Validity and Reproducibility of an Interviewer-administered Food Frequency Questionnaire for the Assessment of Riboflavin Intake in Malaysian Women in Selangor

@#Introduction: The aim of this study was to assess the validity and reproducibility of a food frequency questionnaire (FFQ) specifically developed for the assessment of riboflavin intake among Malaysian women in Selangor. Methods: The study was carried out in Universiti Putra Malaysia (UPM), which consisted of 204 healthy women (102 Chinese and 102 Malay) aged between 19 and 45 years. The FFQs were interviewer-administered, which were completed twice; at the beginning of the study (FFQ-1) and two weeks thereafter (FFQ-2). A two-day 24-hour dietary recall (24DR) was interviewer-administered as the standard criteria method. Data were analyzed using Wilcoxon signed ranks test, Spearman correlation coefficient (SCC), intra-class correlation coefficient (ICC) and Bland-Altman plots to determine the validity and reproducibility. Results: Median riboflavin intake derived from 24DRs was significantly higher than FFQ-2 (p<0.01). Both FFQ-1 and FFQ-2 correlated significantly (p<0.01) with 24DRs with r-value of 0.264 and 0.227, respectively. As for reproducibility between FFQs, SCC value was statistically significant (p<0.01) at 0.545 whereby ICC value was 0.752, which considered as good. Most data points fell between the limits of agreements and were found closer to the horizontal line in the middle. However, the plots showed no linear trend existed between FFQ and 24DR over the range of mean riboflavin intake. Conclusion: The newly developed FFQ were found to be valid and relatively reproducible in the assessment of riboflavin intake among Malaysian women in Selangor.

Gender Analysis of Food Items Selection for Food Frequency Questionnaire Development

BACKGROUND: The aims of this study were 1) to compare foods between men and women with high contributions to absolute intake and the variability in energy and nutrient intakes, which are common criteria of selecting foods for food frequency questionnaire (FFQ), 2) to analyze possible inaccuracies due to not taking gender into consideration. METHODS: The study used 1-day 24 hour recall data of 7,952 participants (n=3,250 men, n=4,702 women) aged 19–64 years who participated in the 2013–2014 Korea National Health and Nutrition Examination Survey. Foods which have high possibility of being included in FFQ items, called candidate foods, were selected by analyzing their contribution to absolute intake and variability in the intakes of energy and 15 nutrients in total participants, men and women. RESULTS: The number of candidate foods selected was 133 for total participants, 126 for men, and 153 for women. Intakes of candidate foods for total participants were significantly higher in energy and six nutrients out of selected 16 nutrients than those of candidate foods for men only. On the contrary, all nutrient intakes of candidate foods for total participants were significantly lower than those of candidate foods for women only. CONCLUSIONS: Differences were revealed between men and women not only in the total numbers, but also in the selected food items from the candidate foods for FFQ. Thus, developing FFQs without considering gender may produce systematic errors in dietary assessment, possibly in different directions for men and women.

Development and relative validity of semi-quantitative food frequency questionnaire for Korean adults / 한국영양학회지

PURPOSE: This study was implemented to develop and validate the semi-quantitative food frequency questionnaire (SQ-FFQ) to assess energy, carbohydrates, fat, protein, minerals, and vitamins as well as fatty acids and alcohol in Korean adults. METHODS: The SQ-FFQ consisted of 88 food items, and 12 food groups were selected based on information of frequently consumed foods from the Korean Health and Nutrition Examination survey. Each portion size was categorized as one of three amounts: small (0.5 times), medium (1 time), and large (1.5 times). A total of 111 subjects finished 3-day diet records and the SQ-FFQ. The relative validity of SQ-FFQ was assessed by comparison with the 3-day diet records. RESULTS: The mean nutrient intakes obtained from the SQ-FFQ were estimated to be greater than those of the two 3-day dietary records. Spearman's correlation coefficient between the two methods was the highest for energy (r = 0.583; p < 0.001) and lowest for saturated fatty acid (r = 0.121). Correlation coefficients were energy (r = 0.583; p < 0.001), carbohydrates (r = 0.500; p < 0.001), protein (r = 0.466; p < 0.001), fat (r = 0.411; p < 0.001), dietary fiber (r = 0.467; p < 0.001), alcohol (r = 0.527; p < 0.001), calcium (r = 0.409; p < 0.001), phosphorus (r = 0.499; p < 0.001), potassium (r = 0.418; p < 0.001), magnesium (r = 0.427; p < 0.001), and zinc (r = 0.464; p < 0.001), respectively, for all subjects. CONCLUSION: The developed SQ-FFQ in this study seems to be useful for estimating nutritional status, particularly energy, carbohydrates, protein, fat, dietary fiber, alcohol, calcium, phosphorus, potassium, magnesium, and zinc of Korean adults.

