Validation Information: Shorter Food Frequency e-Questionnaire (FFeQ)
Affret 2018
Relative Validity and Reproducibility of a New 44-Item Diet and Food Frequency Questionnaire Among Adults: Online Assessment
Background/Objectives:Dietary questionnaires currently available which can assess the habitual diet are timely, costly, or not adapted well to the modern diet; thus, there is a need for a shorter food frequency e-Questionnaire (FFeQ) adapted to Western diets, in order to properly estimate energy and macronutrient intakes or rank individuals according to food and nutrient intakes. The aim of this study was to evaluate the relative validity and reproducibility of a 30-minute and 44-item FFeQ in a sample of adults obtained from the general population.
Methods: A sample of French adults was recruited through social media and an advertising campaign. A total of 223 volunteers completed the FFeQ twice at one-year intervals and were included in the reproducibility study. During that interval, 92 participants completed three-to-six 24-hour recalls and were included in the validity study. Nutrient and dietary intakes were computed for all validity and reproducibility participants. The level of agreement between the two methods was evaluated for nutrient and food group intakes using classification into quintiles of daily intake, correlation coefficients and Bland-Altman plots.
Results: For relative validity, correlation coefficients ranged from 0.09 to 0.88 (unadjusted correlation coefficients, median: 0.48) and 0.02 to 0.68 (deattenuated and energy adjusted correlation coefficients, median: 0.50) for food group and nutrient intakes, respectively. The median proportion of subjects classified into the same or adjacent quintile was 73% and 66% for food and nutrient intakes, respectively. Bland-Altman plots showed good agreement across the range of intakes. Regarding reproducibility, intraclass correlation coefficients ranged from 0.33 to 0.72 (median: 0.60) and 0.55 to 0.73 (median: 0.64), for food and nutrient intakes, respectively.
Conclusions: The FFeQ showed acceptable validity and reproducibility in a sample of adults based on their food and nutrient intakes. The FFeQ is a promising and low-cost tool that can be used in large-scale online epidemiological studies or clinical routines and could be integrated into evidence-based smartphone apps for assessing diet components.
Total number of nutrients validated: 31
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: 7
- Micronutrients: 24
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 24hr Recall | Adults | Both | Energy (kcal) | -77 | 565 | 0.47 (P) | 66 | 5 | -1207 | 1053 | |
| Protein (g) | -4 | 24 | 0.57 (P) | 72 | 5 | -52 | 44 | ||||
| Fat (g) | -4 | 27 | 0.47 (P) | 59 | 5 | -58 | 50 | ||||
| Saturated Fat (g) | -2 | 11 | 0.61 (P) | 67 | 5 | -24 | 20 | ||||
| MUFA (g) | 3 | 12 | 0.35 (P) | 58 | 5 | -21 | 27 | ||||
| PUFA(g) | -0.1 | 5 | 0.32 (P) | 58 | 5 | -10.1 | 9.9 | ||||
| Carbohydrates (g) | -1 | 73 | 0.44 (P) | 71 | 5 | -147 | 145 | ||||
| Sugars (g) | 4 | 43 | 0.28 (P) | 71 | 5 | -82 | 90 | ||||
| Fiber (g) | -1 | 8 | 0.4 (P) | 64 | 5 | -17 | 15 | ||||
| Sodium (mg) | -403 | 1484 | 0.37 (P) | 64 | 5 | -3371 | 2565 | ||||
| Calcium (mg) | 442 | 553 | 0.42 (P) | 70 | 5 | -664 | 1548 | ||||
| Iron (mg) | 1.1 | 5 | 0.28 (P) | 62 | 5 | -8.9 | 11.1 | ||||
| Zinc (mg) | 0.4 | 5 | 0.4 (P) | 61 | 5 | -9.6 | 10.4 | ||||
| Retinol (µg) | 506.6 | 480 | 0.11 (P) | 41 | 5 | -453.4 | 1466.6 | ||||
| Vitamin B12 (µg) | 2 | 6 | 0.31 (P) | 65 | 5 | -10 | 14 | ||||
| Vitamin C (mg) | 13 | 69 | 0.54 (P) | 78 | 5 | -125 | 151 | ||||
| Fruit (g) | 122 | 260 | 0.67 (P) | 77 | 5 | -398 | 642 |
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.
Affret A, El Fatouhi D, Dow C, Correia E, Boutron-Ruault MC, Fagherazzi G. Relative Validity and Reproducibility of a New 44-Item Diet and Food Frequency Questionnaire Among Adults: Online Assessment. J Med Internet Res. 2018;20(7):e227.