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Validation Information: FFQ (Italy)
A new self-administered semi-quantitative food frequency questionnaire to estimate nutrient intake among Italian adults: development design and validation process
Food Frequency Questionnaires (FFQs) are valuable research tools in nutritional epidemiology. This study aimed to develop and validate a new semi-quantitative FFQ, specifically designed for the Italian population and best fitted for self-administration. During the development process, we adapted to Italian needs the validated FFQ proposed by the Fred Hutchinson Cancer Research Center, revising food items, food frequency scale, portion sizes, and time frame. To assess the validity of the proposed FFQ, we compared the estimated daily intake using FFQ with the mean of 3-day food diaries and one 24-hour recall (considered as reference method). The validation process was conducted among a cohort of 51 healthy subjects enrolled in a clinical trial. Four statistical tests were applied on 23 estimated nutrient intakes. Spearman's coefficients ranged from 0.223 (sodium) to 0.748 (alcohol) and were good (≥0.50) and acceptable (0.20-0.49) for 7 and 16 nutrients, respectively. Cross classification showed a good agreement (≥50% in the same tertile or ≤10% in the opposite tertile) for 7 nutrients. The weighted Cohen's kappa values indicated an acceptable outcome (0.20-0.60) for 13 nutrients. Bland Altman plots did not show heteroscedasticity in the error terms, despite the presence of a bias. Our study provided a new Italian semi-quantitative FFQ for self-administration with an acceptable validation level. Its definitive release requires additional refinements and efforts.
Total number of nutrients validated: 21
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:
- Saturated Fat
- Mono-unsaturated Fat
- Poly-unsaturated Fat
- Non‐starch polysaccharides(NSP)
- Folic Acid
- Vitamin B12
- Vitamin C
- Fruit & Vegetables
- Urinary Nitrogen
To find information on the other validated nutrients please read the validation study.
- Macronutrients: 9
- Micronutrients: 12
|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|
|mean of 3-day food diaries and one 24-hour recall||Adults||Both||Energy (kcal)||31% (Median)||0.524 (S)||0.265||49%||3||−548||1751|
|Protein (g)||24% (Median)||0.514 (S)||0.353||43%||3||-31||72|
|Fat (g)||56% (Median)||0.502 (S)||0.118||41%||3||-18||102|
|Saturated Fat (g)||46% (Median)||0.366 (S)||0.5||51%||3||-9||35|
|MUFA (g)||59% (Median)||0.475 (S)||-0.029||27%||3||-7||46|
|PUFA (g)||86% (Median)||0.534 (S)||0.353||43%||3||-3||24|
|Carbohydrate (g)||11% (Median)||0.574 (S)||0.441||49%||3||-126||170|
|Total Sugar (g)||21% (Median)||0.340 (S)||0.412||51%||3||-53||73|
|Fibre (g)||10% (Median)||0.552 (S)||-0.029||27%||3||-25||29|
|Sodium (mg)||77% (Median)||0.233 (S)||0.235||39%||3||-1031||6243|
|Calcium (mg)||62% (Median)||0.271 (S)||0.294||41%||3||-270||1333|
|Iron (mg)||52% (Median)||0.395 (S)||0.059||29%||3||-6||20|
|Zinc (mg)||48% (Median)||0.271 (S)||0.206||35%||3||-4||14|
|Folate (µg)||42% (Median)||0.486 (S)||0.059||33%||3||-129||414|
|Vitamin C (mg)||48% (Median)||0.298 (S)||-0.147||29%||3||-95||208|
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.
Zanini B, Simonetto A, Bertolotti P, Marullo M, Marconi S, Becchetti C, et al. A new self-administered semi-quantitative food frequency questionnaire to estimate nutrient intake among Italian adults: development design and validation process. Nutrition Research. 2020;80:18-27.