Relative Validity and Reproducibility of a New 44-Item Diet and Food Frequency Questionnaire Among Adults: Online Assessment (Preprint)

BACKGROUND Dietary questionnaires currently available which can assess the habitual diet are timely, costly, or not adapted well to the modern diet; thus, there is a need for a shorter food frequency e-Questionnaire (FFeQ) adapted to Western diets, in order to properly estimate energy and macronutrient intakes or rank individuals according to food and nutrient intakes. OBJECTIVE The aim of this study was to evaluate the relative validity and reproducibility of a 30-minute and 44-item FFeQ in a sample of adults obtained from the general population. METHODS A sample of French adults was recruited through social media and an advertising campaign. A total of 223 volunteers completed the FFeQ twice at one-year intervals and were included in the reproducibility study. During that interval, 92 participants completed three-to-six 24-hour recalls and were included in the validity study. Nutrient and dietary intakes were computed for all validity and reproducibility participants. The level of agreement between the two methods was evaluated for nutrient and food group intakes using classification into quintiles of daily intake, correlation coefficients and Bland-Altman plots. RESULTS For relative validity, correlation coefficients ranged from 0.09 to 0.88 (unadjusted correlation coefficients, median: 0.48) and 0.02 to 0.68 (deattenuated and energy adjusted correlation coefficients, median: 0.50) for food group and nutrient intakes, respectively. The median proportion of subjects classified into the same or adjacent quintile was 73% and 66% for food and nutrient intakes, respectively. Bland-Altman plots showed good agreement across the range of intakes. Regarding reproducibility, intraclass correlation coefficients ranged from 0.33 to 0.72 (median: 0.60) and 0.55 to 0.73 (median: 0.64), for food and nutrient intakes, respectively. CONCLUSIONS The FFeQ showed acceptable validity and reproducibility in a sample of adults based on their food and nutrient intakes. The FFeQ is a promising and low-cost tool that can be used in large-scale online epidemiological studies or clinical routines and could be integrated into evidence-based smartphone apps for assessing diet components.

Download Full-text

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.

Download Full-text

Web-based Food Behaviour Questionnaire: Validation with Grades Six to Eight Students

Canadian Journal of Dietetic Practice and Research ◽

10.3148/70.4.2009.172 ◽

2009 ◽

Vol 70 (4) ◽

pp. 172-178 ◽

Cited By ~ 55

Author(s):

Rhona M. Hanning ◽

Dawna Royall ◽

Jenn E. Toews ◽

Lindsay Blashill ◽

Jessica Wegener ◽

...

Keyword(s):

Dietary Assessment ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Food Group ◽

Nutrient Intakes ◽

Web Based ◽

Qualitative Feedback ◽

Diet Recall ◽

Ethnic Students ◽

The Web

Purpose: The web-based Food Behaviour Questionnaire (FBQ) includes a 24-hour diet recall, a food frequency questionnaire, and questions addressing knowledge, attitudes, intentions, and food-related behaviours. The survey has been revised since it was developed and initially validated. The current study was designed to obtain qualitative feedback and to validate the FBQ diet recall. Methods: “Think aloud” techniques were used in cognitive interviews with dietitian experts (n=11) and grade six students (n=21).Multi-ethnic students (n=201) in grades six to eight at urban southern Ontario schools completed the FBQ and, subsequently, one-on-one diet recall interviews with trained dietitians. Food group and nutrient intakes were compared. Results: Users provided positive feedback on the FBQ. Suggestions included adding more foods, more photos for portion estimation, and online student feedback. Energy and nutrient intakes were positively correlated between FBQ and dietitian interviews, overall and by gender and grade (all p<0.001). Intraclass correlation coefficients were ≥0.5 for energy and macronutrients, although the web-based survey underestimated energy (-10.5%) and carbohydrate (-15.6%) intakes (p<0.05). Under-estimation of rice and pasta portions on the web accounted for 50% of this discrepancy. Conclusions: The FBQ is valid, relative to 24-hour recall interviews, for dietary assessment in diverse populations of Ontario children in grades six to eight.

Download Full-text

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.

