Validation Information: FFQ Malaysia)
Shahar 2021
Development and Relative Validity of a Semiquantitative Food Frequency Questionnaire to Estimate Dietary Intake among a Multi-Ethnic Population in the Malaysian Cohort Project
Measuring dietary intakes in a multi-ethnic and multicultural setting, such as Malaysia, remains a challenge due to its diversity. This study aims to develop and evaluate the relative validity of an interviewer-administered food frequency questionnaire (FFQ) in assessing the habitual dietary exposure of The Malaysian Cohort (TMC) participants. We developed a nutrient database (with 203 items) based on various food consumption tables, and 803 participants were involved in this study. The output of the FFQ was then validated against three-day 24-h dietary recalls (n = 64). We assessed the relative validity and its agreement using various methods, such as Spearman’s correlation, weighed Kappa, intraclass correlation coefficient (ICC), and Bland–Altman analysis. Spearman’s correlation coefficient ranged from 0.24 (vitamin C) to 0.46 (carbohydrate), and almost all nutrients had correlation coefficients above 0.3, except for vitamin C and sodium. Intraclass correlation coefficients ranged from −0.01 (calcium) to 0.59 (carbohydrates), and weighted Kappa exceeded 0.4 for 50% of nutrients. In short, TMC’s FFQ appears to have good relative validity for the assessment of nutrient intake among its participants, as compared to the three-day 24-h dietary recalls. However, estimates for iron, vitamin A, and vitamin C should be interpreted with caution.
Total number of nutrients validated: 10
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: 3
- Micronutrients: 7
| Comparator | Lifestage | Sex | Nutrient Measured | Mean Difference | Standard Deviation | Correlation Coefficient | Cohen's Kappa Coefficient | Percentage Agreement | Percentage Agreement Categories | Lower Limits of Agreement | Upper Limits of Agreement |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 3-day diet recall | Adults and Elderly | Both | Energy (kcal) | 26% (Median) | 0.364 (S); 0.53 (ICC) | ||||||
| Protein (g) | 16% (Median) | 0.329 (S); 0.52 (ICC) | |||||||||
| Fat (g) | 36% (Median) | 0.316 (S); 0.44 (ICC) | |||||||||
| Carbohydrates (g) | 18% (Median) | 0.456 (S); 0.59 (ICC) | |||||||||
| Sodium (mg) | -6.3 (Median) | 0.291 (S); 0.48 (ICC) | |||||||||
| Calcium (mg) | 22% (Median) | 0.312 (S); -0.01 (ICC) | |||||||||
| Iron (mg) | 19% (Median) | 0.425 (S); 0.38 (ICC) | |||||||||
| Vitamin C (mg) | 47% (Median) | 0.239 (S); 0.40 (ICC) |
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.
Shahar S, Shahril MR, Abdullah N, Borhanuddin B, Kamaruddin MA, Yusuf NAM, et al. Development and Relative Validity of a Semiquantitative Food Frequency Questionnaire to Estimate Dietary Intake among a Multi-Ethnic Population in the Malaysian Cohort Project. Nutrients. 2021;13(4):01.