Validity and reproducibility of two semi-quantitative alcohol frequency questionnaires for the Colombian population

Abstract

Objective: To determine the relative validity and reproducibility of two alcohol intake frequency questionnaires (AFQ-A; AFQ-B), designed to classify subjects according to their alcohol intake level, in Bucaramanga, Colombia. Method: One hundred and nine randomly selected subjects, aged between 20 and 60 years, completed three 30-day semi-quantitative alcohol intake records (30-DR). The AFQs were applied three months after the last 30-DR. AFQ-A contained 53 items; AFQ-B contained five items, with the alcoholic drinks for AFQ-B selected by Max_r. The correlation and agreement between alcohol intake assessed with the AFQs and the 30-DR were obtained using Pearson's correlation coefficient (r), Lin's concordance correlation coefficient (r C ), Spearman's rank correlation coefficient (r S ), Bland and Altman's limits of agreement (LOA) and Cohen's weighted kappa statistic (K w ). Results: The reproducibility of the 30-DR was poor; r S ranged from 0.33 to 0.41. The reproducibility of the AFQs was higher, with r S between 0.50 and 0.73. The agreement (K w ) of the 30-DR and the AFQs was 0.40. The lower and upper LOA were between 2 56.4% and 211.0%. The AFQs and 30-DR were well correlated. Assessment of relative validity between the two methods yielded r values for alcohol between 0.52 and 0.60, which reduced to 0.20-0.29 after energy adjustment. Conclusions: These AFQs may be useful to rank subjects according to their alcohol intake. The AFQ-B is easy and quick to apply, and is also highly cost-effective. Keywords Alcohol consumption Food-frequency questionnaire Max_r ColombiaDuring the last 50 years, Colombia -like many other countries of the world -has experienced demographic and epidemiological transitions. The changes attributed to these transitions include ageing of the population, changed dietary habits to high intakes of foods rich in fats, sugar and salt, and increased alcohol consumption 1 -3 . The prevalence of alcohol consumption has increased in Colombia during the last 15 years, reaching 86% among the population older than 12 years in 1997, and also the age at which consumption begins has decreased to 9 years old 4 -6 . Despite the need to quantify alcohol intake and establish whether or not it is related to dietary habits, chronic diseases, trauma and social or mental diseases, there are no valid instruments available for this purpose in Colombia.Even when alcohol is not a nutrient, methods used in the study of diet can be applied in the quantification of alcohol consumption 7 . The research on dietary intake and its relationship with chronic diseases has been carried out with simplified questionnaires that ask about the dietary pattern before the disease. Alcohol frequency questionnaires (AFQs) have been the most useful tool in epidemiological research 7 -9 , not only for their low cost but also because they result in good classification of subjects based on their intake. Moreover, the level of intake can be measured with more validity 10 . However, alcohol consumption is a difficult-to-m...

Tipología de los consumidores de alcohol y sus factores determinantes en Bucaramanga, Colombia

“…Ahora se cuenta con herramientas de medición (9)(10)(11)24), y explicaciones matemáticas y conceptuales que permiten explicar cómo se establecen las relaciones entre el alcohol y los sujetos en esta población, y sobre cómo puede, dentro de esa dinámica, llegarse al consumo excesivo de alcohol, el consumo problemático y la dependencia.…”

“…Este estudio es el resultado de diez años de investigación aplicada en el tema; en él se incorporaron el conocimiento y la experiencia previamente adquiridos, y la tecnología diagnós-tica desarrollada y validada en esta población (8)(9)(10)(11)14,24 * Tipo de consumo: A, no excede el límite de unidades internacionales de consumo semanal de alcohol y es negativo para CPA y CAGE; B, excede el límite de unidades internacionales de consumo semanal de alcohol y es negativo para CPA y CAGE; C, es positivo para CPA, y/o CAGE o ambos, sin importar si excede o no el límite de unidades internacionales de consumo semanal de alcohol. † Promedio e intervalo de confianza del 95%.…”

“…Los resultados presentados cobran relevancia en la medida en que son producto de un proceso en el cual la correcta medición fue garantizada previamente (9,11). Se discriminaron tres tipos de consumidores de alcohol, con suficiente poder discriminatorio para ser utilizados en estudios epidemiológicos.…”

Diseño de cuestionarios de frecuencia de consumo para estudiar la relación dieta-cáncer en Colombia

“…Sin embargo, uno de éstos, desarrollado en una sociedad y cultura en particular, puede que no sea útil en otra (12,13), lo que obliga al desarrollo de cuestionarios específicos, y a realizar estudios de reproducibilidad y validez complementarios que permitan calibrar los resultados de la investigación epidemiológica (14)(15)(16)(17).…”

“…Los cuestionarios de frecuencia de consumo son el método simplificado más utilizado para la medición de la exposición de la dieta a largo plazo. La elección de la lista de chequeo de alimentos es el primer paso en la construcción del cuestionario; de la elección correcta de los alimentos dependen los resultados (9)(10)(11)(12)(13).…”