Refinement and validation of an FFQ developed to estimate macro- and micronutrient intakes in a south Indian population

Abstract Objective Potential error sources in nutrient estimation with the FFQ include inaccurate or biased recall and overestimation or underestimation of intake due to too many or too few items on the FFQ, respectively. Here we report the refinement of an FFQ that overestimated nutrient intake and its validation against multiple 24 h recalls. Study design Data on 2527 participants in south India (Trivandrum) were available for the original FFQ (OFFQ) that overestimated nutrient intake (132 food items). After excluding participants with implausible energy intake estimates (<2·72 MJ/d (<650 kcal/d), >15·69 MJ/d (>3750 kcal/d)) we ran stepwise regression analyses with selected nutrients as the outcomes and food intake (servings/d) as predictor variables (n 1867). From these results and expert consultation we refined the FFQ (RFFQ), and validated it by comparing intakes obtained with it and the mean of two 24 h recalls among 100 participants. Results The OFFQ overestimated usual daily nutrient intake before and after exclusions [for energy: 13·39 (sd 5·46) MJ (3201 (sd 1305) kcal) and 10·96 (sd 2·65) MJ (2619 (sd 634) kcal), respectively]. In stepwise analyses, fifty-seven food items explained 90 % of the variance in nutrients; we retained thirteen food items because participants consumed them at least twice monthly and twelve food items that local nutritionists recommended. Mean energy intake estimated from the RFFQ (eighty-two food items) was 7·94 (sd 2·05) MJ (1897 (sd 489) kcal). The de-attenuated correlations between mean 24 h recall and RFFQ intakes ranged from 0·25 (vitamin A) to 0·82 (fat). Conclusion We refined an FFQ that overestimated nutrient intake by shortening and redesigning, and validated it by comparisons with 24 h dietary recall data.

[1]  T. Jørgensen,et al.  Relative validity of a food frequency questionnaire used in the Inter99 study , 2008, European Journal of Clinical Nutrition.

[2]  S. Yusuf,et al.  Nutrient estimation from an FFQ developed for a black Zimbabwean population , 2005, Nutrix Journal.

[3]  E. Bhatia,et al.  Validation and reproducibility of a food frequency questionnaire to assess energy and fat intake in affluent north Indians. , 2005, The National medical journal of India.

[4]  S. Yusuf,et al.  Development of a semi-quantitative food frequency questionnaire for use in United Arab Emirates and Kuwait based on local foods , 2005, Nutrition journal.

[5]  F. Parvez,et al.  Validity of a food-frequency questionnaire for a large prospective cohort study in Bangladesh , 2004, British Journal of Nutrition.

[6]  D. Shahar,et al.  Selection of food items for inclusion in a newly developed food-frequency questionnaire , 2004, Public Health Nutrition.

[7]  V. McCormack,et al.  Validation of a food frequency questionnaire to assess macro- and micro-nutrient intake among South Asians in the United Kingdom , 2004, European journal of nutrition.

[8]  N. S. Fornés,et al.  Reproducibility and validity of a food-frequency questionnaire for use among low-income Brazilian workers , 2003, Public Health Nutrition.

[9]  S. Yusuf,et al.  Development and evaluation of cultural food frequency questionnaires for South Asians, Chinese, and Europeans in North America. , 2003, Journal of the American Dietetic Association.

[10]  H. Boeing,et al.  Portion size adds limited information on variance in food intake of participants in the EPIC-Potsdam study. , 2003, The Journal of nutrition.

[11]  J. Hébert,et al.  Development and testing of a quantitative food frequency questionnaire for use in Gujarat, India , 1999, Public Health Nutrition.

[12]  A. Katagiri,et al.  [Reproducibility and validity of a semi-quantitative food frequency questionnaire]. , 1998, [Nihon koshu eisei zasshi] Japanese journal of public health.

[13]  Ambady Ramachandran,et al.  Dietary profile of urban south Indians and its relations with glycaemic status. , 1998, Diabetes research and clinical practice.

[14]  K. Krishnaswamy,et al.  Development and testing of a quantitative food frequency questionnaire for use in Kerala, India , 1998, Public Health Nutrition.

[15]  S. Chadha,et al.  Dietary profile of adults in an urban & a rural community. , 1995, The Indian journal of medical research.

[16]  D Feskanich,et al.  Reproducibility and validity of food intake measurements from a semiquantitative food frequency questionnaire. , 1993, Journal of the American Dietetic Association.

[17]  W. Willett,et al.  Development and validation of a food frequency questionnaire in Spain. , 1993, International journal of epidemiology.

[18]  A. Tjønneland,et al.  Influence of individually estimated portion size data on the validity of a semiquantitative food frequency questionnaire. , 1992, International journal of epidemiology.

[19]  G A Colditz,et al.  Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. , 1992, American journal of epidemiology.

[20]  W. Willett,et al.  Contributions of specific foods to absolute intake and between-person variation of nutrient consumption. , 1991, Journal of the American Dietetic Association.

[21]  Stefani Striegel Food composition tables , 1988 .

[22]  W. Willett,et al.  Reproducibility and validity of a semiquantitative food frequency questionnaire. , 1985, American journal of epidemiology.

[23]  B. Shatenstein,et al.  Development and validation of a food frequency questionnaire. , 2007, Canadian journal of dietetic practice and research : a publication of Dietitians of Canada = Revue canadienne de la pratique et de la recherche en dietetique : une publication des Dietetistes du Canada.

[24]  D. Shahar,et al.  Development of a semi-quantitative Food Frequency Questionnaire (FFQ) to assess dietary intake of multiethnic populations , 2004, European Journal of Epidemiology.

[25]  X. Shu,et al.  Validity and reproducibility of the food frequency questionnaire used in the Shanghai Women's Health Study , 2004, European Journal of Clinical Nutrition.

[26]  Meera G. Jain Culture-specific food frequency questionnaires: Development for use in a cardiovascular study. , 1999, Canadian journal of dietetic practice and research : a publication of Dietitians of Canada = Revue canadienne de la pratique et de la recherche en dietetique : une publication des Dietetistes du Canada.

[27]  M. Singer,et al.  Nutritional Epidemiology , 2020, Definitions.

[28]  C. Gopalan,et al.  Nutritive value of Indian foods , 1971 .