Download Full-text

Validation and reproducibility of an FFQ for use among adults in Botswana

Public Health Nutrition ◽

10.1017/s1368980012004636 ◽

2012 ◽

Vol 16 (11) ◽

pp. 1995-2004 ◽

Cited By ~ 12

Author(s):

Maria D Jackson ◽

Boitumelo S Motswagole ◽

Lemogang D Kwape ◽

Rosemary I Kobue-Lekalake ◽

Tidimalo B Rakgantswana ◽

...

Keyword(s):

Vitamin E ◽

Correlation Coefficients ◽

Food Group ◽

Leafy Vegetables ◽

Spearman Correlation ◽

Food Groups ◽

Nutrient Intakes ◽

Relative Validity ◽

Dark Green ◽

Β Carotene

AbstractObjectiveTo evaluate the validity and reproducibility of a 122-item interviewer-administered quantitative FFQ developed to determine food and nutrient intakes of adults in Botswana.DesignRelative validity of the FFQ was evaluated by comparing nutrient and food group intakes against four non-consecutive 24 h recalls administered over 12 months. The FFQ was repeated after 1 year to assess reproducibility.SettingKanye, Botswana.SubjectsSeventy-nine adults aged 18–75 years.ResultsSpearman correlation coefficients for the validity of energy-adjusted nutrients ranged from 0·42 (carbohydrate) to 0·49 (protein) for macronutrients and from 0·23 (Fe) to 0·44 (PUFA) for micronutrients. Exact agreement of quartile distribution for nutrients between the FFQ and recalls ranged from 27 % to 72 %. Weighted kappa values were lowest for retinol (0·13), Fe (0·22) and β-carotene (0·25) and ranged from 0·33 (SFA) to 0·59 (folate) for other nutrients (energy, carbohydrate, protein, fat, Ca and vitamin E). Spearman correlation coefficients between the recalls and FFQ for food groups ranged from 0·18 (dark green leafy and yellow vegetables) to 0·58 (poultry). Reproducibility correlation coefficients (energy-adjusted) varied between 0·39 for retinol and 0·66 for vitamin E, with most values falling between 0·50 and 0·60.ConclusionsThe FFQ had good relative validity for estimating habitual food group and nutrient intakes, but was poor for some micronutrients (Fe, retinol and β-carotene) and foods (fruits and dark green leafy vegetables).

Download Full-text

Relative validity of an FFQ for pre-school children in the mother–child ‘Rhea’ birth cohort in Crete, Greece

Public Health Nutrition ◽

10.1017/s1368980014000445 ◽

2014 ◽

Vol 18 (3) ◽

pp. 421-427 ◽

Cited By ~ 11

Author(s):

Vasiliki Leventakou ◽

Vaggelis Georgiou ◽

Leda Chatzi ◽

Katerina Sarri

Keyword(s):

Birth Cohort ◽

School Children ◽

Correlation Coefficients ◽

Weighted Kappa ◽

Food Group ◽

Kappa Statistics ◽

Nutrient Intakes ◽

Relative Validity ◽

Food Records ◽

The Mean

AbstractObjectiveTo examine the relative validity of an FFQ based on parental report for pre-school children in the mother–child ‘Rhea’ birth cohort.DesignThe children’s mothers completed an FFQ that referred to the children’s dietary intake for the previous year by telephone interview. Mothers completed also three food records, two on weekdays and one on a weekend day. Spearman correlation coefficients were calculated for the energy-adjusted values. Weighted kappa statistics (κw) and the Bland–Altman technique were used to test the degree of agreement between the two dietary methods.SettingHeraklion, Crete, Greece, 2011–2012.SubjectsA total of ninety-nine mothers (corresponding to fifty-one boys and forty-eight girls) participated in the validation study.ResultsThe mean and median values of all food group and nutrient intakes did not differ significantly between the two dietary methods. Overall, fair agreement was observed between the FFQ and the food records for ranking participants based on their intake, with κw ranging from 0·21 to 0·40 for most foods and nutrients. On average, 88 % of participants were classified into the same or adjacent tertiles for nutrient and food group intakes by both dietary methods. The degree of agreement was also confirmed by the visual examination of the Bland–Altman plots.ConclusionsThe study indicates that the Rhea 4 years FFQ is a relatively accurate tool for assessing habitual food group and nutrient intakes among pre-school children in Crete, Greece.

