Log in Register

Tool Library Tool Information Best Practice Guidelines – Evaluation Checklist (opens new tab)

Validation Information: FFQ (FODMAPs)

Barrett 2011

Development and Validation of a Comprehensive Semi-Quantitative Food Frequency Questionnaire that Includes FODMAP Intake and Glycemic Index

Background Fermentable, short chain carbohydrates (FODMAPs) have been identified as triggers for functional gastrointestinal symptoms. In addition, excess FODMAP consumption has been implicated in the onset of Crohn’s disease, and animal studies suggest that a low glycemic index diet can impair absorption of fructose, a major dietary FODMAP. Such hypotheses cannot be tested without the ability to quantify FODMAP ingestion with a validated dietary assessment tool.

Objective To assess the validity and reproducibility of a 297- item comprehensive, semi-quantitative food frequency questionnaire (FFQ) in estimating intake of macro- and micronutrients, FODMAPs, and glycemic index/load.

Subjects/setting One hundred healthy participants were recruited to complete the FFQ on two occasions, plus four 1-week food diaries kept during a 12-month period. Participants exhibiting major dietary change during the study period or low energy reporting on the FFQ were excluded.

Main outcome measures Validation and reproducibility of the semi-quantitative FFQ by comparison with the mean of four 1-week food diaries.

Statistical analyses performed Validation was assessed using Wilcoxon signed rank test, Spearman’s correlation, Bland-Altman, and weighted K statistics. Reproducibility was examined using Shrout-Fleiss intraclass correlation coefficient.

Results Seventy-two participants fulfilled inclusion and exclusion criteria. Demographics of the participants were comparable with 2006 Australian Census data. Consistent with other reported FFQs, the FFQ overestimated nutrient intake by a mean 140% (range=95% to 249%). However, based on the other analyses performed, it demonstrated validity for intake of sugars, fiber, alcohol, glycemic index, glucose, FODMAPs, calcium, folate, phosphate, potassium, iron, and magnesium; moderate validation for energy, total fat, saturated fat, carbohydrates, sodium, thiamin, sucrose, and retinol; poor validation for protein, mono/polyunsaturated fat, starch, glycemic load, niacin, and zinc. Riboflavin intake was not validated. Intraclass correlation coefficients for reproducibility ranged from 0.352 to 0.928.

Conclusions The FFQ was validated for assessment of a wide range of nutrients, including the new class of carbohydrates, FODMAPs, and glycemic index. This provides a useful tool for dietary research, particularly in the area of gastroenterological disorders.

Web Link

Validation Information

Year of Publication

Tool Information

Dietary Exposure Measured
Full Nutrient
Tool Type
Food Frequency Questionnaire
Timeframe Tool Measures info
Portion Size Measures info
Foods were listed as typical serving sizes obtained from NUTTAB 206
Reporting Method info
Format info
Supplements Measured
Administration Method info

Study Information

Study Location
Associated Nutrient Database
NUTTAB 2006, FoodWorks Professional Edition was used to hold the database
Comparator Validated Against
Food Diary Estimated


Sample Size
Adults, Elderly
Age of Population

Range: 23-72 years

Median: 34 years

Other Notable Characteristics
There were a greater proportion of women and higher education levels and weekly income in the studied group

Total number of nutrients validated: 36 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: 21
  • Micronutrients: 13
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 (kJ) 1441† 1832.6† 0.55 (S)†; 0.72 (ICC)† 0.35 (W)† 44† 3 -2224.12† 5106.12†
Protein (g) 14.8† 15.0† 0.49 (S)†; 0.61 (ICC)† 0.27 (W)† 46† 3 -15.16† 44.76†
Fat (g) 2.6† 12.6† 0.58 (S)†; 0.81 (ICC)† 0.33 (W)† 46† 3 -22.51† 27.71†
Saturated Fat (g) -0.9† 6.4† 0.44(S)†; 0.82 (ICC)† 0.34(W)† 51† 3 -13.75† 11.95†
MUFA (g) 5.3† 7.7† 0.39(S)†; 0.78 (ICC)† 0.22 (W)† 44† 3 -10.14† 20.74†
PUFA (g) 0.7† 3.7† 0.38(S)†; 0.83 (ICC)† 0.28 (W)† 47† 3 -6.68† 8.08†
Carbohydrates (g) 62.4† 28.8† 0.54(S)†; 0.76 (ICC)† 0.31(W)† 47† 3 4.90† 119.90†
Total Sugar (g) 40.8† 30.4† 0.55(S)†; 0.77 (ICC)† 0.39(W)† 58† 3 -19.95† 101.55†
Fibre (g) 9.8† 6.2† 0.59(S)†; 0.73 (ICC)† 0.44(W)† 54† 3 -2.55† 22.15†
Sodium (mg) 425† 861.0† 0.52(S)†; 0.77 (ICC)† 0.34(W)† 49† 3 -1297.03† 2147.03†
Calcium (mg) 265.5† 292.7† 0.56(S)†; 0.64 (ICC)† 0.41(W)† 56† 3 -319.80† 850.80†
Iron (mg) 3.4† 1.9† 0.67(S)†; 0.69 (ICC)† 0.45(W)† 56† 3 -0.36† 7.16†
Zinc (mg) 3.1† 2.5† 0.46(S)†; 0.72 (ICC)† 0.28(W)† 49† 3 -1.90† 8.10†
Retinol (µg) -24.3† 194.6† 0.48(S)†; 0.66 (ICC)† 0.38(W)† 54† 3 -413.45† 364.85†
Folate (µg) 191.3† 144.9† 0.50(S)†0.68 (ICC)† 0.38(W)† 51† 3 -98.49† 481.09†
Vitamin C 105.2† 80.7† 0.63(S)†; 0.536 (ICC)† 0.38(W)† 48† 3 -56.20† 266.60†

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.

Barrett JS, Gibson PR. Development and validation of a comprehensive semi-quantitative food frequency questionnaire that includes FODMAP intake and glycemic index. Journal of the American Dietetic Association. 2010;110(10):1469-76.