Development and evaluation of a dish-based semiquantitative food frequency questionnaire for Korean adolescents

BACKGROUND/OBJECTIVES: The purpose of this study was to develop a dish-based semiquantitative food frequency questionnaire s(FFQ) for Korean adolescents and evaluate its reproducibility and validity. SUBJECTS/METHODS: Based on 24-hour dietary recall data from the 4th Korean National Health and Nutrition Examination Survey (KNHANES), we developed a FFQ with 71 items. From a quota sample of 160 adolescents recruited using gender and age group as stratification variables, 153 participated in the complete data collection process. The FFQ was administered to each subject twice, at an interval of 3-4 weeks, to evaluate the test-retest reliability. The validity of the FFQ was assessed relative to 8-day food record data. RESULTS: The study findings demonstrated the FFQ's satisfactory reproducibility. Spearman correlation coefficients ranged from 0.64(for β-carotene) to 0.81(for protein). From cross-classification analyses, the proportion of subjects in the same intake quartile was highest for protein (65.4%) and lowest for vitamin A(47.1%). With regard to validity analysis, Spearman correlation coefficients ranged from 0.27(for vitamin A and fiber) to 0.90 (for energy). The proportions of subjects in the opposite categories between the first FFQ and the 8-day food record data were generally low within the range from 0.74% (for energy and carbohydrate) to 13.2% (for α-carotene). CONCLUSIONS: In conclusion, the dish-based semiquantitative FFQ developed in this study can be useful for grouping Korean adolescents according to major macro- and micronutrient intakes with reasonable reproducibility and validity.

Nutrient intakes and frequently consumed foods among Korean adults according to the intake frequency of Baechu (Chinese cabbage) kimchi: Based on the 2012~2013 Korea National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: The purpose of this study is to analyze nutrient intake and frequently consumed foods according to the intake frequency of Baechu (Chinese cabbage) kimchi by Korean adults. METHODS: Data from analysis of 7,122 subjects aged 19~64 years from 2012, 2013 KNHANES were obtained from health behavior interviews and the 24-hour dietary recall method. RESULTS: With the daily intake frequency of Baechu kimchi, subjects with two times a day were the highest proportion among total subjects. As Baechu kimchi intake frequency of breakfast, lunch, and dinner increased, the rate of skipping meals decreased significantly (p < 0.05). In addition, all food intake and daily nutrient intake increased significantly with increasing frequency of daily Baechu kimchi intake (Crude p for trend < 0.05, Adjusted p for trend < 0.05). With the frequently consumed foods by daily Baechu kimchi intake frequency in 2012 and 2013, among 509 foods top ranked foods were white rice, Baechu kimchi, beer, distilled alcoholic drink, milk, and pork. CONCLUSION: The results of this study could be used in the future to promote consumption of kimchi in the Korean population.

Vegetable intake is associated with lower Frammingham risk scores in Korean men: Korea National Health and Nutrition Survey 2007-2009

BACKGROUND/OBJECTIVES: Observational studies suggest that an association between vegetable consumption and coronary heart disease (CHD). However, the results are inconsistent. This study aimed to investigate the daily intake of vegetables on a national level and its effect on the risk of CHD risk, as determined by the Framingham Risk Score (FRS). SUBJECTS/METHODS: This study was conducted a cross-sectional design of 2,510 male adults 40-64y of age who participated in the 2007-2009 Korean National Health and Nutrition Examination Survey. Daily intake of vegetable was assessed by 24-h recall, and the consumption frequency of vegetables was determined using a food frequency questionnaire. The odd ratio of CHD risk according to daily intake and frequency of vegetables was analyzed. RESULTS: Total vegetable intake was inversely and significantly associated with the risk of CHD (Model 1: 4th vs. 1st quartile, OR = 0.74, 95% CI = 0.58-0.96, P for trend = 0.0015), and the significant relationship with CHD risk remained even after adjusting for potential confounders (Model 3: 4th vs. 1st quartile, adjusted OR [aOR] = 0.69, 95% CI = 0.49-0.95, P for trend = 0.0492). Subjects in the higher quartiles of non-salted vegetable intake had 31% lower odds of the risk of CHD compared to those in the lowest quartile after adjusting for various potential confounders in model 3 (aOR = 0.69; 95% CI = 0.49-0.97, P for trend = 0.0478). No significant associations between the frequency of vegetable intake (total, green, white and red vegetable) and the risk of CHD were found. CONCLUSIONS: The major results of this study indicate that higher vegetable intake may help prevent CHD in Korean men.