Download Full-text

Relative validity of a 3 d estimated food record in German toddlers

Public Health Nutrition ◽

10.1017/s1368980012003230 ◽

2012 ◽

Vol 16 (4) ◽

pp. 645-652 ◽

Cited By ~ 10

Author(s):

Guo Cheng ◽

Annett Hilbig ◽

Claudia Drossard ◽

Ute Alexy ◽

Mathilde Kersting

Keyword(s):

Ascorbic Acid ◽

Rank Correlation ◽

Correlation Coefficients ◽

Reference Method ◽

Assessment Instrument ◽

Dietary Intakes ◽

Food Record ◽

Nutrient Intakes ◽

Relative Validity ◽

Acid Intake

AbstractObjectiveTo determine the relative validity of a 3 d estimated food record (EFR) used to assess energy and nutrient intakes in toddlers, using a 3 d weighed food record (WDR) as the reference method.DesignParents reported the food and beverage intakes of their children using an EFR concurrently with a WDR over three consecutive days. Estimation of mean differences, Spearman correlation coefficients, cross-classifications and Bland–Altman plots were used to assess the agreement between the intakes of energy and fourteen nutrients obtained from the EFR and the WDR.SettingData obtained from a representative sample of infants or toddlers in Germany.SubjectsSixty-seven toddlers aged 10–36 months who had completed an EFR for a 3 d recording period that corresponded to the WDR were included in the present analysis.ResultsEnergy and nutrient intakes did not differ between the EFR and the WDR, except for linoleic acid and retinol. For all dietary intakes, Spearman rank correlation coefficients between the EFR and the WDR ranged from 0·35 to 0·80 (P ≤ 0·004). The proportion of participants correctly classified into quartiles ranged from 75 % for ascorbic acid intake to 96 % for Fe intake, and the percentage of misclassification was 9 % or less. The weighed κ values ranking the participants ranged from 0·23 for ascorbic acid intake to 0·59 for Fe intake. The Bland–Altman plots indicated a good agreement for all dietary intakes estimated from the EFR.ConclusionsOur study suggests that this EFR is a valid assessment instrument for estimating the energy and nutrient intakes among toddlers at the group level.

Download Full-text

A Quantitative Food Frequency Questionnaire for Women in Southeast China: Development and Reproducibility

Asia Pacific Journal of Public Health ◽

10.1177/101053950501700108 ◽

2005 ◽

Vol 17 (1) ◽

pp. 29-35 ◽

Cited By ~ 23

Author(s):

M. Zhang ◽

CW Binns ◽

AH Lee

Keyword(s):

Food Frequency Questionnaire ◽

Eating Habits ◽

Chinese Women ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Food Group ◽

Kappa Statistics ◽

Food Frequency ◽

Southeast China ◽

Intraclass Correlation Coefficients

This study describes the development and reproducibility of a 128-item quantitative food frequency questionnaire (FFQ) to measure usual food consumption for women in southeast China. The FFQ was pre-tested using 51 Chinese women who recently migrated to Australia. Cronbach's alpha coefficient was 0.81 for internal consistency. The reliability of the FFQ was then assessed by another test-retest study. A sample of 41 women residing in southeast China was interviewed twice within 12 weeks. Intraclass correlation coefficients were moderate to high for mean food group consumption (0.43-0.96) and mean daily nutrient intakes (0.47-0.89). Kappa statistics for eating habits ranged from 0.27 to 0.89 in the test-retest. The mean ratio of energy intake to basal metabolic rate was 1.73 (S.D. 0.39) in both test and retest samples. The study confirmed that the FFQ method using standard containers is appropriate to assess dietary intake for women in southeast China. Asia Pac J Public Health 2005: 17(1): 29-35.

Download Full-text

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.

