Log in Register

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

Validation Information: FFQ (Energy intake, 4-6 year olds)

Dutman 2010

Validation of an FFQ and options for data processing using the doubly labelled water method in children

Objectives: To validate an FFQ designed to estimate energy intake in children against doubly labelled water (DLW). To investigate how quality control and standard beverage portion sizes affect the validity of the FFQ.

Design: Thirty healthy children, aged 4–6 years, participated. Total energy expenditure (EE) was measured by the DLW method during an observation period of 15 d. At the end of this period parents filled out an FFQ designed to assess the child’s habitual energy intake (EI) of the preceding four weeks.

Setting: Validation study in The Netherlands.

Subjects: Thirty healthy children (fifteen boys and fifteen girls), aged 4–6 years.

Results: Mean EI (6117 (sd 1025) kJ/d) did not differ significantly from mean EE (6286 (sd 971) kJ/d; P = 0·15); the mean EI:EE ratio was 0·98. The Pearson correlation coefficient between EI and EE was 0·62. The Bland–Altman plot showed no systematic bias and a constant bias close to zero. Less intensive quality control of the FFQ maintained the mean EI:EE ratio and decreased the correlation slightly. Using standard instead of individually measured beverage portion sizes decreased the mean EI:EE ratio, but maintained the correlation.

Conclusions: It can be concluded that the developed FFQ is a valid instrument to estimate mean energy intake in a group of 4- to 6-year-old children and performs reasonably well to rank the subjects with respect to energy intake. It is therefore a useful instrument to estimate energy intake in children in surveys and epidemiological studies in The Netherlands.

Web Link

Validation Information

Year of Publication

Tool Information

Dietary Exposure Measured
Tool Type
Food Frequency Questionnaire
Timeframe Tool Measures info
4 weeks
Portion Size Measures info
Portion sizes were quantified in natural units (e.g. numbers of, slices of)
Reporting Method info
Usual; Retrospective
Format info
Supplements Measured
Not reported
Administration Method info

Study Information

Study Location
Associated Nutrient Database
The Netherlands Food Composition Table NEVO 2001
Comparator Validated Against
Doubly Labelled Water


Sample Size
Children (4-6 years)
Age of Population

Mean (SD): 5.2 (0.7) years

Other Notable Characteristics
Subjects were recruited through advertising at schools and day care centres

Total number of nutrients validated: 1 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: 0
  • Micronutrients: 0
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
Doubly labelled water Children (4-6 years) Both Energy (kcal) 40 -12.9 0.62 (P) 53 3

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.

Dutman A.E, Stafleu A, Kruizinga A, Brants H. A.M, Westerterp K.R, Kistemaker C, Meuling W.J.A & Goldbohm R.A. Validation of an FFQ and options for data processing using the doubly labelled water method in children. (2010). Public Health Nutrition 14 (3) 410-417