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      Development and validation of a Semi-quantitative food frequency questionnaire among older people in north of Iran

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          Abstract

          Background:

          The study was conducted to assess reliability of modified semi-quantitative food frequency questionnaire (SQFFQ) as a part of the Amirkola Health and Aging Project (AHAP).

          Methods:

          The study was carried out in a sample of 200 men and women aged 60 years and older. A 138-item SQFFQ and two 24-hour dietary recalls were completed. The reliability of SQFFQ was evaluated by comparing eighteen food groups, energy and nutrient intakes derived from both methods using Spearman and Pearson’s correlation coefficients for food groups and nutrients, respectively. Bland-Altman plots and Pitman’s tests were applied to compare the two dietary assessment methods.

          Results:

          The mean (SD) age of subjects was 68.16 (6.56) years. The average energy intake from 24-hour dietary recalls and the SQFFQ were 1470.2 and 1535.4 kcal/day, respectively. Spearman correlation coefficients, comparing food groups intake based on two dietary assessment methods ranged from 0.25 (meat) to 0.62 (tea and coffee) in men and from 0.39 (whole grains) to 0.60 (sugars) in women. Pearson correlation coefficients for energy and macronutrients were 0.53 for energy to 0.21 for zinc in male and 0.71 for energy to 0.26 for vitamin C in females. The Pitman’s test reflected the reasonable agreement between the mean energy and macronutrients of the SQFFQ and 24-hour recalls.

          Conclusions:

          The modified SQFFQ that was designed for the AHAP was found to be reliable for assessing the intake of several food groups, energy, micro-and macronutrients.

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          Most cited references28

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          Validity and reliability of a new food frequency questionnaire compared to 24 h recalls and biochemical measurements: pilot phase of Golestan cohort study of esophageal cancer.

          A pilot study was carried out to evaluate validity and reproducibility of a food frequency questionnaire (FFQ), which was designed to be used in a prospective cohort study in a population at high risk for esophageal cancer in northern Iran. The FFQ was administered four times to 131 subjects, aged 35-65 years, of both sexes. Twelve 24-h dietary recalls for two consecutive days were administered monthly during 1 year and used as a reference method. The excretion of nitrogen was measured on four 24-h urine samples, and plasma levels of beta-carotene, retinol, vitamin C and alpha-tocopherol was measured from two time points. Relative validity of FFQ and 24-h diet recall was assessed by comparing nutrient intake derived from both methods with the urinary nitrogen and plasma levels of beta-carotene, retinol, vitamin C and alpha-tocopherol. Correlation coefficients comparing energy and nutrients intake based on the mean of the four FFQ and the mean of twelve 24-h diet recalls were 0.75 for total energy, 0.75 for carbohydrates, 0.76 for proteins and 0.65 for fat. Correlation coefficients between the FFQ-based intake and serum levels of beta-carotene, retinol, vitamin C and vitamin E/alpha-tocopherol were 0.37, 0.32, 0.35 and 0.06, respectively. Correlation coefficients between urinary nitrogen and FFQ-based protein intake ranged from 0.23 to 0.35. Intraclass correlation coefficients used to measure reproducibility of FFQ ranged from 0.66 to 0.89. We found that the FFQ provides valid and reliable measurements of habitual intake for energy and most of the nutrients studied.
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            Mediterranean Diet: From a Healthy Diet to a Sustainable Dietary Pattern

            The notion of the Mediterranean diet has undergone a progressive evolution over the past 60 years, from a healthy dietary pattern to a sustainable dietary pattern, in which nutrition, food, cultures, people, environment, and sustainability all interact into a new model of a sustainable diet. An overview of the historical antecedents and recent increased interest in the Mediterranean diet is presented and challenges related to how to improve the sustainability of the Mediterranean diet are identified. Despite its increasing popularity worldwide, adherence to the Mediterranean diet model is decreasing for multifactorial influences – life styles changes, food globalization, economic, and socio-cultural factors. These changes pose serious threats to the preservation and transmission of the Mediterranean diet heritage to present and future generations. Today’s challenge is to reverse such trends. A greater focus on the Mediterranean diet’s potential as a sustainable dietary pattern, instead than just on its well-documented healthy benefits, can contribute to its enhancement. More cross-disciplinary studies on environmental, economic and socio-cultural, and sustainability dimensions of the Mediterranean diet are foreseen as a critical need.
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              Dietary assessment in the elderly: validation of a semiquantitative food frequency questionnaire.

              The study was conducted to assess the relative validity of a 170-item semiquantitative food frequency questionnaire (SFFQ) adapted for use in the elderly. The study was carried out in a sample of 80 men and women aged 55-75 y participating in a community based prospective cohort study in Rotterdam, The Netherlands. The two-step dietary assessment comprised a simple self-administered questionnaire (20 min) followed by a structured interview with trained dietitians (20 min) based on the completed questionnaire. Multiple food records (FR) collected over a one year period served as reference method. 24 h urine urea was used as indirect marker for protein intake. Compared with FR, the SFFQ generally overestimated nutrient intake as reflected by difference in means and the ratio of SFFQ to FR. Energy adjustment reduced the observed overestimation. Pearson's correlation coefficients varied from close to 0.5 to about 0.9 for crude data, and after adjustment for age, sex, total energy intake, and for within-person variability in daily intake for 0.4-0.8. Cross-classification into quintiles resulted in correct classification into the same or adjacent quintile of 75.8% for crude and 76.8% for energy-adjusted data. Validation of protein intake estimated by SFFQ with protein excretion from 24h urine urea indicated overestimation of protein intake by SFFQ. Spearman correlation coefficient between protein intake estimated from urea excretion and SFFQ was 0.67. Adaptation of a SFFQ for use in the elderly resulted in a valid and time-efficient dietary assessment instrument. Its ability to adequately rank study subjects according to their dietary intake support its application in epidemiological studies in the elderly.
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                Author and article information

                Journal
                Caspian J Intern Med
                Caspian J Intern Med
                CJIM
                Caspian Journal of Internal Medicine
                Babol University of Medical Sciences (Babol, Iran )
                2008-6164
                2008-6172
                Winter 2018
                : 9
                : 1
                : 78-86
                Affiliations
                [1 ]Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
                [2 ]Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
                [3 ]3.Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
                [4 ]School of Public Health, University of Sydney, Sydney, Australia
                Author notes
                [* ]Correspondence: Reza Ghadimi, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. E-mail: rezaghadimi@yahoo.com, Tel: 0098 1132190557, Fax: 0098 1132197667
                Article
                10.22088/cjim.9.1.78
                5771365
                29387324
                c51b427a-08ab-4f52-ba45-d9c7dd3d2848

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 7 August 2017
                : 14 October 2017
                : 11 December 2017
                Categories
                Original Article

                reliability,semi quantitative food frequency questionnaire,cohort study,elderly.

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