Download Full-text

Development and Validation of a Semiquantitative Food Frequency Questionnaire to Assess Dietary Intake in 40–65-Year-Old Mexican Women

Annals of Nutrition and Metabolism ◽

10.1159/000506920 ◽

2020 ◽

Vol 76 (1) ◽

pp. 73-82

Author(s):

Alexandra Tijerina ◽

Josep A. Tur

Keyword(s):

Pearson Correlation ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Reference Method ◽

Epidemiological Studies ◽

Test Method ◽

Mexican Women ◽

Food Groups ◽

Nutrient Intakes ◽

Food Frequency

Background and Aims: Food frequency questionnaires (FFQ) have been widely used in epidemiologic studies since 1990s, but instruments need to be validated. The aim of this work was to create and assess the validity and reproducibility of an interview administered FFQ to be used in a Mexican women’s bone health cohort study, located in Monterrey city, Mexico. Methods: Validation of FFQ formed by 11 food groups and 136 food and beverage items was performed on 40–65-year-old Mexican women (n = 200) by applying 2 FFQ (test method) and six 24-h dietary recalls (24hR, reference method; 1 per season on weekdays and 2 on weekends). Pearson correlation coefficient was calculated of both logs, transformed intakes and energy-adjusted nutrient intakes based on the residual method, and intraclass correlation coefficients were calculated. Results: The relative validity of FFQ against the average of six 24hR for intakes of energy, macronutrients, cholesterol, water, vitamins and minerals required for bone metabolism such as vitamin D, calcium, magnesium, phosphorus were obtained. Pearson coefficients of correlation show significance (p < 0.05) for the validity, 0.244–0.820 and 0.258–0.794, for energy-unadjusted and adjusted data, respectively. Reproducibility coefficients range 0.186–0.810 for energy-unadjusted data and 0.174–0.597 for energy-adjusted data. Most nutrients showed lower than 5% of misclassification. Conclusion: The designed 136-item FFQ shows acceptable validity and reproducibility, and it is useful to be applied on 40–65-year-old Mexican women for the estimation of nutrient intakes in epidemiological studies.

Download Full-text

Relative Validity and Reproducibility of a Quantitative Food Frequency Questionnaire for Adolescents with Type 1 Diabetes: Validity of a Food Frequency Questionnaire

International Journal of Endocrinology ◽

10.1155/2014/976508 ◽

2014 ◽

Vol 2014 ◽

pp. 1-11 ◽

Cited By ~ 2

Author(s):

Rosana de Moraes Borges Marques ◽

Amanda Cristine de Oliveira ◽

Sheylle Almeida da Silva Teles ◽

Maria Luiza Ferreira Stringuini ◽

Nélida Shimid Fornés ◽

...

Keyword(s):

Type 1 Diabetes ◽

Dietary Intake ◽

Food Frequency Questionnaire ◽

Pearson Correlation ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Food Frequency ◽

Relative Validity ◽

Intraclass Correlation Coefficients

Background.Food frequency questionnaires are used to assess dietary intake in epidemiological studies.Objective.The aim of the study was to assess the relative validity and reproducibility of a quantitative food frequency questionnaire (QFFQ) for adolescents with type 1 diabetes. Methods: Validity was evaluated by comparing the data generated by QFFQs to those of 24-hour recalls (24 hrs). QFFQs were applied twice per patient to assess reproducibility. Statistical analysis included performingt-tests, obtaining Pearson correlation coefficients when necessary, correcting measurements for randomness by the weightedkappamethod, calculating intraclass correlation coefficients, and generating Bland-Altman plots (P<0,05).Results.The total energy and nutrient intake as estimated by the QFFQs were significantly higher than those from 24 hrs. Pearson correlation coefficients for energy-adjusted, deattenuated data ranged from 0.32 (protein) to 0.75 (lipid, unsaturated fat and calcium). Weightedkappavalues ranged from 0.15 (vitamin C) to 0.45 (calcium). Bland-Altman plots indicated acceptable validity. As for reproducibility, intraclass correlation coefficients ranged from 0.24 (calcium) to 0.65 (lipid), and the Bland-Altman plots showed good agreement between the two questionnaires. Conclusion: The QFFQ presented an acceptable ability to classify correctly and with good reproducibility, adolescents with type 1 diabetes according to their levels of dietary intake.

Download Full-text