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Validation Information: Scottish Collaborative Group FFQ

Mohd-Shukri 2013

Evaluation of an FFQ to assess total energy and nutrient intakes in severely obese pregnant women

FFQ are popular instruments for assessing dietary intakes in epidemiological studies but have not been validated for use in severely obese pregnancy. The aim of the present study was to compare nutrient intakes assessed by an FFQ with those obtained from a food diary among severely obese pregnant women. Comparison of an FFQ containing 170 food items and a food diary for 4 d (three weekdays and one weekend day); absolute agreement was assessed using the paired t test and relative agreement by Pearson/Spearman correlation, cross-classification into tertiles and weighted kappa values. Antenatal metabolic clinic for severely obese women. Thirty-one severely obese (BMI at booking ≥40·0 kg/m2) and thirty-two lean control (BMI = 20·0 - 24·9 kg/m2) pregnant women. The findings showed that nutrient intakes estimated by the FFQ were significantly higher than those from the food diary; average correlation was 0·32 in obese and 0·43 in lean women. A mean of 48·5% of obese and 47·3% of lean women were correctly classified, while 12·9% (obese) and 10·0% (lean) were grossly misclassified. Weighted κ values ranged from −0·04 to 0·79 in obese women and from 0·16 to 0·78 in lean women. Overall, the relative agreement between the FFQ and food diary was lower in the obese group than in the lean group, but was comparable with earlier studies conducted in pregnant women. The validity assessments suggest that the FFQ is a useful tool for ranking severely obese pregnant women according to the levels of their dietary intake.

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Validation Information

Author
Mohd-Shukri
Year of Publication
2013

Tool Information

Dietary Exposure Measured
Full Nutrient, Food Groups
Tool Type
Food Frequency Questionnaire
Timeframe Tool Measures info
2-3 Months
Portion Size Measures info
A ‘measure’ was designed to be a small portion size so that a single standard portion of a food would often be equivalent to 2 measures. A colour photograph additionally accompanied the FFQ.
Reporting Method info
Retrospective; Usual
Format info
Online
Supplements Measured
Excluded
Administration Method info
Self-administered

Study Information

Study Location
Edinburgh, Scotland
Associated Nutrient Database
UK National Nutrient Databank (based on McCance & Widdowson’s The Composition of Foods, fifth edition) used for the FFQ. The food diary was analysed by WinDiets.
Comparator Validated Against
Food Diary Estimated

Participants

Sample Size
63
Lifestage
Adults
Age of Population

Range: 21-44.5 years (Obese); 21.1-42.3 years (Lean)

Mean: 33.6 years (Obese); 33.1 years (Lean)

Sex
Female Only
Other Notable Characteristics
Pregnant Women (between 12 and 29 weeks' gestation) from an ongoing cohort study of severe obesity in pregnancy at the Antenatal Metabolic Clinic, Royal Infirmary of Edinburgh, UK. Data split by BMI status (obese vs lean women)

Total number of nutrients validated: 36 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: 10
  • Micronutrients: 25
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
Estimated Food Diary Adults Female Only Energy (kJ) 0.28 (P) 0.47 45 3
Energy (kJ) 0.46 (P) 0.56 50 3
Protein (g) 0.19 (P) 0.47 42 3
Protein (g) 0.49 (P) 0.74 53 3
Fat (g) 0.38 (P) 0.69 61 3
Fat (g) 0.30 (P) 0.56 50 3
Saturated Fat (g) 0.50 (P) 0.79 64 3
Saturated Fat (g) 0.60 (P) 0.74 53 3
MUFA (g) 0.39 (P) 0.36 38 3
MUFA (g) 0.43 (P) 0.72 55 3
PUFA (g) 0.52 (P) 0.63 50 3
PUFA (g) 0.19 (P) 0.56 48 3
Carbohydrates (g) 0.23 (P) 0.37 52 3
Carbohydrates (g) 0.05 (P) 0.32 44 3
Total sugars (g) 0.08 (P) 0.28 31 3
Total sugars (g) 0.35 (P) 0.52 48 3
Fibre (NSP) (g) 0.53 (P) 0.55 50 3
Fibre (NSP) (g) -0.09 (P) -0.04 26 3
Sodium (mg) 0.40 (P) 0.59 41 3
Sodium (mg) 0.33 (P) 0.56 48 3
Calcium (mg) 0.59 (P) 0.78 56 3
Calcium (mg) 0.41 (P) 0.51 45 3
Iron (mg) 0.59 (P) 0.63 50 3
Iron (mg) 0.10 (P) 0.27 32 3
Zinc (mg) 0.66 (P) 0.77 62 3
Zinc (mg) 0.66 (P) 0.47 45 3
Retinol (µg) 0.25 (P) 0.67 56 3
Retinol (µg) 0.25 (P) 0.67 61 3
Folic Acid (mcg) 0.39 (P) 0.59 47 3
Folic Acid (mcg) 0.39 (P) 0.22 45 3
Vitamin B12 (µg) 0.46 (P) 0.16 38 3
Vitamin B12 (µg) 0.39 (P) 0.41 35 3
Vitamin C (mg) 0.33 (P) 0.57 50 3
Vitamin C (mg) 0.33 (P) 0.57 50 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.

Mohd-Shukri NA, Bolton JL, Norman JE, Walker BR, Reynolds RM. Evaluation of an FFQ to assess total energy and nutrient intakes in severely obese pregnant women. Public health nutrition. 2013 Aug 1;16(08):1427-35.