Validation of a food frequency questionnaire as a tool for assessing dietary intake in cardiovascular disease research and surveillance in Bangladesh

Abstract

Background: Cardiovascular disease (CVD) has emerged as a major public health concern in Bangladesh. Diet is an established risk factor for CVD but a tool to assess dietary intake in Bangladesh is lacking. This study aimed to validate a food frequency questionnaire (FFQ) using the 24-h dietary recall method and corresponding nutritional biological markers among rural and urban populations of Bangladesh. Method: Participants of both genders aged 18-60 years were included in the analysis (total n = 146, rural n = 94 and urban n = 52). Two FFQs of 166 items were administered three-months apart, during which time three 24-h dietary recalls were also completed. Participants were asked to recall their frequency of consumption over the preceding 3 months. Urine and blood samples were collected for comparison between FFQ-estimates of nutrients and their corresponding biomarkers. Methods were compared using unadjusted, energy-adjusted, de-attenuated correlation coefficients, 95% limits of agreement (LOA) and quartile classification.

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

“…urinary nitrogen or blood-lipid profile that confirm results of food intake (6,(8)(9)(10) . Food frequency questionnaires has numerous advantages compared to other dietary tools as they allow the assessment of food intake over a long-time interval and can estimate the past intake of large populations (11) . Further, although FFQs are not the easiest dietary assessment tools to use, they are still deemed to be inexpensive, exert a low burden on participants, and easy to administer (11,12) .…”

“…Yet, to minimse the burden on participants, ultimately an FFQ should be comprised of a limited number of food types. Additionally, it is necessary to adapt the food list according to the population's food consumption habits (11) . Similar to all other dietary tools, FFQs can exhibit measurement errors and it is strongly advised that they get validated among the studied population (7,11) .…”

“…Additionally, it is necessary to adapt the food list according to the population's food consumption habits (11) . Similar to all other dietary tools, FFQs can exhibit measurement errors and it is strongly advised that they get validated among the studied population (7,11) . In other words, FFQs ought to be culture and population specific (13) .…”

“…In other words, FFQs ought to be culture and population specific (13) . This means that it is unacceptable for them to be used cross-culturally (in different countries) except if they were validated in those countries (11,13) .…”

Metabolic Groups Related to Blood Vitamin Levels and Inflammatory Biomarkers in Brazilian Children and Adolescents

“…Brazilian children and adolescents with lower plasma status of riboflavin, pyridoxal, and cobalamin (metabolic group 2) (i) also had higher RBC levels of homocysteine, (ii) were eating foods containing less vitamin B2, vitamin A, and vitamin B12, (iii) had higher percentage of individuals eating lower amounts of vitamin A assessed by FFQ, and (iv) had higher percentage of individuals with plasma levels below cutoff for b-carotene and riboflavin. The big differences found comparing FFQ and 24 h dietary recall for vitamin B12, vitamin A and folate intakes are expected and explained by lower correlations for vitamin B12 intake between these two instruments (52), and by low to moderate agreement between these two instruments for foods consumed occasionally, such as fruits and dark green vegetables, which are good sources of vitamin A and folate (53)(54)(55).…”