Validity and reliability of a food frequency questionnaire to estimate dietary intake among Lebanese children

Abstract

BackgroundNutritional status during childhood is critical given its effect on growth and development as well as its association with disease risk later in life. The Middle East and North Africa (MENA) region is experiencing alarming rates of childhood malnutrition, both over- and under-nutrition. Hence, there is a need for valid tools to assess dietary intake for children in this region. To date, there are no validated dietary assessment tools for children in any country of the MENA region. The main objective of this study was to examine the validity and reliability of a Food Frequency Questionnaire (FFQ) for the assessment of dietary intake among Lebanese children.MethodsChildren, aged 5 to 10 years (n = 111), were recruited from public and private schools of Beirut, Lebanon. Mothers (proxies to report their children’s dietary intake) completed two FFQs, four weeks apart. Four 24-hour recalls (24-HRs) were collected weekly during the duration of the study. Spearman correlations and Bland-Altman plots were used to assess validity. Linear regression models were used to derive calibration factors for boys and girls. Reproducibility statistics included Intraclass Correlation Coefficient (ICC) and percent agreement.ResultsCorrelation coefficients between dietary intake estimates derived from FFQ and 24-HRs were significant at p < 0.001 with the highest correlation observed for energy (0.54) and the lowest for monounsaturated fatty acids (0.26). The majority of data points in the Bland-Altman plots lied between the limits of agreement, closer to the middle horizontal line. After applying the calibration factors for boys and girls, the mean energy and nutrient intakes estimated by the FFQ were similar to those obtained by the mean 24-HRs. As for reproducibility, ICC ranged between 0.31 for trans-fatty acids and 0.73 for calcium intakes. Over 80 % of study participants were classified in the same or adjacent quartile of energy and nutrients intake.ConclusionsFindings of this study showed that the developed FFQ is reliable and is also valid, when used with calibration factors. This FFQ is a useful tool in dietary assessment and evaluation of diet-disease relationship in this age group.Electronic supplementary materialThe online version of this article (doi:10.1186/s12937-015-0121-1) contains supplementary material, which is available to authorized users.

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

“…Few studies have published data of reproducibility of FFQ in children [13–15, 38–41] and only one, carried out in forty-seven Japanese children aged 6 years, used a period of six months to examine reproducibility, closer to the period used in our study [41]. The average of reproducibility coefficients in our study was 0.42, lower than that observed in the Japanese study that reported correlations higher than 0.50 for all nutrients.…”

“…More recently published studies have shown that FFQ may produce valid and satisfactory estimates of a wide range of food and nutrient intakes in preschool children of Greece [12], Lebanon [13] and Denmark [14]. However, there is clearly a need for more valid FFQs in preschool children in many countries including Spain, where, as far as we know, no valid FFQ exists for dietary assessment of food and nutrients in children aged 4 to 5 years.…”

Poor Food Consumption in Middle Aged and Elderly Indigenous People in Southern Brazil

“…Participants unable to recall the foods and quantities were not included in this analysis. Although this disadvantage, this approach is used as gold standard to validate other food intake methods like food frequency questionnaire [10], which was not applicable to our study since Indians food habits were different from the general population.…”

Measuring eating habits and physical activity in children: Synthesis of information using indexes and clusters / Medición de hábitos saludables y no saludables en niños: Síntesis de la información utilizando indicadores y conglomerados

“…Un número creciente de estudios en el mundo utilizan y validan cuestionarios de autorreporte para la medición de HA y de AF (Bauman et al, 2010;Bel-Serrat et al, 2012;Moghames et al, 2016;Pérez et al, 2011;Saeedi, Skeaff, Wong y Skidmore, 2016;Telford, Salmon, Jolley y Crawford, 2004;Wilson, Magarey y Mastersson, 2008). En Latinoamérica se encuentran cuestionarios validados en Brasil (Hinnig, Mariath, Mascarenhas, Dianezi y Pimentel, 2014), Chile (Lera, Fretes, González, Salinas y Vio, 2015) y México (Guerrero et al, 2014).…”