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Validity and Reliability of a Water Frequency Questionnaire to Estimate Daily Total Water Intake in Adults.

ABSTRACT: The purpose of this investigation was to assess the validity and reliability of a seven-day water frequency questionnaire (TWI-FQ) to estimate daily total water intake (TWI) in comparison to a water turnover objective reference value via deuterium oxide (D₂O). Data collection occurred over 3 weeks, with a wash-out period during week two. Healthy adults (n = 98; 52% female; 41 ± 14 y; BMI, 26.4 ± 5.5 kg·m^-2) retrospectively self-reported consumption frequencies of 17 liquids and 35 foods with specified volumes/amounts for weeks one and three via TWI-FQ. Standard water content values were utilized to determine the volume of water consumed from each liquid and food for calculation of mean daily TWI for each week. Diet records were completed daily during week two to estimate metabolic water production. To assess validity of the TWI-FQ, participants consumed D₂O at the start of each week and provided urine samples immediately before ingestion, the following day, and at the end of the week to calculate water turnover. Metabolic water was subtracted from water turnover to estimate TWI. TWI-FQ validity was assessed via Bland-Altman plot for multiple observations. Reliability was assessed via intraclass correlation and Pearson's correlation between weeks. TWI-FQ significantly underestimated D₂O TWI by -350 ± 1,431 mL·d^-1 (95% confidence interval (CI): -551, -149 mL·d^-1). TWI-FQ TWI was significantly correlated (r = 0.707, P <0.01) and not different (198 ± 1,180 mL·d^-1, 95% CI: -38, 435 mL·d^-1) between weeks. TWI-FQ intraclass correlation = 0.706 was significant [95% CI: 0.591, 0.793; F _{(97, 98)} = 5.799], indicating moderate test-retest reliability. While this tool would not be suitable for individual TWI assessment, the magnitude of bias may be acceptable for assessment at the sample-level.

SUBMITTER: Colburn AT

PROVIDER: S-EPMC8236537 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Nutritional status during childhood is critical given its effect on growth and development as well as its association with disease risk later in life. The Middle East and North Africa (MENA) region is experiencing alarming rates of childhood malnutrition, both over- and under-nutrition. Hence, there is a need for valid tools to assess dietary intake for children in this region. To date, there are no validated dietary assessment tools for children in any country of the MENA region. The main objective of this study was to examine the validity and reliability of a Food Frequency Questionnaire (FFQ) for the assessment of dietary intake among Lebanese children.Children, aged 5 to 10 years (n = 111), were recruited from public and private schools of Beirut, Lebanon. Mothers (proxies to report their children's dietary intake) completed two FFQs, four weeks apart. Four 24-hour recalls (24-HRs) were collected weekly during the duration of the study. Spearman correlations and Bland-Altman plots were used to assess validity. Linear regression models were used to derive calibration factors for boys and girls. Reproducibility statistics included Intraclass Correlation Coefficient (ICC) and percent agreement.Correlation coefficients between dietary intake estimates derived from FFQ and 24-HRs were significant at p < 0.001 with the highest correlation observed for energy (0.54) and the lowest for monounsaturated fatty acids (0.26). The majority of data points in the Bland-Altman plots lied between the limits of agreement, closer to the middle horizontal line. After applying the calibration factors for boys and girls, the mean energy and nutrient intakes estimated by the FFQ were similar to those obtained by the mean 24-HRs. As for reproducibility, ICC ranged between 0.31 for trans-fatty acids and 0.73 for calcium intakes. Over 80 % of study participants were classified in the same or adjacent quartile of energy and nutrients intake.Findings of this study showed that the developed FFQ is reliable and is also valid, when used with calibration factors. This FFQ is a useful tool in dietary assessment and evaluation of diet-disease relationship in this age group.

Project description:BackgroundFood frequency questionnaires (FFQ) is an easy and inexpensive tool that can be used to evaluate nutrient and dietary trends of groups and individuals. Few studies in the East Mediterranean region tailored FFQs to describe dietary intakes of older adults. The purpose of the study is therefore to assess the validity and reproducibility of a FFQ, designed for use with older adults living in a Mediterranean Arabic speaking country, Lebanon.MethodsThe FFQ is composed of a list of 90 food items, commonly consumed by adults above 60 years of age. Validity of the FFQ was tested using the mean of two 24-hours dietary recalls (24HDR), and reproducibility, by repeating the questionnaire within a one-month period, along the second dietary recall. Our study included 42 and 76 participants, for the repoducibility and validity analysis respectively. Subjects were randomly selected from 2 of the 8 governorates in the country.ResultsFFQ reproducibility showed a mean relative difference of 1.03% without any significant difference between all paired components of nutrients. Intra class correlation (ICC) showed good and excellent reliability for caloric intake and all macronutrients, moderate to good reliability for all remaining nutrients, except for poly-unsaturated fatty acids, vitamins A, B12 and fibers. Correlation coefficients for all nutrients were fair to strong. Both administrations of the FFQ showed good internal validity. Validation of FFQ showed a mean relative difference between FFQ and mean 24HDR at 19.5%. Agreements between the 2 methods, for classifying individuals in the same or adjacent quartile, for nutrient intake and nutrient adequacy, were 80 and 78.2% respectively. Mean Kappa coefficient was 0.56 and energy-adjusted correlations were within the recommended values for all items except for vitamin A and B12. Adjusting for nutrient-dense food intake improved the agreement for theses 2 vitamins to 0.49 and 0.56, respectively.ConclusionThe proposed FFQ can be considered a valid tool to help describe nutrient intake of older individuals in an Arabic speaking Mediterranean country. It could serve for possible use in the East Mediterranean region for the evaluation of regular dietary intake of community-dwelling older adults.

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Validity and Reliability of a Water Frequency Questionnaire to Estimate Daily Total Water Intake in Adults.

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