Validation of a Dish-Based Semiquantitative Food Questionnaire in Rural Bangladesh

Abstract

A locally validated tool was needed to evaluate long-term dietary intake in rural Bangladesh. We assessed the validity of a 42-item dish-based semi-quantitative food frequency questionnaire (FFQ) using two 3-day food diaries (FDs). We selected a random subset of 47 families (190 participants) from a longitudinal arsenic biomonitoring study in Bangladesh to administer the FFQ. Two 3-day FDs were completed by the female head of the households and we used an adult male equivalent method to estimate the FD for the other participants. Food and nutrient intakes measured by FFQ and FD were compared using Pearson’s and Spearman’s correlation, paired t-test, percent difference, cross-classification, weighted Kappa, and Bland–Altman analysis. Results showed good validity for total energy intake (paired t-test, p < 0.05; percent difference <10%), with no presence of proportional bias (Bland–Altman correlation, p > 0.05). After energy-adjustment and de-attenuation for within-person variation, macronutrient intakes had excellent correlations ranging from 0.55 to 0.70. Validity for micronutrients was mixed. High intraclass correlation coefficients (ICCs) were found for most nutrients between the two seasons, except vitamin A. This dish-based FFQ provided adequate validity to assess and rank long-term dietary intake in rural Bangladesh for most food groups and nutrients, and should be useful for studying dietary-disease relationships.

Validity and reliability of a dish-based semi-quantitative food frequency questionnaire for assessment of energy and nutrient intake among Iranian adults

“…Generally, FFQs are used for ranking individuals according to food or nutrient intake rather than for estimating absolute amounts of intake. In this regard, we used cross-classification analysis whose results for the majority of nutrients were promising, in which approximately more than 60% of participants were classified in the correct quartiles, which is consistent with other studies [12,20,26].…”

“…Therefore, it is very challenging, if not impossible, to estimate usual intake of single ingredients through an FFFQ. Several international studies have developed DFFQs for epidemiological studies [3,16,20]. However, there were some limitations namely not considering seasonal variations of foods [3], the generalizability [16,20], and the gold standards affairs which have limited their usage as a valid tool.…”

Development and Validation of Food Frequency Questionnaire for Food and Nutrient Intake of Adults in Butajira, Southern Ethiopia

“…We observed a moderate to good correlation for almost all food groups according to the previous cutoff point (5). This is in good agreement with previous validation studies assessing food group intakes (8,10,19,20). The good correlation found for vegetable intakes in our study is higher than those reported by other validation studies (8,10,12).…”

“…FFQ showed a fair quartile classi cation agreement for cereals, legumes, and roots and tubers (K values 0.2-0.6). Similarly, other studies reported a fair classi cation agreement for this particular food group (13,19). For beverage intake, our study indicated a misclassi cation (30.5%) into opposite quartile supported by low kappa value (k value <0.2) showing the poor outcome.…”

“…For beverage intake, our study indicated a misclassi cation (30.5%) into opposite quartile supported by low kappa value (k value <0.2) showing the poor outcome. Other study reported a similar nding for beverage intake (19).…”