the MgFFQ and the 14-day food diary was significant (p < 0.05) for all participants (r = 0.798), men (r = 0.855), women (r = 0.759), normal weight (r = 0.762), overweight (r = 0.858), and obese (r = 0.675) weight statuses, and in all age groups. The calcium to magnesium intake (Ca:Mg) ratio in all participants was higher than optimal, 3.39 (2.11). Our results suggest that the MgFFQ is a valid method to capture Mg intake over an extended period of time, therefore acting as a valuable tool to quickly determine Mg intake.

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Reproducibility and relative validity of a semi-quantitative food frequency questionnaire for the Chinese lactating mothers

Nutrition Journal ◽

10.1186/s12937-021-00678-5 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Ye Ding ◽

Fang Li ◽

Ping Hu ◽

Mei Ye ◽

Fangping Xu ◽

...

Keyword(s):

Food Frequency Questionnaire ◽

Dietary Assessment ◽

Correlation Coefficients ◽

Cost Effective ◽

Assessment Method ◽

Food Frequency ◽

Relative Validity ◽

Lactating Mothers ◽

Dietary Record ◽

Spearman’S Correlation

Abstract Background The dietary nutritional status of the lactating mothers is related to maternal health and has a significant impact on the growth and development of infants through the secretion of breast milk. The food frequency questionnaire (FFQ) is the most cost-effective dietary assessment method that can help obtain information on the usual dietary pattern of participants. Until now, the FFQs have been used for different populations in China, but there are few FFQs available for the lactating mothers. We aimed to develop a semi-quantitative, 156-item FFQ for the Chinese lactating mothers, and evaluate its reproducibility and relative validity. Methods A total of 112 lactating mothers completed two FFQs and one 3-d dietary record (3DR). The first FFQ (FFQ1) was conducted during postpartum at 60–65 days and the second FFQ (FFQ2) during subsequent follow-up at 5 weeks. The 3DR was completed with portion sizes assessed using photographs taken by the respondent before and after eating (instant photography) 1 week after FFQ1. Results For reproducibility, the Spearman’s correlation coefficients for food ranged from 0.34 to 0.68, and for nutrients from 0.25 to 0.61. Meanwhile, the intra-class correlation coefficients for food ranged from 0.48 to 0.87, and for nutrients from 0.27 to 0.70. For relative validity, the Spearman’s correlation coefficients for food ranged from 0.32 to 0.56, and for nutrients from 0.23 to 0.72. The energy-adjusted coefficients for food ranged from 0.26 to 0.55, and for nutrients from 0.22 to 0.47. Moreover, the de-attenuation coefficients for food ranged from 0.34 to 0.67, and for nutrients from 0.28 to 0.77. The Bland-Altman plots also showed reasonably acceptable agreement between the two methods. Conclusions This FFQ is a reasonably reproducible and a relative valid tool for assessing dietary intake of the Chinese lactating mothers.

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