Relative validity of a web-based food frequency questionnaire for patients with type 1 and type 2 diabetes in Denmark

Abstract

Background:Diet has an important role in the management of diabetes. However, little is known about dietary intake in Danish diabetes patients. A food frequency questionnaire (FFQ) focusing on most relevant nutrients in diabetes including carbohydrates, dietary fibres and simple sugars was developed and validated.Objectives:To examine the relative validity of nutrients calculated by a web-based food frequency questionnaire for patients with diabetes.Design:The FFQ was validated against a 4-day pre-coded food diary (FD). Intakes of nutrients were calculated. Means of intake were compared and cross-classifications of individuals according to intake were performed. To assess the agreement between the two methods, Pearson and Spearman's correlation coefficients and weighted kappa coefficients were calculated.Subjects:Ninety patients (64 with type 1 diabetes and 26 with type 2 diabetes) accepted to participate in the study. Twenty-six were excluded from the final study population.Setting:64 volunteer diabetes patients at the Steno Diabetes Center.Results:Intakes of carbohydrates, simple sugars, dietary fibres and total energy were higher according to the FFQ compared with the FD. However, intakes of nutrients were grossly classified in the same or adjacent quartiles with an average of 82% of the selected nutrients when comparing the two methods. In general, moderate agreement between the two methods was found.Conclusion:The FFQ was validated for assessment of a range of nutrients. Comparing the intakes of selected nutrients (carbohydrates, dietary fibres and simple sugars), patients were classified correctly according to low and high intakes. The FFQ is a reliable dietary assessment tool to use in research and evaluation of patient education for patients with diabetes.

Development and relative validation of a short food frequency questionnaire for assessing dietary intakes of non-alcoholic fatty liver disease patients

“…The relative validity of our newly developed SFFQ was examined in relation to 4DDDs from 55 NAFLD patients, focusing on results for sugar, fat, fruit, and vegetables. This approach to validation of dietary assessment tools has been extensively utilised in the literature [18,[39][40][41][42]. Correlations between the two instruments for sugar, fat and fruit were highly significant and all nutrients had moderate correlation coefficients (0.4-0.51) very much in line with, or better than, reported correlations in comparable studies.…”

Dietary habits and adherence to dietary recommendations in patients with type 1 and type 2 diabetes compared with the general population in Denmark

“…Dietary intake of total energy, energy-contributing macronutrients and foods in patients with diabetes was assessed using a web-based semi-quantitative food frequency questionnaire (FFQ) whereas dietary intake in the general population based on DANSDA data was assessed using a precoded food diary. In collaboration with the National Food Institute, we have previously performed a study of the relative validity of the FFQ in patients with diabetes against the food diary used in DANSDA (12). The FFQ covers intake in the previous three months and consists of 270 food items and mixed dishes.…”

“…The FFQ is a retrospective method for assessment of dietary intake where biases caused by errors in memory and perception of portion sizes of food are main issues, why our FFQ was only based on the last three months, an HbA1c period, in order to reduce the risk of memory bias. Our FFQ also included photos with the option of choosing habitual portion sizes instead of using predefined standard portion sizes as done in most FFQs, and we have previously performed a validation of our FFQ against the food diary used in DANSDA and found good alignment between the two dietary assessments methods (12). Our FFQ and the food diary used in DANSDA are based on the same principles using the same software system at the National Food Institute.…”

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

“…Web-based dietary assessments provide a lot of advantages [ 19 , 20 ]: they have the potential to save time and financial resources, may be preferred by participants, and response quality can be improved directly by including cutoff values and alert messages in case of inconsistencies, abnormal or missing data. Several examples of 24-hour recall and Web-based FFQs already exist in the literature [ 21 - 26 ]. Because 24-hour recalls need to be repeated to assess the overall diet, Web-based FFQs might be more feasible in large-scale studies.…”