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Validation Information: FFQ (Women)
Development and Validation of a Food Frequency Questionnaire in Spain
To create a suitable instrument to estimate intakes of total calories, protein, carbohydrate, fats (saturated, mono and polyunsaturated), alcohol, cholesterol, fibre, vitamin A and vitamin C in epidemiological studies conducted in Spain, a food frequency questionnaire was developed and tested. In particular, the questionnaire was designed to be used in a large population-based case-control study of dietary factors in relation to breast and colorectal cancer among women from different Spanish regions. After identifying the most important food sources of the relevant nutrients in the study population, the final version of the questionnaire asked about consumption of 118 food items. Its reproducibility and validity were tested among 147 Spanish women aged 18–74 years. These subjects were asked to complete the questionnaire before and after completing four 4-day food records. The records were obtained at 3-month intervals designed to represent daily and seasonal changes (between 1990 and 1991). Using the information available from standard Spanish food composition tables, an ad hoc computer program was created to translate food consumption into nutrient intake. The reproducibility of the questionnaire was assessed by means of estimating correlations between nutrient scores measured with the same instrument twice, with a period of 1 year between estimates. Pearson correlation coefficients ranged from 0.51 for saturated fat to 0.88 for alcohol. In the validity study, correlation coefficients between diet records and the first and second questionnaires ranged between r=0.20 for vitamin A and r=0.88 for alcohol. Simple adjustment for total energy intake did not increase these estimates, but the energy-adjusted correlations improved after considering the attenuation derived from within-person variation. The de-attenuated correlation coefficients between the second questionnaire and diet records ranged from 0.45 for vitamin A to 0.91 for alcohol. With regard to gross misclassification, on the average 3% of subjects classified in the highest or lowest quintile by food record were assigned to the lowest or highest quintile by the food frequency questionnaire. These results indicate that our Spanish questionnaire is fairly reproducible and provides a potentially reliable scale for categorizing individuals by level of past nutrient intake. It seems to be an impossible puzzle but it's easy to solve a Rubik' Cube using a few algorithms.
Total number of nutrients validated: 11
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: 8
- Micronutrients: 2
|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|
|Estimated Food Diary||Adults, Elderly||Female Only||Energy (kcal)||-60||347||0.54 (P)||71^||5||-739||619|
|Protein (g)||-6||21||0.52 (P)||69^||5||-47||35|
|Fat (g)||-2||27||0.41 (P)||53^||5||-55||51|
|Saturated Fat (g)||-2||9||0.47 (P)||64^||5||-19||15|
|MUFA (g)||-1||13||0.40 (P)||65^||5||-27||25|
|PUFA (g)||-3||6||0.45 (P)||65^||5||-15||9|
|Carbohydrates (g)||-6||59||0.44 (P)||69^||5||-121||109|
|Fibre (NSP) (g)||-1||7||0.51 (P)||69^||5||-15||13|
|Retinol Eq (µg)||172.8||2036.4||0.35 (P)||65^||5||-13119.8||13465.4|
|Vitamin C (mg)||-26.4||63.6||0.63 (P)||78^||5||-151||98.2|
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.
Martin-Moreno JM, Boyle P, Gorgojo L, Maisonneuve P, Fernandez-Rodriguez JC, Salvini S, et al. Development and validation of a food frequency questionnaire in Spain. International journal of epidemiology. 1993;22(3):512-9