Application and Evaluation of Web-based Food Frequency Questionnaire for Korean Adolescents / 대한지역사회영양학회지

OBJECTIVES: We previously developed a dish-based semi-quantitative food frequency questionnaire (FFQ) for Korean adolescents and reported that it had reasonable reliability and validity. The objective of the current study was to construct a web-based dietary evaluation system applying the FFQ for Korean adolescents and examine its applicability in the context of reliability and validity. METHODS: A web-based food frequency questionnaire system was designed using a comprehensive approach, incorporating not only dietary data survey but also up-to-date nutrition information and individualized eating behavior guidelines. A convenience sample of 50 boys and girls aged 12~18 years agreed to participate in the study and completed the FFQ twice and 3 days of dietary recall on the developed website during a two-month period. The FFQ’s reliability and validity was examined using correlation and cross classification analysis. We also measured participants’ subjective levels of the web site’s usability, visual effect, understanding, and familiarity. RESULTS: Spearman correlation coefficients for reliability ranged from 0.74 (for vitamin A) to 0.94 (for energy). From cross-classification analyses, the proportion of subjects in the same intake quartile was highest for energy (82.0%) and lowest for vitamin A (56.0%). With regard to validity analysis, Spearman correlation coefficients ranged from 0.34 (for fiber) to 0.79 (for energy). The proportions of subjects in the opposite categories between the first FFQ and 3-day diet recall data were generally low from 0.00% (for fat) to 36.2% (for sodium). Average subjective levels of the website’s usability, visual effect, understanding, and familiarity were all found to be over 4 points out of 5 points. CONCLUSIONS: The web-based dietary evaluation system developed can serve as a valid and attractive tool for administering FFQ to Korean adolescents.

Development and Validation of a Food Frequency Question¬naire for Vitamin D intake among Urban Pregnant Women in Malaysia

Introduction: A culturally valid tool is lacking in order to assess vitamin D intake among Malaysians. This study aimed to develop and determine the validity and reliability of a semi-quantitative food frequency questionnaire (FFQ) for assessment of vitamin D intake among pregnant women living in urban areas of Malaysia. Method: A total of 79 volunteer mothers (aged 18 to 40 years) in their first trimester of pregnancy participated in this study voluntarily. They completed both the 3-day 24-hour dietary recalls (3DR) and semi-quantitative food frequency questionnaires (FFQ1). The FFQ1 was validated against vitamin D intake calculated from the 3DR. After one week, 41 (51.89%) subjects completed the same FFQ1 (now called FFQ2) for reliability assessment. Results: The median vitamin D intake from 3DR was 117.6 IU/ day with an interquartile range (IQR) of 54.8 to 193.7 IU/ day. The median and IQR values from FFQ1 were 147.7 and 103.7 to 233.9 IU/ day, respectively. The Spearman correlation coefficient was strong and positive, r=0.810 (p=0.01); cross-classification analyses revealed no misclassification and the Bland-Altman plot showed good agreement between the two dietary methods. The intra-class correlation (ICC) for reliability of vitamin D intake was 0.98; the cross-classification analysis showed 95.12% and was classified into the same quartile which supported a consistent habitual eating pattern. Conclusion: The new FFQ developed to assess vitamin D intake showed high correlation and high agreement with the majority of the sample population classified into the same quartile. It is concluded that the new FFQ is a valid and reliable screening tool for vitamin D intake for pregnant women in the urban areas of Malaysia.

