Project description:To create a food frequency questionnaire specifically designed to capture the dietary habits of Saudis and test its validity and reliability. Methods: This investigation is a longitudinal, test-retest study conducted in King Saud University, Riyadh, Kingdom of Saudi Arabia between December 2015 and March 2016. A list of 140 food items was included in the questionnaire where a closed-ended and open-ended approach was used. Regarding past year food frequency consumption and 24 hours dietary recall, body weight and height were collected. Internal consistency, test-retest reliability, completeness of the food list, and criterion validity were assessed. Results: One-hundred and thirty eight participants were interviewed to complete the 24 hours dietary recall and the constructed questionnaire. Approximately 85% of the food items reported in the dietary recall were covered in the food frequency questionnaire. The association of body mass index with meats (regression coefficients: 2.28) and dairy products consumption frequency was statistically significant (regression coefficients: 2.31). A high overall reproducibility rate of the questionnaire was detected (Pearsons' correlation coefficient: 0.78 p less than 0.001). Conclusion: The developed questionnaire has a high reliability and reasonable validity, and suitable for use in nutritional epidemiological investigations in Saudi Arabia.
Project description:The objectives were to develop a Mediterranean oriented semi-quantitative food frequency questionnaire (FFQ) and evaluate its validity in measuring energy and nutrient intakes. For FFQ development, the main challenge was to merge food items and practices reflecting cultural Mediterranean preferences with other food choices ensuing from diet transition to more westernized dietary patterns. FFQ validity was evaluated by comparing nutrient intakes against the average of two 24-h dietary recalls for 179 pregnant women. Although the mean intake values for most nutrients and energy tended to be higher when determined by the FFQ, the Cohen's d was below 0.3. Bland-Altman plots confirmed the agreement between the two methods. Positive significant correlations ranged from 0.35 to 0.77. The proportion of women classified correctly was between 73.2% and 92.2%, whereas gross misclassification was low. Weighted kappa values were between 0.31 and 0.78, while intraclass correlation coefficients were between 0.49 and 0.89. Our methodological approach for the development and validation of this FFQ provides reliable measurements of energy, macro- and micronutrient intakes. Overall, our culture-specific FFQ could serve as a useful assessment tool in studies aiming at monitoring dietary intakes, especially in the Mediterranean region, where countries share common cultural dietary habits.
Project description:Diet is a recognized risk factor and cornerstone for chronic kidney disease (CKD) management; however, a tool to assess dietary intake among Bangladeshi dialysis patients is scarce. This study aims to validate a prototype Bangladeshi Hemodialysis Food Frequency Questionnaire (BDHD-FFQ) against 3-day dietary recall (3DDR) and corresponding serum biomarkers. Nutrients of interest were energy, macronutrients, potassium, phosphate, iron, sodium and calcium. The BDHD-FFQ, comprising 132 food items, was developed from 606 24-h recalls and had undergone face and content validation. Comprehensive facets of relative validity were ascertained using six statistical tests (correlation coefficient, percent difference, paired t-test, cross-quartiles classification, weighted kappa, and Bland-Altman analysis). Overall, the BDHD-FFQ showed acceptable to good correlations (p < 0.05) with 3DDR for the concerned nutrients in unadjusted and energy-adjusted models, but this correlation was diminished when adjusted for other covariates (age, gender, and BMI). Phosphate and potassium intake, estimated by the BDHD-FFQ, also correlated well with the corresponding serum biomarkers (p < 0.01) when compared to 3DDR (p > 0.05). Cross-quartile classification indicated that <10% of patients were incorrectly classified. Weighted kappa statistics showed agreement with all but iron. Bland-Altman analysis showed positive mean differences were observed for all nutrients when compared to 3DDR, whilst energy, carbohydrates, fat, iron, sodium, and potassium had percentage data points within the limit of agreement (mean ± 1.96 SD), above 95%. In summary, the BDHD-FFQ demonstrated an acceptable relative validity for most of the nutrients as four out of the six statistical tests fulfilled the cut-off standard in assessing dietary intake of CKD patients in Bangladesh.
Project description:BackgroundSurvivors of childhood acute lymphoblastic leukemia (cALL) experience cardiometabolic and bone complications after treatments. This study aimed at developing and validating an interview-administrated food frequency questionnaire (FFQ) that will serve to estimate the impact of nutrition in the development of long-term sequalea of French-Canadian cALL survivors.MethodsThe FFQ was developed to assess habitual diet, Mediterranean diet score, nutrients promoting bone health and antioxidants. It was validated using a 3-day food record (3-DFR) in 80 cALL survivors (50% male) aged between 11.4 and 40.1 years (median of 18.0 years). Reproducibility was evaluated by comparing FFQs from visit 1 and 2 in 29 cALL survivors.ResultsWhen compared to 3-DFR, the mean values for macro- and micronutrient intake were overestimated by our FFQ with the exception of lipid-related nutrients. Correlations between nutrient intakes derived from the FFQs and the 3-DFRs showed moderate to very good correlations (0.46-0.74). Intraclass correlation coefficients assessing FFQ reproducibility ranged from 0.62 to 0.92, indicating moderate to good reliability. Furthermore, classification into quartiles showed more than 75% of macro- and micronutrients derived from FFQs 1 and 2 classified into the same or adjacent quartile.ConclusionsOverall, our results support the reproducibility and accuracy of the developed FFQ to appropriately classify individuals according to their dietary intake. This validated tool will be valuable for future studies analyzing the impact of nutrition on cardiometabolic and bone complications in French-speaking populations.
