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

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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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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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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Reproducibility of a food frequency questionnaire for adolescents

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2007000900026 ◽

2007 ◽

Vol 23 (9) ◽

pp. 2187-2196 ◽

Cited By ~ 28

Author(s):

Dirce Maria Lobo Marchioni ◽

Silvia Maria Voci ◽

Flávia Emília Leite de Lima ◽

Regina Mara Fisberg ◽

Betzabeth Slater

Keyword(s):

Vitamin C ◽

Food Frequency Questionnaire ◽

Extreme Values ◽

Intraclass Correlation ◽

Weighted Kappa ◽

Fat Intake ◽

Food Frequency ◽

Unsaturated Fat ◽

Total Fat ◽

The City

To assess the reproducibility of a validated 76-item food frequency questionnaire designed to estimate diet in adolescents (Adolescent Food Frequency Questionnaire - AFFQ) in the city of Sao Paulo, Brazil, a test-retest study was conducted (n = 49). Intraclass correlation coefficient (ICC), weighted kappa, and percentage of agreement were used in both crude and energy-adjusted nutrient intakes. Bland Altman plots were used to examine the limits of agreement for energy and macronutrients. The ICC ranged from 0.48 (carbohydrates) to 0.65 (vitamin C) in crude values and from 0.25 (total fat) to 0.58 (vitamin C) in adjusted values. Kappa values ranged from 0.28 (protein and fiber) to 0.56 (unsaturated fat). Bland Altman showed a trend towards larger difference in energy according to increased intake values and a bias towards extreme values for fat intake. The percent of individuals classified in the same category on the two occasions was on average 54.2%. By conclusion, the Adolescent Food Frequency Questionnaire showed reasonable reproducibility and can be used in studies that aim to classify groups into intake categories.

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

10.2196/preprints.9113 ◽

2017 ◽

Author(s):

Aurélie Affret ◽

Douae El Fatouhi ◽

Courtney Dow ◽

Emmanuelle Correia ◽

Marie-Christine Boutron-Ruault ◽

...

Keyword(s):

Large Scale ◽

Intraclass Correlation ◽

Daily Intake ◽

Correlation Coefficients ◽

Food Group ◽

Dietary Intakes ◽

Nutrient Intakes ◽

Food Frequency ◽

Relative Validity ◽

Reproducibility Study

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.

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Validity and reproducibility of a Food Frequency Questionnaire for German descendants living in Brazil

Revista de Nutrição ◽

10.1590/1678-9865202134e200048 ◽

2021 ◽

Vol 34 ◽

Author(s):

Graciella CHIARELLI ◽

Doroteia Aparecida HÖFELMANN ◽

João Luiz Gurgel Calvet da SILVEIRA ◽

Maria Urania ALVES ◽

Luciane Coutinho de AZEVEDO

Keyword(s):

Correlation Coefficient ◽

Intraclass Correlation Coefficient ◽

Food Frequency Questionnaire ◽

Intraclass Correlation ◽

Reference Method ◽

Weighted Kappa ◽

Target Population ◽

Weak Correlation ◽

Food Frequency ◽

Dietary Recall

ABSTRACT Objective This study evaluated reproducibility, relative validity, using a 24-hour recall questionnaire as a reference standard, and estimated calibration factors for a food frequency questionnaire adapted for use with German descendants living in Brazil. Methods The target population consisted of 50 volunteers, of both genders, aged over 20 years, living in a German colonization city in southern Brazil. The food frequency questionnaire was applied twice, in the first and third months of the investigation. During this period, three 24-hour recalls were applied, with an interval of one month between them. Reproducibility was estimated by the intraclass correlation coefficient. Validity was tested by the intraclass correlation coefficient, weighted kappa test and Bland-Altman method. Calibration factors were estimated using linear regression. Results Among the food frequency questionnaires, there was a strong correlation for energy and most of the nutrients corrected for energy. There was a weak correlation between a food frequency questionnaire and a 24-hour dietary recall. However, the exact concordance in the categorization in tertiles among the instruments ranged from 28% (vitamin A) to 52% (fiber and potassium). Gross values of the food frequency questionnaire were reduced with the calibration and approached the consumption data estimated by the 24-hour dietary recall. Conclusions The food frequency questionnaire showed good reproducibility, however, weak correlation with the 24-hour dietary recall. The calibration of the data obtained by the food frequency questionnaire brought them closer to the reference method.