Development and validation of a food frequency questionnaire for dietary intake assessment among multi-ethnic primary school-aged children

<p><b>INTRODUCTION</b>This study aimed to develop and validate a food frequency questionnaire (FFQ) to assess habitual diets of multi-ethnic Malaysian children aged 7-12 years.</p><p><b>METHODS</b>A total of 236 primary school children participated in the development of the FFQ and 209 subjects participated in the validation study, with a subsample of 30 subjects participating in the reproducibility study. The FFQ, consisting of 94 food items from 12 food groups, was compared with a three-day dietary record (3DR) as the reference method. The reproducibility of the FFQ was assessed through repeat administration (FFQ2), seven days after the first administration (FFQ1).</p><p><b>RESULTS</b>The results of the validation study demonstrated good acceptance of the FFQ. Mean intake of macronutrients in FFQ1 and 3DR correlated well, although the FFQ intake data tended to be higher. Cross-classification of nutrient intake between the two methods showed that < 7% of subjects were grossly misclassified. Moderate correlations noted between the two methods ranged from r = 0.310 (p < 0.001) for fat to r = 0.497 (p < 0.001) for energy. The reproducibility of the FFQ, as assessed by Cronbach's alpha, ranged from 0.61 (protein) to 0.70 (energy, carbohydrates and fat). Spearman's correlations between FFQ1 and FFQ2 ranged from rho = 0.333 (p = 0.072) for protein to rho = 0.479 (p < 0.01) for fat.</p><p><b>CONCLUSION</b>These findings indicate that the FFQ is valid and reliable for measuring the average intake of energy and macronutrients in a population of multi-ethnic children aged 7-12 years in Malaysia.</p>

Dietary Intakes of Older Adults with and without Dementia Compared to Healthy Eating Recommendations.

Background: The Alzheimer’s Research Trust (2012) report that 820,000 people are currently living with dementia in the UK with prevalence increasing in line with the ageing population and a new case estimated to occur every 3.2 minutes. Whilst there is currently no cure, early diagnosis and intervention may be essential in reducing the considerable health, economic and social burden of dementia. Although multifactorial in aetiology, diet and lifestyle factors have been identified as potentially protective and pathogenic for dementia development, Staehelin, [1]. The aim of this study was to compare the dietary intakes of a group of older adults early in their dementia disease to those of healthy controls in order to inform the development of future dietary intervention studies and service delivery to delay the onset and slow the progression of cognitive decline. Methods: Ethical approval was granted from the National Research Ethics Service Committee London. Participants with a diagnosis of dementia (Alzheimer’s, vascular or mixed type) were recruited from Memory Clinics across Sussex, with consent obtained from both the participant and their designated carer. Routine clinical data was extracted from the patient notes and any additional data collected during a 2hr initial interview. Healthy controls were recruited from community groups in the Brighton area. Anthropometric measurements were made according to standard age-appropriate procedures and dietary intakes were assessed using an adapted version of the EPIC Food Frequency Questionnaire (FFQ) Adamson et al. [2]. FFQ’s were coded and converted into nutritional information using the FETA software (Mulligan et al, unpublished). Relative nutrient intakes (expressed as a percentage of the age- and gender-appropriate dietary reference values (DRV) and adherence to a Mediterranean style diet Trichopoulou et al. [3] were compared between groups using independent t tests or non-parametric equivalents as appropriate. Results: Ninety-six cases and 53 controls had FFQ data available for analysis. Cases were more likely to be older (mean age 80.7[6.2] and 68.1[6.0] years), female (58% and 28% respectively) (p≤0.001) and of a higher BMI (26.4[3.8] and 25.0[3.2] kg/m2; p=0.02) than controls. Cases consumed significantly more energy in the form of saturated fat (13.8[2.6] and 12.2[3.2]% of energy) and significantly less as polyunsaturated fat (5.6[1.6] and 6.6[1.5]%) and alcohol (2.0[3.2] and 3.8[4.3]%) (p≤0.001). The differences in fat remained significant even when only healthy weight individuals were analysed (p<0.05). No significant differences in relative micronutrient intakes were observed, with the exception of magnesium (p=0.04). Food-based analyses suggested that adults with dementia were less likely to consume fruit and nuts and seeds (p≤0.007) and more likely to consume sugars and snacks (p<0.001) than controls. These differences remained significant, with the exception of fruit, when analysed within healthy weight adults only (p≤0.005). Controls showed greater adherence to a Mediterraean–style diet (p=0.001) and specifically higher scores for the fruit, vegetable and meat components of this score (p≤0.01). Discussion: The cross-sectional nature of this data limits the ability to draw conclusions regarding causality however it would appear that the current diet of older adults with dementia may fail to meet healthy eating recommendations, particularly with regard to the balance of fats. The cognitive benefits of a Mediterranean diet have been widely reportedSofrizzi et al, [4] and the food-based analyses would seem to support this theory, with potentially beneficial foods like fruits, nuts and alcohol underconsumed in a sample of adults with diagnosed cognitive impairment. Conclusion: This data would suggest that older adults with cognitive impairment have sub-optimal dietary intakes not solely explained by their greater age or BMI. Ongoing follow up of this cohort will confirm the impact of this on disease progression.

