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Validation Information: FFQ (Mediterranean Diet-Elderly)

Fernandez-Ballart 2010

Relative validity of a semi-quantitative food-frequency questionnaire in an elderly Mediterranean population of Spain

The aim of the present study was to assess reproducibility and relative validity of a self-administered FFQ used in the PREDIMED Study, a clinical trial for primary prevention of CVD by Mediterranean diet in a population at high cardiovascular risk. The FFQ was administered twice (FFQ1 and FFQ2) to explore reproducibility at 1 year. Four 3 d dietary records (DR) were used as reference to explore validity; participants therefore recorded their food intake over 12 d in the course of 1 year. The degree of misclassification in the FFQ was also evaluated by a contingency table of quintiles comparing the information from the FFQ2 and the DR. A total of 158 men and women (aged 55–80 years) were asked not to modify their dietary habits during the study period. Reproducibility for food groups, energy and nutrient intake, explored by the Pearson correlation coefficient (r) ranged 0·50–0·82, and the intraclass correlation coefficient (ICC) ranged from 0·63 to 0·90. The FFQ2 tended to report higher energy and nutrient intake than the DR. The validity indices of the FFQ in relation to the DR for food groups and energy and nutrient intake ranged (r) from 0·24 to 0·72, while the range of the ICC was between 0·40 and 0·84. With regard to food groups, 68–83 % of individuals were in the same or adjacent quintile in both methods, a figure which decreased to 55–75 % for energy and nutrient intake. We concluded that FFQ measurements had good reproducibility and a relative validity similar to those of FFQ used in other prospective studies.

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Validation Information

Author
Fernandez-Ballart
Year of Publication
2010

Tool Information

Dietary Exposure Measured
Full Nutrient, Food Groups
Tool Type
Food Frequency Questionnaire
Timeframe Tool Measures info
1 year
Portion Size Measures info
Serving sizes are specified for each food item.
Reporting Method info
Usual; Retrospective
Format info
Paper
Supplements Measured
Not Reported
Administration Method info
Self-administered

Study Information

Study Location
Tarragona, Pamplona-Valencia, Spain
Associated Nutrient Database
Tablas de Composición de Alimentos (Food Composition Tables) Moreiras, Madrid
Comparator Validated Against
Food Diary Estimated

Participants

Sample Size
158
Lifestage
Adults, Elderly
Age of Population

Range: 55-80 years

Mean(SD): 65.5(7.4) years

Sex
Both
Other Notable Characteristics
Participants from the PREDIMED Study

Total number of nutrients validated: 20 info

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:

  • Energy
  • Fat
  • Saturated Fat
  • Mono-unsaturated Fat
  • Poly-unsaturated Fat
  • Carbohydrates
  • Protein
  • Sugar
  • Non‐starch polysaccharides(NSP)
  • Sodium
  • Calcium
  • Iron
  • Zinc
  • Retinol
  • Folate
  • Folic Acid
  • Vitamin B12
  • Vitamin C
  • Fruit & Vegetables
  • Urinary Nitrogen

To find information on the other validated nutrients please read the validation study.

  • Energy
  • Macronutrients: 8
  • Micronutrients: 11
Comparator Lifestage Sex Nutrient Measured info Mean Difference Standard Deviation info Correlation Coefficient info Cohen's Kappa Coefficient Percentage Agreement Percentage Agreement Categories info Lower Limits of Agreement Upper Limits of Agreement
Estimated Food Diary Adults, Elderly Both Energy (kcal) 234 805 0.36 (P); 0.53 (ICC) 68^ 5 -1343 1711
Energy (kJ) 837 3366 0.36 (P); 0.53 (ICC) 68.4^ 5 -5761 7435
Protein (g) 6 30 0.28 (P); 0.44 (ICC) 68.4^ 5 -52 65
Fat (g) 8 107 0.47 (P); 0.63 (ICC) 68.4^ 5 -57 73
Saturated Fat (g) 7 33 0.52 (P); 0.68 (ICC) 74.8^ 5 -13 27
MUFA (g) 2 10 0.51 (P); 0.67 (ICC) 71.5^ 5 -31 35
PUFA (g) 2 17 0.43 (P); 0.60 (ICC) 64.6^ 5 -11 15
Carbohydrates (g) 13 7 0.38 (P); 0.55 (ICC) 72.2^ 5 -197 223
Fibre (NSP) (g) 5 9.5 0.49 (P); 0.66 (ICC) 71.2^ 5 -14 24
Vitamin B12 (µg) 3.1 4.8 0.38 (P); 0.54 (ICC) 69.6^ 5 -6.3 13
Vitamin C (mg) 62.1 84.3 0.65 (P); 0.78 (ICC) 74.7^ 5 -103 227
Fruit (g) -8 175 0.57 (P); 0.72 (ICC) 73.4^ 5 -351 335
Vegetables (g) 191 151 0.70 (P); 0.81 (ICC) 76.6^ 5 -106 488

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.

Fernández-Ballart JD, Piñol JL, Zazpe I, Corella D, Carrasco P, Toledo E, et al. Relative validity of a semi-quantitative food-frequency questionnaire in an elderly Mediterranean population of Spain. British Journal of Nutrition. 2010;103(12):1808-16.