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      Validity and Reproducibility of a Dietary Questionnaire for Consumption Frequencies of Foods during Pregnancy in the Born in Guangzhou Cohort Study (BIGCS)

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          Abstract

          This study aimed to examine the reproducibility and validity of a new food frequency questionnaire (FFQ) used in a birth cohort study to estimate the usual consumption frequencies of foods during pregnancy. The reference measure was the average of three inconsecutive 24 h diet recalls (24 HR) administrated between two FFQs, and the reproducibility was measured by repeating the first FFQ (FFQ1) approximately eight weeks later (FFQ2). A total of 210 pregnant women from the Born in Guangzhou Cohort Study (BIGCS) with full data were included in the analysis. The Spearman’s correlation coefficients of FFQ1 and FFQ2 ranged from 0.33 to 0.71. The intraclass correlation coefficients of the two FFQs ranged from 0.22 to 0.71. The Spearman’s correlation coefficients of the 24 HR and FFQ2 ranged from 0.23 to 0.62. Cross-classification analysis showed 65.1% of participants were classified into same and contiguous quintiles, while only 3.2% were misclassified into the distant quintiles. Bland-Altman methods showed good agreement for most food groups across the range of frequencies between FFQ1 and FFQ2. Our findings indicated that the reproducibility and validity of the FFQ used in BIGCS for assessing the usual consumption frequencies of foods during pregnancy were acceptable.

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          Most cited references28

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          Statistical methods for assessing agreement between two methods of clinical measurement.

          In clinical measurement comparison of a new measurement technique with an established one is often needed to see whether they agree sufficiently for the new to replace the old. Such investigations are often analysed inappropriately, notably by using correlation coefficients. The use of correlation is misleading. An alternative approach, based on graphical techniques and simple calculations, is described, together with the relation between this analysis and the assessment of repeatability.
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            Development, validation and utilisation of food-frequency questionnaires - a review.

            The purpose of this review is to provide guidance on the development, validation and use of food-frequency questionnaires (FFQs) for different study designs. It does not include any recommendations about the most appropriate method for dietary assessment (e.g. food-frequency questionnaire versus weighed record). A comprehensive search of electronic databases was carried out for publications from 1980 to 1999. Findings from the review were then commented upon and added to by a group of international experts. Recommendations have been developed to aid in the design, validation and use of FFQs. Specific details of each of these areas are discussed in the text. FFQs are being used in a variety of ways and different study designs. There is no gold standard for directly assessing the validity of FFQs. Nevertheless, the outcome of this review should help those wishing to develop or adapt an FFQ to validate it for its intended use.
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              Validity and reproducibility of the food frequency questionnaire used in the Shanghai Women's Health Study.

              To evaluate the validity and reliability of the food frequency questionnaire (FFQ) used in the Shanghai Women's Health Study (SWHS), 200 SWHS participants were recruited for a dietary calibration study. Study participants completed an FFQ at baseline and 24-h dietary recalls (24-HDR) twice per month consecutively for 12 months. At the end of the study, a second FFQ was administered. Of the 200 study participants, 196 completed 24 or more days of 24-h dietary recalls, 191 completed two FFQs from whom the results of this report were based. The FFQ included the foods that accounted for 86% of the foods recorded in the 24-HDR surveys. Validity of the FFQ was evaluated by comparing intake levels of major nutrients and foods obtained from the second FFQ with those derived from the multiple 24-HDR. The median intake for major nutrients, rice, poultry and meat derived from the second FFQ and the 24-HDR was similar, with the differences ranging from 1.3 to 12.1%. The FFQ tended to overestimate the intake level of total vegetables and total fruits, and the differences were explained mainly by over-reporting seasonal vegetables and fruits consumption in the FFQ. Nutrient and food intake assessed by the FFQ and the multiple 24-HDR correlated very well, with the correlation coefficients being 0.59-0.66 for macronutrients, 0.41-0.59 for micronutrients, and 0.41-0.66 for major food groups. The reliability of the FFQ was assessed by comparing the correlation and median intake of nutrients and food groups obtained from the two FFQs that were administered approximately 2 y apart. The median intake levels for selected nutrients and food groups derived from the two FFQs were similar with differences below 10%. At the individual level, the intake levels of these dietary variables obtained from two FFQs also correlated well. When nutrient and food group intakes were categorized into quartiles, FFQ and 24-HDR produced exact agreement rates between 33 and 50%. Misclassification to adjacent quartile was common, ranging from 34-48%, while misclassification to an extreme quartile was rare (1-6%). These data indicate that the SWHS FFQ can reliably and accurately measure usual intake of major nutrients and food groups among women in Shanghai.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                28 July 2016
                August 2016
                : 8
                : 8
                : 454
                Affiliations
                [1 ]Division of Birth Cohort Study, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, 9 Junsui Road, Tianhe District, Guangzhou 510623, China; ymyeasy@ 123456126.com (M.-Y.Y.); Hjr0703@ 123456163.com (J.-R.H.); cnnfezx@ 123456163.com (N.-N.C.); lujinhua10@ 123456gmail.com (J.-H.L.); shsy_22@ 123456163.com (S.-Y.S.); xiaowanqing87@ 123456163.com (W.-Q.X.); hufang0351083@ 123456126.com (F.H.); xiaohuiyun1982@ 123456126.com (H.-Y.X.); kiky205@ 123456163.com (Y.-Y.W.); mountain_xia@ 123456163.com (X.-Y.X.); mzmxly81@ 123456163.com (Y.L.); mewmewprincess@ 123456hotmail.com (L.Q.); mywachy@ 123456163.com (Y.-F.W.); bighcy@ 123456163.com (C.-Y.H.)
                [2 ]Department of Neonatal Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, 9 Junsui Road, Tianhe District, Guangzhou 510623, China
                Author notes
                [* ]Correspondence: qxiu0161@ 123456163.com (X.Q.); huimin.xia876001@ 123456gmail.com (H.-M.X.); Tel.: +86-20-3836-7162 (X.Q.); +86-20-3807-6001 (H.-M.X.)
                [†]

                These authors contributed equally to the study.

                Article
                nutrients-08-00454
                10.3390/nu8080454
                4997369
                27483304
                e87e20fd-7892-4241-afbe-925652f7bac4
                © 2016 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 08 June 2016
                : 22 July 2016
                Categories
                Article

                Nutrition & Dietetics
                validation,dietary assessment,pregnant women,food frequency questionnaire,china

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