A Short Questionnaire for Assessment of Dietary Vitamin D Intake.

Aims: Dietary vitamin D intake is difficult to assess as it is irregular. In Sweden, main sourcesare oily fish, fortified dairy products and margarines. This relative validation study intends to investigate the agreement in dietary vitamin D intake between a short vitamin D questionnaire and a four day food record. Study Design: A cross sectional study design was implemented. Place and Duration of Study: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg. Assessments were conducted between January 2009 and December 2012. Methodology: Ninety-five female subjects (25-40 years old) performed a short vitamin D questionnaire (VDQ), covering the consumption of four foods with high vitamin D content (oily fish, milk, margarine and yoghurt/sour milk). They also performed a food record for four consecutive days in connection to the VDQ. Results: Median (quartile 1-quartile 3) dietary vitamin D intake was 4.7 (3.6-7.4) μg/day assessed by food record and 3.4 (2.3-4.6) μg/day assessed by VDQ. The dietary intakes of vitamin D correlated significantly between methods (P=.007). The amounts of vitamin D derived from each of the four foods did not differ between methods (P>.05). Conclusion: The short VDQ, including only four foods with high vitamin D content (oily fish, milk, margarine and yoghurt/sour milk), was able to capture the majority of the dietary vitamin D intake reported in food records. This relative validation study shows that the short questionnaire is a useful tool when assessing intake of major sources of dietary vitamin D on a group level.

Development and Validation of Food Frequency Questionnaire (FFQ) Among Elderly Individuals in Klang Valley / Jurnal Sains Kesihatan Malaysia

Polyphenol is a non-nutrient phytochemical compound existed abundantly in plant-based diet which has the properties to prevent age related oxidative damage induced diseases. However, there are diffi culties in quantifying its intake and local food frequency questionnaire (FFQ) for the assessment is not available. Therefore, this study aimed to develop and validate FFQ for estimation of dietary polyphenol intake among 93 individuals aged 60 years and above recruited from several senior citizen clubs in Klang Valley. Phase I of the study involved the development of FFQ consisted of 117 items under 9 categories and formation of the database extracted from PHENOL-EXPLORER. In Phase II, the intake of polyphenol estimated using FFQ was compared with reference method consisted of 2-day diet records and diet history questionnaire (DHQ). The mean dietary polyphenol intake estimated from FFQ and the reference method was 2770.7 ± 1552.4 mg/d and 2171.4 ± 898.8 mg/d, respectively. Spearman’s rho and Kendall’s tau-b analysis indicated that there was a signifi cant positive correlation between polyphenol intake estimated from FFQ and reference method (r = 0.41, p < 0.001; r = 0.28, p < 0.001). For Bland-Altman plot, 95.7% of scattered plot fell within ± 1.96 SD limits of agreement revealed that there was good agreement between the two methods used. Cross-classifi cation analysis showed that 36.6% was categorized in the same quartile, 78.5% in identical and contiguous quartiles, with only 3.2% in the opposite quartiles. Regression analysis showed that all categories in FFQ signifi cantly account for the inter-variance for dietary polyphenol intake after controlling for the other variables (R2 = 1.000, p < 0.001). In conclusion, the newly developed FFQ is considered valid and has the potential to be used as a tool to estimate polyphenol intake among elderly individuals in Malaysia

Association of food intake with serum levels of phosphorus and potassium in hemodialysis patients / 한국영양학회지