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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.

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Statistical approaches for assessing the relative validity of a food-frequency questionnaire: use of correlation coefficients and the kappa statistic

Public Health Nutrition ◽

10.1079/phn2002429 ◽

2003 ◽

Vol 6 (3) ◽

pp. 313-321 ◽

Cited By ~ 234

Author(s):

LF Masson ◽

G MCNeill ◽

JO Tomany ◽

JA Simpson ◽

HS Peace ◽

...

Keyword(s):

Food Frequency Questionnaire ◽

Pearson Correlation ◽

Rank Correlation ◽

Correlation Coefficients ◽

Kappa Statistic ◽

Weighted Kappa ◽

Collaborative Group ◽

Spearman Correlation ◽

Food Frequency ◽

Relative Validity

AbstractObjective:To compare different statistical methods for assessing the relative validity of a self-administered, 150-item, semi-quantitative food-frequency questionnaire (FFQ) with 4-day weighed diet records (WR).Design:Subjects completed the Scottish Collaborative Group FFQ and carried out a 4-day WR. Relative agreement between the FFQ and WR for energy-adjusted nutrient intakes was assessed by Pearson and Spearman rank correlation coefficients, the percentages of subjects classified into the same and opposite thirds of intake, and Cohen's weighted kappa.Subjects:Forty-one men, mean age 36 (range 21-56) years, and 40 women, mean age 33 (range 19-58) years, recruited from different locations in Aberdeen, Scotland.Results:Spearman correlation coefficients tended to be lower than Pearson correlation coefficients, and were above 0.5 for 10 of the 27 nutrients in men and 17 of the 27 nutrients in women. For nutrients with Spearman correlation coefficients above 0.5, the percentage of subjects correctly classified into thirds ranged from 39 to 78%, and weighted kappa values ranged from 0.23 to 0.66.Conclusions:Both Spearman correlation coefficients and weighted kappa values are useful in assessing the relative validity of estimates of nutrient intake by FFQs. Spearman correlation coefficients above 0.5, more than 50% of subjects correctly classified and less than 10% of subjects grossly misclassified into thirds, and weighted kappa values above 0.4 are recommended for nutrients of interest in epidemiological studies.

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Reproducibility and Validity of a Food Frequency Questionnaire (FFQ) Developed for Middle-Aged and Older Adults in Semarang, Indonesia

Nutrients ◽

10.3390/nu13114163 ◽

2021 ◽

Vol 13 (11) ◽

pp. 4163

Author(s):

Ahmad Syauqy ◽

Diana Nur Afifah ◽

Rachma Purwanti ◽

Choirun Nissa ◽

Deny Yudi Fitranti ◽

...

Keyword(s):

Older Adults ◽

Correlation Coefficient ◽

Food Frequency Questionnaire ◽

Correlation Coefficients ◽

Reference Method ◽

Weighted Kappa ◽

Nutritional Epidemiology ◽

Kappa Statistics ◽

Middle Aged ◽

Food Frequency

We assessed the reproducibility and validity of a food frequency questionnaire (FFQ) among middle-aged and older adults in Semarang, Indonesia. A total of 259 subjects aged 40–80 years completed two FFQs (nine-month apart) and nine 24 h dietary recalls (24HDRs, as a reference method). The reproducibility of the FFQ was analyzed using correlation coefficient, intra-class correlation coefficient (ICC), weighted kappa statistics and misclassification analysis. The validity was estimated by comparing the data acquired from FFQ1 and 24HDRs. The crude Pearson’s correlation coefficients and ICC for total energy and nutrients between FFQ1 and FFQ2 ranged from 0.50 to 0.81 and 0.44 to 0.78, respectively. Energy adjustment decreased the correlation coefficients for most nutrients. The crude, energy-adjusted and de-attenuated correlation coefficients for FFQ1 and 24HDRs ranged from 0.41 to 0.70, 0.31 to 0.89 and 0.54 to 0.82, respectively. The agreement rates for the same or adjacent quartile classifications were 81.1–94.6% for two FFQs and 80.7–89.6% for FFQ1 and 24HDRs. The weighted kappa values were 0.21 to 0.42 for two FFQs and 0.20 to 0.34 for FFQ1 and 24HDRs. A positive mean difference was found in the Bland–Altman analyses for energy and macronutrients. The FFQ could be acceptable for nutritional epidemiology study among Indonesians.

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