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      Validity and reliability of a simplified food frequency questionnaire: a cross sectional study among physical health examination adults in southwest region of China

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          Abstract

          Background

          In China, many people are regarded suitable for participating in regular physical examination for diagnosis and prevention of diseases. Some simplified food frequency questionnaires have been designed and used; however, the accuracy of the questionnaire is absent. This study aimed to examine the reliability and validity of simplified food frequency questionnaire (SFFQ) used among adults undergoing physical examination in southwest region of China.

          Methods

          This was a cross-sectional study conducted among physical health examination adults in the Southwest region of China. A total of 239 participants aged 20–65 were included from February 2019 to June 2019. The performance of SFFQ was evaluated by means of a three-day 24-h dietary record (3R24). The relative validity and agreement was assessed by Pearson’s correlation and intra-class correlation coefficients ( ICC), respectively.

          Results

          The median energy-adjusted ICC of food groups between SFFQ2 and SFFQ1 was 0.59 (range: 0.49–0.73) and the ICC of nutrients was 0.47(range: 0.39–0.76). The Pearson correlation showed a valid comparisons between SFFQ1 and 3R24, ranging from -0.086 to 0.93 for food and 0.21 to 0.71 for nutrition, respectively. The energy-adjustment slightly increased the correlation coefficients.

          Conclusions

          The reliability and validity of SFFQ was acceptable, and it could be an appropriate dietary assessment tool for the future epidemiological studies conducted among physical health examination adults of southwest China.

          Trial registration

          CHiCTR, ChiCTR1900020934, Registered 22 January 2019, https://www.chictr.org.cn/edit.aspx?pid=35414&htm=4 .

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          Most cited references14

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          A Dish-based Semi-quantitative Food Frequency Questionnaire for Assessment of Dietary Intakes in Epidemiologic Studies in Iran: Design and Development

          Background: Earlier forms of food frequency questionnaire (FFQ) used in Iran have extensive lists of foods, traditional categories and food-based design, mostly with the interviewer-administered approach. The aim of the current paper is to describe the development of a dish-based, machine-readable, semi-quantitative food frequency questionnaire (DFQ). Methods: Within the framework of the Study on the Epidemiology of Psychological, Alimentary Health and Nutrition project, we created a novel FFQ using Harvard FFQ as a model. Results: The following steps were taken to develop the questionnaire: Construction of a list of commonly consumed Iranian foods, definition of portion sizes, design of response options for consumption frequency of each food item and finally a pilot test of the preliminary DFQ. From a comprehensive list of foods and mixed dishes, we included those that were nutrient-rich, consumed reasonably often or contributed to between-person variations. We focused on mixed dishes, rather than their ingredients, along with foods. To shorten the list, the related food items or mixed dishes were categorized together in one food group. These exclusions resulted in a list of 106 foods or dishes in the questionnaire. The portion sizes used in the FFQ were obtained from our earlier studies that used dietary recalls and food records. The frequency response options for the food list varied from 6-9 choices from “never or less than once a month” to “12 or more times per day”. Conclusions: The DFQ could be a reasonable dietary assessment tool for future epidemiological studies in the country. Validation studies are required to assess the validity and reliability of this newly developed questionnaire.
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            Adaptation and validation of a food frequency questionnaire (FFQ) to assess dietary intake in Moroccan adults