PURPOSE: Elevated serum phosphorus and potassium levels are a major problem for hemodialysis (HD) patients. Hyperphosphatemia and hyperkalemia are closely related to intake of dietary phosphorus and potassium. METHODS: This study was conducted in order to investigate the effects of food consumed on serum phosphorus and potassium levels in 48 HD patients (20 males and 28 females). We collected anthropometric data, biochemical parameters, and dietary data of the subjects. Dietary data for usual intake were obtained by use of a food-frequency questionnaire (FFQ) consisting of 21 food items. RESULTS: The mean body mass index (BMI) was 22.2 +/- 3.0 kg/m2, mean serum phosphorus level was 4.50 +/- 1.52 mg/dl, and mean serum potassium level was 4.74 +/- 0.73 mEq/l. Hyperphosphatemia (> 4.5 mg/dl) was found in 45.8% of subjects, and hyperkalemia (> 5.0 mEq/l) in 35.4%. Subjects who took medication only were 56% of total, and those who took medication with dietary therapy were 27%. Patients with medication and dietary therapy showed significantly lower serum phosphorus levels compared to patients with medication only (p < 0.05). Mean duration of HD was 7.9 +/- 7.3 years and it showed positive correlation with serum potassium levels (p < 0.05). Serum phosphorus levels showed positive correlation with intake of mixed grains and soybean milk (p < 0.05). Serum potassium levels showed positive correlation with intake of mixed grains (p < 0.01), potatoes, fish, and high-potassium vegetables (p < 0.05). On the other hand, intake of white rice showed negative correlation with serum potassium levels (p < 0.05). CONCLUSION: The results of our study suggest that intake of white rice rather than mixed grains is an important factor in sustaining normal serum phosphorus and potassium levels. In addition, limiting intake of soybean milk, potatoes, and fish to under three serving per week is recommended. Finally, conduct of a strict dietary therapy along with medical treatment is desirable because inappropriate food intake increases serum phosphorus and potassium levels to a higher than normal range.

Development and Evaluation of the Semi-quantitative Food Frequency Questionnaire to Assess Folate Intake in Women of Child-bearing Age / 대한지역사회영양학회지

The aim of this study was to develop and evaluate the simple semi-quantitative food frequency questionnaire (FFQ) for assessing folate intake in women of reproductive age. We developed a 30-item FFQ, and tested the reliability and validity in 97 women aged between 20 and 39 yrs using the FFQs and 24-h recalls, which were carried out twice, respectively. Assessing the reliability, the correlation coefficients were 0.53 (Spearman's) and 0.49 (Pearson's) for folate. There was no significant difference of folate intake between FFQ1 and FFQ2. 36.1% subjects were classified into the same quartile and 83.5% into the same or adjacent quartile divided by folate intake. On determining the validity, the mean folate intake obtained from the FFQ (FFQ1) and 24h-recalls (2-d) were 306.6 +/- 167.2 microg/d and 326.9 +/- 103.3 microg/d, respectively. There was no significant difference between folate intakes from the two methods. The correlation coefficients for folate were 0.24 (Spearman's) and 0.26 (Pearson's). 39.2% of the subjects were categorized into the same quartile and 70.1% were into the same or adjacent quartile. In addition, sensitivity (64.3%) and specificity (62.3%) were estimated to evaluate the adequacy of folate intake. These results suggest that this FFQ would be a useful and a valuable instrument to assess the intake of folate among the Korean women of child-bearing age.

Comparison of major dish item and food group consumption between normal and obese Korean children: application to development of a brief food frequency questionnaire for obesity-related eating behaviors

This study sought to compare intake levels of major dish items and food groups between normal and obese Korean children in order to understand obesity-related eating behaviors. The study was also conducted to apply the information on the differences in major dish items and food groups found in this study to development of a brief food frequency questionnaire (FFQ) for children's obesity-related eating behaviors. Finally, the developed FFQ was evaluated for reliability. A total of 290, 24-hour dietary recall data from 9-11 year-old normal or obese participants in the 2001 Korean National Health and Nutrition Examination Survey (KNHANES) were reviewed to identify dish items and food groups showing outstanding differences between the normal and obese groups. Based on the level of intake amount between the two groups, a total of 7 items, including ddeokbokggi, spaghetti, ham roast, pork cutlet, dairy products & ices, kimchi, and fruits, were selected to be included in the FFQ. The former 5 items were seen to be consumed more in the obese group, while the latter 2 items were so in the normal group. The questionnaire was formatted into a frequency response section of a seven-category option and reference period of the last 7 days. Test-retest reliability of the developed FFQ was examined by administering it to 153, 9-11 year-old children at a public elementary school in Seoul twice at a month interval. The level of reliability was found to be reasonably high. In conclusion, this study suggests that high consumption of several high-calorie dish items and low consumption of kimchi and fruits may be important eating behaviors in relation to obesity risk among 9-11 year-old children who need nutrition educators' attention. The current study also implies that a simple FFQ can be utilized to reliably assess 9-11 year-old children's diets.

