Reproducibility and Validity of a Food Frequency Questionnaire Designed to Assess Diet in Children Aged 4-5 Years

Abstract

BackgroundThe food frequency questionnaire (FFQ) is the most efficient and cost-effective method to investigate the relationship between usual diet and disease in epidemiologic studies. Although FFQs have been validated in many adult populations worldwide, the number of valid FFQ in preschool children is very scarce. The aim of this study was to evaluate the reproducibility and validity of a semi-quantitative FFQ designed for children aged 4 to 5 years.Materials and methodsIn this study, we have included 169 children aged 4–5 years from the INMA project in Valencia, a population-based prospective cohort study of mothers and children in Spain. The 105-items FFQ was administered twice to the parents or care-givers of children over a 9-month period. Reproducibility was explored by comparing intake of nutrients by the FFQs, while validity was examined by comparing the nutrient values from the FFQs with the average nutrient values of three 24 hour dietary recall (24hDR) taken in the period, and also, with the concentration in blood specimens for several vitamins (carotenoids, folate, vitamin B12, vitamin C and α-tocopherol). Pearson correlation coefficients and de-attenuated correlation coefficients were calculated and we also evaluated misclassification by quintile distribution.ResultsAll correlation coefficients for reproducibility for nutrients and major food groups were statistically significant; the average correlation coefficients for daily intake were 0.43 for food groups and 0.41 for nutrients. The average correlation coefficients for validity for daily intakes against 24hDR was r = 0.30, and the average for de-attenuated correlation coefficients was r = 0.44. When evaluating validity against the blood concentration of vitamins, statistically significant correlations were observed for vitamin C (0.35), lycopene (0.31), β-Cryptoxantin (0.40), and vitamin E (0.29); the average of correlation coefficients was r = 0.21.ConclusionDespite some low to moderate correlations for reproducibility and validity, overall this study suggests that the FFQ may be a good method for assessing a wide range of food groups and nutrients intake in children aged 4–5 years.

Impact of lifestyle behaviors in early childhood on obesity and cardiometabolic risk in children: Results from the Spanish INMA birth cohort study

“…Dietary data were collected using a FFQ that can cause recall bias and be subjected to measurement error. However, the FFQ was previously validated in this population . We used a predefined score based on lifestyle factors.…”

Concentrations of urinary arsenic species in relation to rice and seafood consumption among children living in Spain

“…However, it can be a reliable source of long-term exposure among individuals with consistent intake patterns (Kile et al, 2009; Marchiset-Ferlay et al, 2012; Navas-Acien et al, 2009). Further, in this study, the children’s usual diet was measured in personal interviews with parents and children’s guardians using a validated FFQ, which although reliable may be subject to misclassification (Vioque et al, 2016). …”

“…Children’s body mass index (BMI) was calculated in kg/m 2 . Four-year-old children’s dietary intake was assessed with a validated FFQ asking about consumption of 105 food items in the previous year (Vioque et al, 2016). Parents or children’s guardians provided the information regarding children’s diet, and it was recorded in the FFQ during personal interviews administered by trained nutritionists.…”

Dietary Intake of Trans Fatty Acids in Children Aged 4–5 in Spain: The INMA Cohort Study

“…The FFQ was derived from an adult version of the FFQ previously validated among the mothers of the INMA Study [14]. The FFQ was modified to include foods and portion sizes appropriate to children aged 4–5 and further validated with three 24-h recalls and several biomarkers in a sample of 169 children aged 4–5 from the Valencia cohort [15]. To address the reproducibility and validity against the 24-h recalls Pearson’s correlations adjusted for energy intakes were performed and the correlation coefficients were 0.44 and 0.23, respectively; in both cases statistically significant [15].…”

“…The FFQ was modified to include foods and portion sizes appropriate to children aged 4–5 and further validated with three 24-h recalls and several biomarkers in a sample of 169 children aged 4–5 from the Valencia cohort [15]. To address the reproducibility and validity against the 24-h recalls Pearson’s correlations adjusted for energy intakes were performed and the correlation coefficients were 0.44 and 0.23, respectively; in both cases statistically significant [15]. The range of the reproducibility and validity coefficients of the FFQ was similar to those observed for other FFQs in the literature [16].…”