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Validation Information: FFQ (Suihua, North China)

Xia 2011

Reproducibility and Relative Validity of a Food Frequency Questionnaire Developed for Female Adolescents in North China


This study aims to evaluate the reproducibility and validity of a food frequency questionnaire (FFQ) developed for female adolescents in the Suihua area of North China. The FFQ was evaluated against the average of 24-hour dietary recalls (24-HRs).

Methodology/Principal Findings

A total of 168 female adolescents aged 12 to 18 completed nine three consecutive 24-HRs (one three consecutive 24 HRs per month) and two FFQs over nine months. The reproducibility of the FFQ was estimated using intraclass correlation coefficients (ICCs), and its relative validity was assessed by comparing it with the 24-HRs. The mean values of the 24-HRs were lower than those of the FFQs, except for protein (in FFQ1) and iron (in FFQ2). The ICCs for all nutrients and food groups in FFQ1 and FFQ2 were moderately correlated (0.4–0.8). However, all the ICCs decreased after adjusting for energy. The weighted κ statistic showed moderate agreement (0.40–0.6) for all nutrients and food groups, except for niacin and calcium, which showed poor agreement (0.35). The relative validity results indicate that the crude Spearman's correlation coefficients of FFQ1 and the 24-HRs ranged from 0.41 (for Vitamin C) to 0.65 (for fruit). The coefficients of each nutrient and food group in FFQ2 and the 24-HRs were higher than those in FFQ1 and the 24-HRs, indicating good correlation. Although all energy-adjusted Spearman's correlation coefficients were lower than the crude coefficients, de-attenuation to correct for intra-individual variability improved the correlation coefficients. The weighted κ coefficients of nutrients and food groups ranged from 0.32 for beans to 0.52 for riboflavin in FFQ1 and the 24-HRs, and 0.32 for Vitamin C to 0.54 for riboflavin in FFQ2 and the 24-HRs.


The FFQ developed for female adolescents in the Suihua area is a reliable and valid instrument for ranking individuals within this study.


Web Link

Validation Information

Year of Publication

Tool Information

Dietary Exposure Measured
Full Nutrient, Food Groups
Tool Type
Food Frequency Questionnaire
Timeframe Tool Measures info
9 months
Portion Size Measures info
Portion sizes were determined using coloured photographs
Reporting Method info
Usual; Retrospective
Format info
Supplements Measured
Not reported
Administration Method info
Interviewer administered

Study Information

Study Location
Suihua, North China
Associated Nutrient Database
A nutrient calculator software (Fei Hua V2.3) was used by a registered dietitian based on the Chinese food composition tables Institute for Nutrition and Food Security, Chinese Center for Disease Control and Prevention), based on China Food Composition Tables
Comparator Validated Against
24hr Recall


Sample Size
Age of Population

Mean (SD): 16.1 (1.3) years

Female Only
Other Notable Characteristics
Subjects were adolescent females (12-18yrs) from a multi-level cluster sample from 3 middle schools in the Suihua district of Heilongjiang Province of China

Total number of nutrients validated: 13 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: 4
  • Micronutrients: 9
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
24hr recall Adolescents Female Only energy (kcal) 327 340 0.65 (S) 0.41 (W)
Protein (g) 11 22 0.59 (S) 0.45 (W)
Fat (g) 14 18 0.62 (S) 0.49 (W)
Carbohydrates (g) 40 106 0.63 (S) 0.43 (W)
Fibre (g) 6 10 0.52 (S) 0.40 (W)
Calcium (mg) 121 187 0.64 (S) 0.54 (W)
Iron (mg) -2 5 0.62 (S) 0.48 (W)
Zinc 2 4 0.62 (S) 0.46 (W)
Retinol (µg) 124 324 0.62 (S) 0.43 (W)
Vitamin C (mg) 20 37 0.43 (S) 0.32 (W)
Fruit 39 123 0.71 (S) 0.40 (W)
Vegetables 49 94 0.57 (S) 0.43 (W)

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.

Xia W, Sun Cailong, Zhang L, Zhang,X, Wang J & Wu, L. Reproducibility and Relative Validity of a Food Frequency Questionnaire Developed for Female Adolescents in Suihua, North China. PlosONE 2011 6(5) 1-7