Project description:We developed a culturally-specific Food Frequency Questionnaire (FFQ) to the Ethiopian context and evaluate its validity in comparison to two 24-h dietary recalls (24-HRs) of food and nutrient intake. To evaluate the validity of a culturally-specific FFQ against two 24-HRs, we used a paired t-test, Wilcoxon-signed-rank test, Correlation coefficients, cross-classification, κ and Bland-Altman analysis. The FFQ was obtained 15 d after the second 24-HR was completed. A total of 105 adults, of which 43 (41 %) were men and 62 (59 %) women, aged 20-65 years participated in this present study. Mean energy and macronutrient intake obtained from the FFQ were significantly higher than those obtained from the mean of two 24-HRs. For energy and nutrient intakes, the crude correlation ranged from 0⋅05 (total fat) to 0⋅49 (vitamin B1). The de-attenuated correlation ranged from to 0⋅10 (total fat) to 0⋅80 (vitamin A). For the majority of food groups, no significant difference was observed in the median intake of food and nutrients. Crude correlation for food groups ranged from 0⋅12 (egg) to 0⋅78 (legumes). The de-attenuated correlation ranged from 0⋅24 (egg) to 1⋅00 (meat/poultry/fish and dairy). The FFQ is valid to assess and rank individuals in terms of intake of most food groups according to high and low intake categories.
Project description:Analysis of dietary patterns and their role in long-term health is limited in phenylketonuria (PKU). Food frequency questionnaires (FFQ) are commonly used to assess habitual intake. A semi-quantitative 89-item FFQ with a portion size photographic booklet was developed for children with PKU as a tool for collecting data on habitual intake of foods, food groups, energy and macronutrient intake. Twenty children with PKU aged 11−16 years, 30 parents of children with PKU aged 4−10 years, and 50 age/gender-matched control children were recruited. To test reproducibility, FFQs were completed twice with a mean interval of 5 weeks (range: 4−10). In order to test validity, FFQs were compared with five 24-h dietary recalls with a mean interval of 10 days (range: 6−18). Energy and macronutrient intake and quantity/week of individual food items were calculated and compared. There was good reproducibility for the FFQ with macronutrient correlations r > 0.6 and good validity data with most correlations r > 0.5. Bland−Altman plots for reproducibility and validity showed mean levels close to 0 and usually within 2 standard deviations. FFQ comparisons of PKU and control groups identified expected differences in % energy from macronutrients (PKU vs. control: carbohydrate 59% vs. 51%, fat 26% vs. 33%, protein 15% vs. 16%). This FFQ for PKU produced comparable data to repeated dietary recalls and is a valid tool for collecting data on habitual food and nutrient intake. It will be useful in assessing changes in dietary phenylalanine tolerance of new pharmacological treatments for PKU.
Project description:Background and objectiveA culture-specific web-based food frequency questionnaire (FFQ) to assess dietary intake in the United Arab Emirates (UAE) adult population was developed using data from the 2009-2010 national nutrition survey. The objective of this study was to assess the relative validity of the newly developed FFQ for use in the adult Emirati population (AE-FFQ), which contained a list of 139 food lines.MethodsA convenient sample of 60 (36 females and 24 males) adult Emiratis completed 3 non-consecutive 24HRs over a period of one month, followed by the AE-FFQ, which assessed the intake over the previous month. Relative validity was evaluated by comparing nutrient and food group intakes from the AE-FFQ with the average three 24HRs using Wilcoxon signed-rank tests, Spearman's correlation coefficients (CC), Bland-Altman analysis, and cross-classification.ResultsThe AE-FFQ overestimated energy and most nutrients and food groups. Bland-Altman analysis showed significant proportional bias between the 2 methods. Deattenuated energy-adjusted Spearman correlation coefficients were poor to good ranging from 0.06 (iron) to 0.62 (fiber) for nutrients, 0.39 median value, and from -0.01 (cruciferous vegetables) to 0.64 (eggs) for food groups, 0.41 median value. A fairly acceptable agreement was obtained, with correct classification into the same or adjacent quartile ranging from 34% (vitamin B12) to 78% (pyridoxine), median 69% for nutrients and from 55% (diet soft drinks) to 87% (soft drinks), median 67% for food groups.ConclusionsThe AE-FFQ is an acceptable tool for ranking UAE adults (aged 18 to 50) according to their dietary intake to investigate the role of Emirati dietary patterns on health and disease. Caution is needed for assessing absolute intake, however, given the bias observed in assessing group-level agreement.
