Nutritools

Log in Register

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

Validation Information: FFQ (China)

Zhuang 2012

Reproducibility and Relative Validity of a Food Frequency Questionnaire Developed for Adults in Taizhou, China

Objective: To evaluate the reproducibility and validity of a food frequency questionnaire (FFQ) developed to investigate the relationship between dietary factors and diseases in the adult Chinese population in East China.

Methods: A total of 78 males and 129 females aged 30–75 years completed four inconsecutive 24-hour dietary recalls (24-HRs, served as a reference method) and two FFQs (FFQ1 and FFQ2) over a nine-month interval. The reproducibility of the FFQ was estimated with correlation coefficients, cross-classification, and weighted kappa statistic. The validity was assessed by comparing the data obtained from FFQ and 24-HRs.

Results: The median nutrient intakes assessed with FFQs were higher than the average of four 24-HRs. For the food groups, Spearman, Pearson, and intraclass correlation coefficients between FFQ1 and FFQ2 ranged from 0.23 to 0.61, 0.27 to 0.64, and 0.26 to 0.65, respectively. For total energy and nutrient intakes, the corresponding coefficients ranged from 0.25 to 0.61, 0.28 to 0.64, and 0.28 to 0.62, respectively. The correlations between FFQ1 and FFQ2 for most nutrients decreased after adjustment with total energy intake. More than 70% of the subjects were classified into the same and adjacent categories by both FFQs. For food groups, the crude, energy-adjusted, and de-attenuated Spearman correlation coefficients between FFQ2 and the 24-HRs ranged from 0.17 to 0.59, 0.10 to 0.57, and 0.11 to 0.64, respectively. For total energy and nutrient intakes, the corresponding coefficients ranged from 0.20 to 0.58, 0.08 to 0.54, and 0.09 to 0.56, respectively. More than 67% of the subjects were classified into the same and adjacent categories by both instruments. Both weighted kappa statistic and Bland-Altman Plots showed reasonably acceptable agreement between the FFQ2 and 24-HRs.

Conclusion: The FFQ developed for adults in the Taizhou area is reasonably reliable and valid for assessment of most food and nutrient intakes.

Web Link

Validation Information

Author
Zhuang
Year of Publication
2012

Tool Information

Dietary Exposure Measured
Full Nutrient, Food Groups
Tool Type
Food Frequency Questionnaire
Timeframe Tool Measures info
1 year
Portion Size Measures info
Portion sizes were determined using coloured photographs from a book provided to participants
Reporting Method info
Usual; Retrospective
Format info
Paper
Supplements Measured
Not reported
Administration Method info
Interviewer adminstered

Study Information

Study Location
Taizhou, China
Associated Nutrient Database
Chinese Food Composition tables
Comparator Validated Against
24hr Recall

Participants

Sample Size
129 (Female)
Lifestage
Adults, Elderly
Age of Population

Range: 30-75 years; Mean (SD): 51.5 (10.5) years

Sex
Both
Other Notable Characteristics
There was a higher proportion of women (62%) and those without high / senior school education (87%) in the cohort

Total number of nutrients validated: 15 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: 5
  • Micronutrients: 10
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 Adults, Elderly Both Energy (kcal) 90.3 (median) 0.56 (S); 0.61 (P) 0.37 (W) 40.6 4
Protein (g) -0.9 (median) 0.58 (S); 0.61 (P) 0.40 (W) 44.0 4
Fat (g) 6 (median) 0.45 (S); 0.50 (P) 0.26 (W) 36.7 4
Carbohydrate (g) 7.8 (median) 0.42 (S); 0.44 (P) 0.22 (W) 32.4 4
Fibre (g) 3.8 (median) 0.30 (S); 0.31 (P) 0.20 (W) 34.3 4
Sodium (mg) 134.2 (median) 0.27 (S); 0.32 (P) 0.16 (W) 30.4 4
Calcium (mg) 150.9 (median) 0.38 (S); 0.41 (P) 0.23 (W) 37.2 4
Iron (mg) 2.7 (median) 0.53 (S); 0.55 (P) 0.36 (W) 42.0 4
Vitamin C (mg) 41.4 (median) 0.28 (S); 0.26 (P) 0.17 (W) 31.4 4
Fruits (g) 48.7 (median) 0.59 (S); 0.65 (P) 0.28 (W) 37.2 4
Vegetables (g) 97.1 (median) 0.30 (S); 0.28 (P) 0.18 (W) 33.8 4

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.

Zhuang M, Yuan Z, Lin L, Hu B, Wang X, Yang Y, Chen X, Jin L, Lu M & Ye W. Reproducibility and Relative Validity of a Food Frequency Questionnaire Developed for Adults in Taizhou, China. PlosOne. 2012 7 (1) 1-11