Validity and Reliability of a Food Frequency Questionnaire (FFQ) to Assess Dietary Intake of Preschool Children

Hafizah, Yatiman Noor; Ang, Lee Choo; Yap, Fendy; Najwa, Wan Nurul; Cheah, Whye Lian; Ruzita, A. T.; Jumuddin, Farra Aidah; Koh, Denise; Lee, Julia Ai Cheng; Essau, Cecilia A.; Reeves, Sue; Summerbell, Carolyn; Gibson, E.L.; Poh, Bee Koon

doi:10.3390/ijerph16234722

Cited by 44 publications

(35 citation statements)

References 36 publications

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“…Conversely, for apps that function solely as diet trackers, their credibility was assessed primarily through the accuracy of their food databases. A total of 20 food items (ie, four food items per major food group: cereals, protein, vegetables, fruits, and fat), which represent an average number of food items consumed by a person per day [ 27 ], were randomly selected for comparison using cross-classification analysis, which is a widely used method to assess agreement in validation studies involving food nutrients [ 28 , 29 ]. Apps that showed more than 7% gross misclassification [ 30 ] were considered not credible.…”

Section: Methodsmentioning

confidence: 99%

Limitations of Existing Dialysis Diet Apps in Promoting User Engagement and Patient Self-Management: Quantitative Content Analysis Study

Lim¹,

Lim²,

Ibrahim³

et al. 2020

JMIR Mhealth Uhealth

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Background With the unprecedented growth of mobile technology, a plethora of dialysis diet apps have been developed to promote patient dietary self-management. Nevertheless, the utility of such apps remains questionable. Objective This study aimed to evaluate the content, features, and quality of commercial dialysis diet apps for adult dialysis patients. Methods This study consisted of a quantitative content analysis of commercial dialysis diet apps downloaded from Google Play and the Apple App Store available in the Asian marketplace, searched for using the following keywords in English: dialysis diet and diet for kidney disease. Free and paid apps available in English that provide nutrition information for adult dialysis patients were included. Apps that were not relevant to the dialysis diet, not meant for patient self-management, or redundant were excluded. Apps were evaluated for language medium (subscore=1), credibility (subscore=1), food database (subscore=1), valuable features (subscore=12), health-behavior theory constructs (subscore=60), and technical quality (subscore=25). The relationships among the variables of interest were determined by Pearson correlation. Stepwise multiple linear regression analysis was performed to identify the features that contribute to greater technical quality of dialysis diet apps. Statistical significance was defined as P<.05. Results A total of 22 out of 253 apps (8.7%) were eligible for evaluation. Based on a 100-point scale, the mean overall score of the apps was 31.30 (SD 14.28). Only 5% (1/22) of the apps offered relevant language options, and 46% (10/22) contained food databases. In addition, 54% (12/22) of the apps were not credible. The mean score for valuable features was 3.45 (SD 1.63) out of 12, in which general education (16/22, 73%), free download (15/22, 68%), and usability (13/22, 59%) were the three most popular features. However, the apps scored a mean of 13.41 (SD 11.56) out of 60 for health-behavior theory constructs. The overall app technical quality was considered poor, with a mean score of 2.70 (SD 0.41) out of 5. The scores of valuable features (r=.65, P=.001) and health-behavior theory constructs (r=.55, P=.009) were positively correlated with the overall technical quality of the commercial dialysis diet apps. Features such as free download (β=.43, P=.03) and usability (β=.41, P=.03) could significantly determine the functional quality of the apps. Health-behavior theory constructs such as self-monitoring could significantly predict both the subjective quality (β=.55, P=.008) and the engagement quality (β=.66, P=.001) of the apps, whereas the information quality domain could be determined by plan or orders (β=.48, P=.007) and knowledge (β=.45, P=.01). Conclusions Although most of the available commercial dialysis diet apps are free and easy to use, they are subject to theory deficiency, limited language options, and a lack of food databases, credibility, tailored education, and overall technical quality.