Project description:Background:Food frequency questionnaires (FFQs) are used to estimate the usual food and nutrient intakes over a period of time. Such estimates can suffer from measurement errors, either due to bias induced by respondent's answers or to errors induced by the structure of the questionnaire (e.g., using a limited number of food items and an aggregated food database with average portion sizes). The "structural validation" presented in this study aims to isolate and quantify the impact of the inherent structure of a FFQ on the estimation of food and nutrient intakes, independently of respondent's perception of the questionnaire. Methods:A semi-quantitative FFQ (n?=?94 items, including 50 items with questions on portion sizes) and an associated aggregated food composition database (named the item-composition database) were developed, based on the self-reported weekly dietary records of 1918 adults (18-79 years-old) in the French Individual and National Dietary Survey 2 (INCA2), and the French CIQUAL 2013 food-composition database of all the foods (n?=?1342 foods) declared as consumed in the population. Reference intakes of foods ("REF_FOOD") and nutrients ("REF_NUT") were calculated for each adult using the food-composition database and the amounts of foods self-reported in his/her dietary record. Then, answers to the FFQ were simulated for each adult based on his/her self-reported dietary record. "FFQ_FOOD" and "FFQ_NUT" intakes were estimated using the simulated answers and the item-composition database. Measurement errors (in %), spearman correlations and cross-classification were used to compare "REF_FOOD" with "FFQ_FOOD" and "REF_NUT" with "FFQ_NUT". Results:Compared to "REF_NUT," "FFQ_NUT" total quantity and total energy intake were underestimated on average by 198?g/day and 666 kJ/day, respectively. "FFQ_FOOD" intakes were well estimated for starches, underestimated for most of the subgroups, and overestimated for some subgroups, in particular vegetables. Underestimation were mainly due to the use of portion sizes, leading to an underestimation of most of nutrients, except free sugars which were overestimated. Conclusion:The "structural validation" by simulating answers to a FFQ based on a reference dietary survey is innovative and pragmatic and allows quantifying the error induced by the simplification of the method of collection.
Project description:The measurement of vitamin D nutritional status through dietary assessment is cost effective. Food frequency questionnaire (FFQ) is usually validated against food records (FR). There is no vitamin D-specific FFQ for Qatar population. The objective of this study was to develop a vitamin D-centric FFQ and validate FFQ against three-day FR for Qatar population. A quantitative FFQ based on vitamin D containing foods consumed in Qatar was developed. Vitamin D contents of foods were gathered from food labels and food composition tables from the United States Department of Agriculture. A vitamin D content database was developed for this study purpose. Dietary intakes while using FFQ and three-day FR were collected from 62 women. Vitamin D intakes from FFQ and three-day FR were validated with quartile comparison and Bland-Altman (BA) tests. BA plot showed an agreement between FFQ and three-day FR vitamin D intakes. The BA index was 3.23%, which is <5%, a commonly used standard for validation. Quartile correlation showed that ?73% of subjects were within the same or adjacent quartile. In conclusion, an agreement was found between vitamin D intakes from FFQ and three-day FR in Qatari women. More studies are needed to validate the vitamin D-specific FFQ in Qatari population at large.
Project description:BackgroundFood Frequency Questionnaires (FFQs) are commonly used in epidemiologic studies to assess long-term nutritional exposure. Because of wide variations in dietary habits in different countries, a FFQ must be developed to suit the specific population. Sri Lanka is undergoing nutritional transition and diet-related chronic diseases are emerging as an important health problem. Currently, no FFQ has been developed for Sri Lankan adults. In this study, we developed a FFQ to assess the regular dietary intake of Sri Lankan adults.MethodsA nationally representative sample of 600 adults was selected by a multi-stage random cluster sampling technique and dietary intake was assessed by random 24-h dietary recall. Nutrient analysis of the FFQ required the selection of foods, development of recipes and application of these to cooked foods to develop a nutrient database. We constructed a comprehensive food list with the units of measurement. A stepwise regression method was used to identify foods contributing to a cumulative 90% of variance to total energy and macronutrients. In addition, a series of photographs were included.ResultsWe obtained dietary data from 482 participants and 312 different food items were recorded. Nutritionists grouped similar food items which resulted in a total of 178 items. After performing step-wise multiple regression, 93 foods explained 90% of the variance for total energy intake, carbohydrates, protein, total fat and dietary fibre. Finally, 90 food items and 12 photographs were selected.ConclusionWe developed a FFQ and the related nutrient composition database for Sri Lankan adults. Culturally specific dietary tools are central to capturing the role of diet in risk for chronic disease in Sri Lanka. The next step will involve the verification of FFQ reproducibility and validity.