Tool Library Tool Information
Validation Information: Food4Me
Online Dietary Intake Estimation: Reproducibility and Validity of the Food4Me Food Frequency Questionnaire Against a 4-Day Weighed Food Record
Background: Advances in nutritional assessment are continuing to embrace developments in computer technology. The online Food4Me food frequency questionnaire (FFQ) was created as an electronic system for the collection of nutrient intake data. To ensure its accuracy in assessing both nutrient and food group intake, further validation against data obtained using a reliable, but independent, instrument and assessment of its reproducibility are required.
Objective: The aim was to assess the reproducibility and validity of the Food4Me FFQ against a 4-day weighed food record (WFR).
Methods: Reproducibility of the Food4Me FFQ was assessed using test-retest methodology by asking participants to complete the FFQ on 2 occasions 4 weeks apart. To assess the validity of the Food4Me FFQ against the 4-day WFR, half the participants were also asked to complete a 4-day WFR 1 week after the first administration of the Food4Me FFQ. Level of agreement between nutrient and food group intakes estimated by the repeated Food4Me FFQ and the Food4Me FFQ and 4-day WFR were evaluated using Bland-Altman methodology and classification into quartiles of daily intake. Crude unadjusted correlation coefficients were also calculated for nutrient and food group intakes.
Results: In total, 100 people participated in the assessment of reproducibility (mean age 32, SD 12 years), and 49 of these (mean age 27, SD 8 years) also took part in the assessment of validity. Crude unadjusted correlations for repeated Food4Me FFQ ranged from .65 (vitamin D) to .90 (alcohol). The mean cross-classification into “exact agreement plus adjacent” was 92% for both nutrient and food group intakes, and Bland-Altman plots showed good agreement for energy-adjusted macronutrient intakes. Agreement between the Food4Me FFQ and 4-day WFR varied, with crude unadjusted correlations ranging from .23 (vitamin D) to .65 (protein, % total energy) for nutrient intakes and .11 (soups, sauces and miscellaneous foods) to .73 (yogurts) for food group intake. The mean cross-classification into “exact agreement plus adjacent” was 80% and 78% for nutrient and food group intake, respectively. There were no significant differences between energy intakes estimated using the Food4Me FFQ and 4-day WFR, and Bland-Altman plots showed good agreement for both energy and energy-controlled nutrient intakes.
Conclusions: The results demonstrate that the online Food4Me FFQ is reproducible for assessing nutrient and food group intake and has moderate agreement with the 4-day WFR for assessing energy and energy-adjusted nutrient intakes. The Food4Me FFQ is a suitable online tool for assessing dietary intake in healthy adults.
Total number of nutrients validated: 20
Not all of the nutrients validated in the validation studies are included in the table below, as statistical data was only selected to be displayed for a number of nutrients, this included:
- Saturated Fat
- Mono-unsaturated Fat
- Poly-unsaturated Fat
- Non‐starch polysaccharides(NSP)
- Folic Acid
- Vitamin B12
- Vitamin C
- Fruit & Vegetables
- Urinary Nitrogen
To find information on the other validated nutrients please read the validation study.
- Macronutrients: 7
- Micronutrients: 12
|Comparator||Lifestage||Sex||Nutrient Measured||Mean Difference||Standard Deviation||Correlation Coefficient||Cohen's Kappa Coefficient||Percentage Agreement||Percentage Agreement Categories||Lower Limits of Agreement||Upper Limits of Agreement|
|Weighed Food Diary||Adults||Both||Energy (kcal)||178||690||0.53 (S)||41||4||-1202||1558|
|Protein (g)||10||29||0.59 (S)||45||4||-48||68|
|Fat (g)||11||30||0.56 (S)||37||4||-49||71|
|Saturated Fat (g)||21||14||0.48 (S)||37||4||-7||49|
|MUFA (g)||8||6||0.56 (S)||53||4||-4||20|
|PUFA (g)||2||5||0.45 (S)||49||4||-8||12|
|Carbohydrates (g)||5||86||0.43 (S)||37||4||-167||177|
|Total Sugars (g)||16||39||0.60 (S)||41||4||-62||94|
|Sodium (mg)||-228||1096||0.37 (S)||49||4||-2420||1964|
|Calcium (mg)||178||357||0.47 (S)||41||4||-536||892|
|Iron (mg)||1.1||5.5||0.50 (S)||41||4||-9.9||12.1|
|Retinol (µg)||189.9||341.4||0.31 (S)||37||4||-492.9||872.7|
|Folate (µg)||63.8||121.8||0.58 (S)||45||4||-179.8||307.4|
|Vitamin B12 (µg)||2.2||3.0||0.46 (S)||39||4||-3.8||8.2|
|Vitamin C (mg)||41.6||72.1||0.54 (S)||37||4||-102.6||185.8|
Some results have been calculated using statistical techniques based on the published data.
For further information on statistical terms click on Statistical tests used in validation studies
All correlations coefficients in the table are unadjusted unless stated otherwise. For adjusted correlation coefficients and other statistical methods used in the study e.g. paired t-tests, please read the validation articles.
- # Adjusted
- † Energy adjusted.
- ‡ For loge-transformed, energy-adjusted nutrient intakes.
- ^ Adjacent included.
- ᵟ Participants provided identical responses.
- (w) = Weighted.
Fallaize R, Forster H, Macready AL, Walsh MC, Mathers JC, Brennan L, et al. Online dietary intake estimation: reproducibility and validity of the Food4Me food frequency questionnaire against a 4-day weighed food record. Journal of medical Internet research. 2014;16(8):e190.