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Validation Information: FFQ (South Asian Women in Britain)

Sevak 2004

Validation of a food frequency questionnaire to assess macro and micro-nutrient intake among South Asians in the United Kingdom

Background: The South Asian population is one of the largest minority ethnic groups in the United Kingdom (UK), forming 2.7% of the UK population. Risk of diseases such as CHD, NIDDM is high in South Asians and risk of cancer low in this population compared both to the native UK population and other migrant groups. It is useful to investigate the experience of disease and dietary exposures for aetiological clues in South Asians. The FFQ was designed for a population-based case-control study of diet and breast cancer.

Aims: To validate a food frequency questionnaire (FFQ) to assess macro- and micronutrient intake among South Asians in the United Kingdom (UK).

Methods: A one-year long study of current diet was conducted using monthly telephone 24-hour recalls followed by administration of an interviewer-administered FFQ to ascertain usual diet during this period. General practices in the Thames and West Midlands regions, England were used to sequentially recruit 100 women from a larger random sample of South Asian migrants from general practitioners' patient lists participating as controls in a case-control study of diet and breast cancer.

Results: A total of 133 women were invited to achieve the final sample of 100 (76% response rate). The proportion of individuals classified by the two dietary assessment methods into the same or adjacent quartiles was high ranging from 65% (vitamin A) to 96% (protein). Misclassification into opposite quartiles was very low (0% to 5%), except for vitamin A (10%). Energyadjusted Spearman correlation coefficients were reasonable for almost all nutrients being highest for protein (0.76), NSP (0.71), folate (0.70) and cholesterol (0.69). Correction for within-person variation in monthly 24-hour recalls had little effect on the magnitude of the nutrient correlations between the FFQ and the 24-hour recalls. Calibration coefficients to correct relative risks for nutrient-disease associations were above 0.50 for most nutrients indicating that the degree of attenuation introduced by the FFQ would be acceptable.

Conclusions: This FFQ was specifically designed for South Asian women in the UK. Despite the diversity of diets, the FFQ had reasonable validity. The role of diet in breast cancer disease aetiology in this population is being assessed with this instrument.

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Validation Information

Year of Publication

Tool Information

Dietary Exposure Measured
Full Nutrient
Tool Type
Food Frequency Questionnaire
Timeframe Tool Measures info
1 Year (Past year)
Portion Size Measures info
Standard portion sizes were used throughout and in the case of traditional dishes a series of 8 coloured photographs of different portion sizes were used.
Reporting Method info
Usual; Retrospective
Format info
Supplements Measured
Not Reported
Administration Method info

Study Information

Study Location
Thames and West Midlands regions, England
Associated Nutrient Database
Comparator Validated Against
24hr Recall


Sample Size
Age of Population

Range: 34-75 years

Mean(SD): 53.5(8.5) years

Female Only
Other Notable Characteristics
South Asian Population

Total number of nutrients validated: 16 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: 8
  • Micronutrients: 7
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 Female Only Energy (kcal) 353 477 0.45 (S); 0.48 (P) 0.30 43 4 -600 1307
Protein (g) 8 15 0.55 (S); 0.57 (P) 0.57 50 4 -23 39
Fat (g) 19 26 0.53 (S); 0.57 (P) 0.41 44 4 -33 72
Saturated Fat (g) 5 8 0.60 (S); 0.60 (P) 0.44 43 4 -11 21
MUFA (g) 8 9 0.48 (S); 0.51 (P) 0.34 46 4 -9 25
PUFA (g) 9 11 0.52 (S); 0.57 (P) 0.38 41 4 -13 31
Carbohydrates (g) 39 62 0.39 (S); 0.43 (P) 0.44 48 4 -86 164
Fibre (NSP) (g) 7 6 0.43 (S); 0.39 (P) 0.54 53 4 -6 19
Calcium (mg) 173 284.6 0.45 (S); 0.45 (P) 0.36 43 4 -396.2 742.2
Iron (mg) 1.7 3.7 0.36 (S); 0.37 (P) 0.41 43 4 -5.7 9.1
Folate (µg) 47 65 0.44 (S); 0.49 (P) 0.44 41 4 -83 177
Vitamin B12 (µg) 0.2 (Geo) 0.52 (S); 0.58 (P) 0.34 40 4
Vitamin C (mg) 36.3 (Geo) 0.40 (S); 0.45 (P) 0.31 40 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.

Sevak L, Mangtani P, McCormack V, Bhakta D, Kassam-Khamis T, dos Santos Silva I. Validation of a food frequency questionnaire to assess macro-and micro-nutrient intake among South Asians in the United Kingdom. European journal of nutrition. 2004 Jun 1;43(3):160-8.