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      A meta-analysis of the reproducibility of food frequency questionnaires in nutritional epidemiological studies

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          Abstract

          Background

          Reproducibility of FFQs measures the consistency of the same subject at different time points. We performed a meta-analysis to explore the reproducibility of FFQs and factors related to reproducibility of FFQs.

          Methods and findings

          A systematic literature review was performed before July 2020 using PubMed and Web of Science databases. Pooled intraclass and Spearman correlation coefficients (95% confidence interval) were calculated to assess the reproducibility of FFQs. Subgroup analyses based on characteristics of study populations, FFQs, or study design were performed to investigate factors related to the reproducibility of FFQs. A total of 123 studies comprising 20,542 participants were eligible for the meta-analysis. The pooled crude intraclass correlation coefficients ranged from 0.499 to 0.803 and 0.499 to 0.723 for macronutrients and micronutrients, respectively. Energy-adjusted intraclass correlation coefficients ranged from 0.420 to 0.803 and 0.507 to 0.712 for macronutrients and micronutrients, respectively. The pooled crude and energy-adjusted Spearman correlation coefficients ranged from 0.548 to 0.851 and 0.441 to 0.793, respectively, for macronutrients; and from 0.573 to 0.828 and 0.510 to 0.744, respectively, for micronutrients. FFQs with more food items, 12 months as dietary recall interval (compared to less than 12 months), and a shorter time period between repeated FFQs resulted in superior FFQ reproducibility.

          Conclusions

          In conclusion, FFQs with correlation coefficients greater than 0.5 for most nutrients may be considered a reliable tool to measure dietary intake. To develop FFQs with higher reproducibility, the number of food items and dietary recall interval should be taken into consideration.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12966-020-01078-4.

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          Most cited references148

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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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            Reliability and relative validity of an FFQ for nutrients in the Tehran lipid and glucose study.

            To describe the relative validity and reliability of the FFQ used for assessing nutrient intakes of participants in the Tehran Lipid and Glucose Study (TLGS). A total of 132 subjects (sixty-one males and seventy-one females) were included in the study. Dietary data were collected monthly by means of twelve 24 h dietary recalls (24hDR). Subjects completed two, 168-item semi-quantitative FFQ. Blood and urine samples were taken every season for measurement of plasma biomarkers and urinary N and K. Mean age and BMI of the participants were 35.5 (sd 16.8) years and 25.5 (sd 5.2) kg/m2, respectively. The mean energy-adjusted and deattenuated correlation coefficients for overall nutrient intake between the 24hDR and FFQ2 were 0.44 and 0.37 in 35-year-olds, respectively, and for individual nutrients ranged from 0.24 to 0.71 in men (mean r = 0.53) and from 0.11 to 0.60 in women (mean r = 0.39). The mean energy-adjusted reliability coefficients varied from 0.48 in 35-year-olds, and ranged from 0.41 to 0.79 in men (mean r = 0.59) and from 0.39 to 0.74 in women (mean r = 0.60). The FFQ2 and 24hDR produced exact agreement rates ranging between 39.6 % and 68.3 % in men and between 39.6 % and 54.1 % in women. The ranges of questionnaire validity coefficients, with the sample correlation between the questionnaires and biochemical marker as the lower limit and the estimate obtained by the method of triads as the upper limit, were 0.21-0.56 (protein) and 0.37-0.61 (K). The FFQ developed for the TLGS has reasonable relative validity and reliability for nutrient intakes in Tehranian adults.
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              Dietary assessment methods in epidemiologic studies

              Diet is a major lifestyle-related risk factor of various chronic diseases. Dietary intake can be assessed by subjective report and objective observation. Subjective assessment is possible using open-ended surveys such as dietary recalls or records, or using closed-ended surveys including food frequency questionnaires. Each method has inherent strengths and limitations. Continued efforts to improve the accuracy of dietary intake assessment and enhance its feasibility in epidemiological studies have been made. This article reviews common dietary assessment methods and their feasibility in epidemiological studies.
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                Author and article information

                Contributors
                nkj0809@gmail.com , niukaijun@tmu.edu.cn
                zhaoyuhong@sj-hospital.org
                Journal
                Int J Behav Nutr Phys Act
                Int J Behav Nutr Phys Act
                The International Journal of Behavioral Nutrition and Physical Activity
                BioMed Central (London )
                1479-5868
                11 January 2021
                11 January 2021
                2021
                : 18
                : 12
                Affiliations
                [1 ]GRID grid.412467.2, ISNI 0000 0004 1806 3501, Present address: Department of Clinical Epidemiology, , Shengjing Hospital of China Medical University, ; Shenyang, China
                [2 ]GRID grid.265021.2, ISNI 0000 0000 9792 1228, Present address: Nutritional Epidemiology Institute and School of Public Health, , Tianjin Medical University, ; Tianjin, China
                Author information
                http://orcid.org/0000-0002-6806-521X
                Article
                1078
                10.1186/s12966-020-01078-4
                7802360
                33430897
                ec29b0cc-f0ce-4df9-bfce-f3106047b6ee
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 30 August 2020
                : 17 December 2020
                Funding
                Funded by: National Key R&D Program of China
                Award ID: 2017YFC0907402
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
                Award ID: 81903302
                Award Recipient :
                Funded by: China Postdoctoral Science Foundation
                Award ID: 2018M641753
                Award Recipient :
                Funded by: 345 Talent Project of Shengjing Hospital of China Medical University
                Award ID: M0294
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2021

                Nutrition & Dietetics
                ffq,food frequency questionnaire,reproducibility,meta-analysis,macronutrients, micronutrients

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