            Background To date, no culture-specific food frequency questionnaires (FFQ) are available in North Africa. The aim of this study was to adapt and examine the reproducibility and validity of an FFQ or use in the Moroccan population. Methods The European Global Asthma and Allergy Network (GA2LEN) FFQ was used to assess its applicability in Morocco. The GA2LEN FFQ is comprised of 32 food sections and 200 food items. Using scientific published literature, as well as local resources, we identified and added foods that were representative of the Moroccan diet. Translation of the FFQ into Moroccan Arabic was carried out following the World Health Organization (WHO) standard operational procedure. To test the validity and the reproducibility of the FFQ, 105 healthy adults working at Hassan II University Hospital Center of Fez were invited to answer the adapted FFQ in two occasions, 1 month apart, and to complete three 24-h dietary recall questionnaires during this period. Pearson correlation, and Bland-Altman plots were used to assess validity of nutrient intakes. The reproducibility between nutrient intakes as reported from the first and second FFQ were calculated using intra-class correlation coefficient (ICC). All nutrients were log-transformed to improve normality and were adjusted using the residual method. Results The adapted FFQ was comprised of 255 items that included traditional Moroccan foods. Eighty-seven adults (mean age 27.3 ± 5.7 years) completed all the questionnaires. For energy and nutrients, the intakes reported in the FFQ1 were higher than the mean intakes reported by the 24-h recall questionnaires. The Pearson correlation coefficients between the first FFQ and the mean of three 24-h recall questionnaires were statistically significant. For validity, de-attenuated correlations were all positive, statistically significant and ranging from 0.24 (fiber) to 0.93 (total MUFA). For reproducibility, the ICCs were statistically significant and ranged between 0.69 for fat and 0.84 for Vitamin A. Conclusion This adapted FFQ is an acceptable tool to assess usual dietary intake in Moroccan adults. Given its representativeness of local food intake, it can be used as an instrument to investigate the role of diet on health and disease outcomes.
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              Development of a Semi-Quantitative Food Frequency Questionnaire to Assess the Dietary Intake of a Multi-Ethnic Urban Asian Population

              Assessing habitual food consumption is challenging in multi-ethnic cosmopolitan settings. We systematically developed a semi-quantitative food frequency questionnaire (FFQ) in a multi-ethnic population in Singapore, using data from two 24-h dietary recalls from a nationally representative sample of 805 Singapore residents of Chinese, Malay and Indian ethnicity aged 18–79 years. Key steps included combining reported items on 24-h recalls into standardized food groups, developing a food list for the FFQ, pilot testing of different question formats, and cognitive interviews. Percentage contribution analysis and stepwise regression analysis were used to identify foods contributing cumulatively ≥90% to intakes and individually ≥1% to intake variance of key nutrients, for the total study population and for each ethnic group separately. Differences between ethnic groups were observed in proportions of consumers of certain foods (e.g., lentil stews, 1%–47%; and pork dishes, 0%–50%). The number of foods needed to explain variability in nutrient intakes differed substantially by ethnic groups and was substantially larger for the total population than for separate ethnic groups. A 163-item FFQ covered >95% of total population intake for all key nutrients. The methodological insights provided in this paper may be useful in developing similar FFQs in other multi-ethnic settings.
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                Author and article information

                Contributors
                xintinli@163.com
                Journal
                Nutr J
                Nutr J
                Nutrition Journal
                BioMed Central (London )
                1475-2891
                6 October 2020
                6 October 2020
                2020
                : 19
                : 114
                Affiliations
                [1 ]GRID grid.410646.1, ISNI 0000 0004 1808 0950, Department of Pathology, , Eastern Hospital, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, ; Chengdu, 610072 China
                [2 ]GRID grid.410646.1, ISNI 0000 0004 1808 0950, Health Management Center, , Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, ; Chengdu, 610072 China
                [3 ]GRID grid.54549.39, ISNI 0000 0004 0369 4060, School of Medicine, , University of Electronic Science and Technology of China, ; Chengdu, 611731 China
                Article
                630
                10.1186/s12937-020-00630-z
                7541293
                33023588
                32638b3b-25fc-4489-9ec4-8ed07a3500d4
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 6 February 2020
                : 30 September 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100009579, Health Department of Sichuan Province;
                Award ID: 18PJ585
                Award ID: 2018-228
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2020

                Nutrition & Dietetics
                physical health examination,sffq,epidemiological studies,southwest china,validity,reliability

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