Validation of the European Prospective Investigation into Cancer (EPIC) FFQ for use among adults in Lebanon

Abstract

Objective: To validate the EPIC food frequency questionnaire (FFQ) in Lebanon. Design: Validation of the EPIC FFQ was done against three 24-hour recalls. Unadjusted and energy adjusted correlations, Bland Altman plots, and weighed kappa statistics were used to assess the agreement between the two methods. Setting: Lebanon. Participants: 119 adults (staff and students) at a Lebanese University. Results: Good unadjusted and energy-adjusted correlation coefficients were found between data from the two methods which ranged from −0.002 (vitamin A) to 0.337 (carbohydrates) and were all statistically significant except for vitamin D, vitamin E, vitamin A, selenium, and niacin. Slight/fair agreement was reported through weighed kappa estimates for unadjusted data ranging from −0.05 (vitamin C) to 0.248 (magnesium) and for energy-adjusted data ranging from −0.034 (vitamin A) to 0.203 (phosphorus). Individuals were categorised into exact and adjacent quartiles with an average of 78% for unadjusted data and 70% for energy-adjusted data, indicating a very good agreement between the EPIC FFQ and the average of the 24-HRs data. The visual inspection of the Bland-Altman plots revealed an over-estimation of energy, carbohydrates, protein, and fat intakes by the FFQ method. Conclusion: Overall, when all tests were taken into consideration, this study demonstrated an acceptable agreement of the EPIC FFQ with the 24-hour dietary recall method and significantly good correlations between dietary intakes. Therefore, the EPIC FFQ can be considered a valid tool for assessing diet in epidemiological studies among Lebanese adults.

Development and Validation of a Food Frequency Questionnaire for Evaluating the Nutritional Status of Patients with Cancer

“…In our study, the FFQ tended to slightly overestimate nutrient intake compared to dietary records, especially energy and carbohydrates. However, this overestimation has also been found in previous studies [ 32 , 36 , 37 , 38 , 39 ].…”

“…In a German cohort of EPIC, the FFQ had fairly good validity and reproducibility for most nutrients with 24 h dietary recall data [ 25 ], and the Netherlands Diet and Cancer cohort also reported that the FFQ correlated well with the overall dietary record [ 31 ]. A validation study of adults in Lebanon demonstrated that the FFQ is a suitable method for assessing dietary intake, as it correlates fairly well with nutrient estimates of 24 h dietary recall and is appropriate for evaluating dietary intake in a large population [ 32 ]. In addition, the American Cancer Society used the FFQ in the Cancer Prevention Study-3 cohort study to assess the quality of diet in participants according to cancer prevention diet guidelines.…”

Identifying health research in the era of COVID-19: A scoping review

“…Cancer studies continued to take place during COVID-19 pandemic knowing that cancer is still considered to be the top leading cause of deaths worldwide that needs crucial and permanent assessment. 68 , 69 Some studies described the possible treatment options of pediatric cancers such as brain tumors, leukemia, fetal and placental cancers and reported the importance of collecting cases from multiple institutions using a standardized case report form in increasing awareness of the occurrence of metastases and the role of systemic therapies. 70 – 75 Other researchers were interested in other types of cancers that were reviewed thoroughly along with their pathogenesis and possible treatment pathways.…”

Cross-cultural adaptation and reproducibility of the EPIC-Norfolk food frequency questionnaire in young people living in Croatia

“…The reliability of the Croatian FFQ was satisfactory for all groups, with Cronbach alpha values around 0.8-0.9 ( 18 ). The EPIC Norfolk FFQ was originally intended for the adult population in the UK and was previously validated for children and adolescents in Italy ( 10 ), Lebanon ( 11 ), Kazakhstan ( 24 ), and Romania ( 25 ).…”

“…Although the EPIC-Norfolk FFQ was designed primarily for the adult population in the UK, the food list is similar to that from the national food consumption survey in Croatia conducted in 2011 and 2012 ( 9 ). The EPIC Norfolk FFQ was validated for children and adolescents in Italy ( 10 ) and in young adults in Lebanon ( 11 ).…”