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Section: Methodsmentioning

confidence: 99%

Limitations of Existing Dialysis Diet Apps in Promoting User Engagement and Patient Self-Management: Quantitative Content Analysis Study

Lim¹,

Lim²,

Ibrahim³

et al. 2020

JMIR Mhealth Uhealth

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show abstract

“…Second, the amount of dairy intake was not included in our study. However, the FFQ is valid and with good reliability for assessing preschool children's food intake [54]. Furthermore, the frequency of dairy intake can be recalled by subjects more easily and accurately than the amount of dairy intake and the results can be modifiable for education and intervention design.…”

Section: Discussionmentioning

confidence: 99%

Association between Dairy Intake and Linear Growth in Chinese Pre-School Children

et al. 2020

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Stunting remains a major public health issue for pre-school children globally. Dairy product consumption is suboptimal in China. The aim of this study was to investigate the relationship between dairy intake and linear growth in Chinese pre-school children. A national representative survey (Chinese Nutrition and Health Surveillance) of children aged under 6 years was done in 2013. Stratified multistage cluster sampling was used to select study participants. A food frequency questionnaire was used to collect dietary information. We calculated height-for-age Z-scores (HAZs) and estimated stunting using the 2006 WHO growth standard. In total, 12,153 children aged two to four years old (24 to <60 months) were studied from 55 counties in 30 provinces in China. Approximately 39.2% (4759/12,153) of those children consumed dairy at least once per day, 11.9% (1450/12,153) consumed dairy at least once in the last week, and nearly half (48.9%, 5944/12,153) did not have any dairy in the last week. The HAZ was −0.15 ± 1.22 and the prevalence of stunting was 6.5% (785/12,153). The HAZ for children who consumed dairy at least once per day or per week was 0.11 points or 0.13 points higher than the children without dairy intake. The risk of stunting for children who consumed dairy at least once per day was 28% lower than the children without dairy intake in the last week, and the risk was similar between weekly dairy consumption and no dairy consumption (AOR: 1.03, 95% CI: 0.74–1.42) after adjusting for potential confounders, including socioeconomic characteristics, lifestyle, health status, and the intake frequency of other foods. Dairy intake was significantly associated with a higher HAZ and a lower risk of stunting for children aged 2–4 years old in China. The proportion of dairy intake was still low in Chinese pre-school children. The promotion of dairy consumption might be an effective and feasible measurement for improving linear growth in Chinese pre-school children.

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“…Although one FFQ related to the whole grain intake and adapted to Swiss adults has been published [19], but it might not be suitable for Malaysian children; due to the fact that cultural and preference can show a discrepancy between settings [10]. While FFQs validated for Malaysian children populations were mostly developed to assess general dietary intake [21,32], our FFQ was developed specifically to estimate whole grain intake. Our interview-administered FFQ has potential to minimize any possible bias and mistake, by providing immediate feedback to the children [10].…”

Section: Discussionmentioning

confidence: 99%

Development, validity and reproducibility of a whole grain food frequency questionnaire in Malaysian children

Koo

Lim

Kaur

et al. 2020

Nutr J

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Background: To date, there is no validated whole grain assessment tool for children in any Southeast Asian countries. Hence, there is a need for a valid tool to assess whole grain intake among Malaysian children. This study aimed to develop, validate and test the reproducibility of a food frequency questionnaire (FFQ) in estimating whole grain intake among Malaysian children. Methods: A total of 392 children participated in the FFQ development and 112 children aged 9-12 years participated in the validation phase; with a subsample of 50 children participating in the reproducibility phase. Three-day diet record (3DR) as the reference method in validation phase. Spearman correlations, mean difference, Bland-Altman plot and cross-classification analyses were used to assess validity. The reproducibility was tested through a repeat administration of the FFQ, with 1 month time interval. Reproducibility analyses involved intra-class correlation coefficient (ICC), Cronbach's alpha and cross-classification analyses. Results: The FFQ consisted of 156 whole grain food items from six food groups. Mean intake of whole grain in FFQ1 and 3DR were correlated well (r = 0.732), demonstrated good acceptance of the FFQ. Bland Altman plots showed relatively good agreement for both the dietary methods. Cross-classification of whole grain intake between the two methods showed that < 9.9% of children were grossly misclassified. Outcomes from ICC (0.989) and Cronbach's alpha (0.995) demonstrated excellent reliability. All the children were classified in the same or adjacent quartile of whole grain intake. Conclusions: Overall, the findings support the validity of the developed FFQ to appropriately estimate the whole grain intake in Malaysian children. This validated FFQ will be a valuable tool for future studies, to analyses the impact of whole grain consumption with disease relationship among Malaysian schoolchildren.

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Validity and Reliability of a Food Frequency Questionnaire (FFQ) to Assess Dietary Intake of Preschool Children

Cited by 44 publications

References 36 publications

Limitations of Existing Dialysis Diet Apps in Promoting User Engagement and Patient Self-Management: Quantitative Content Analysis Study

Limitations of Existing Dialysis Diet Apps in Promoting User Engagement and Patient Self-Management: Quantitative Content Analysis Study

Association between Dairy Intake and Linear Growth in Chinese Pre-School Children

Development, validity and reproducibility of a whole grain food frequency questionnaire in Malaysian children

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