Validation and Calibration of Semi-Quantitative Food Frequency Questionnaire: With Participants of the Korean Health and Genome Study / 대한지역사회영양학회지

We carried out a validation-calibration study of the food frequency questionnaire (FFQ) that we had previously developed for a community-based cohort of the Korean Genome and Health Study of the Korea National Genome Research Institute. We have collected a total of 254 3-day diet records (DRs) from 400 subjects, 200 each randomly selected from the two study cohorts of Ansung and Ansan. FFQ was administered at the time of cohort recruitment in 2001, and DRs were collected during a two month period from January through February of 2002. The mean age was 52.2 years. Farming for men and housewife for women were the most common occupations. The majority of the subjects had undergone 6~12 years of education. The general characteristics including demographic and other data were not different from the total cohort subjects. Absolute levels of consumed nutrients including total energy (energy), protein, fat, carbohydrate, calcium, phosphorus, sodium, potassium, iron, retinol, carotene, vitamin A, thiamin, riboflavin, niacin and vitamin C were compared. The average of energy intake was not significantly different between the data collected by the 2 methods. However, consumptions of protein and fat were higher in data of DRs, whereas that of carbohydrate was higher in FFQ data. Significant correlation of each nutrient consumption between the data sets was observed (p <0.05) except in the case of iron, while the average correlation coefficient between them was 0.22 ranging from 0.33 for energy to 0.11 for iron. The results of cross classification by quantile for exact classification ranged from 25.2% (carotene) to 35.0% (phosphorus), and from 64.6% (vitamin A) to 76.4% (retinol) for adjacent classification. The proportion of completely opposite classification was 8.1% in average. Calibration slope was estimated by regression and calibration parameters ranged from 0.025 for carotene to 0.423 for niacin. We conclude that the FFQ we have developed is an appropriate tool for assessing the nutrient intakes as ranking exposures in epidemiology studies in view that amounts of consumed nutrients obtained by FFQ were similar to those collected by DRs, that correlations between consumed nutrients collected by these methods were significant, and that classification results were relatively fair. The correlation coefficients, however, were lower than expected, which may be mainly due to the survey season. In fact, any short-term dietary survey cannot accurately reflect the overall dietary intakes that change heavily depending on seasons. Further studies including the analysis of chemical indices would be helpful for the studies of causal relationship between the diet and disease.

The Development and Validation of a Food Frequency Questionnaire to Assess Diets of Korean Adolescents / 대한지역사회영양학회지

The purpose of this study was to develop and evaluate the validity of a food frequency questionnaire for Korean adolescents (FFQ-A) which could be used in clinical and epidemiological studies of the lifestyle and health of young people. The FFQ-A was designed to reflect the eating pattern of Korean adolescents, and was based on the 1998 Korean National Health and Nutrition Survey Reports. The FFQ-A had 25 food categories. A total of 125 subjects (aged 13 to 15 years) was recruited from a randomly chosen middle school in a middle-income neighborhood in Anyang, South Korea. Each subject completed a FFQ-A, as well as a three-day dietary record. Data from 117 subjects (boys 47, girls 70) was used in the final analyses. Data on the nutrients was analyzed to estimate the Pearson correlations, Spearman rank-order correlations and agreement with categories. The validity of the FFQ-A was assessed relative to a three-day dietary record. The Pearson correlation coefficients for all the subjects were 0.94, 0.87, 0.77, 0.79, 0.49 and 0.68 for energy, carbohydrate, protein, fat, calcium, and iron, respectively. Similarly the Spearman rank-order correlation coefficients were 0.94, 0.85, 0.79, 0.81, 0.46, and 0.77 for energy, carbohydrate, protein, fat, calcium and iron, respectively. The Kappa values for energy, carbohydrate, protein, fat, calcium, and iron were 0.88, 0.67, 0.63, 0.67, 0.26, and 0.59, respectively. The percentage for misclassification of the lowest quartile into the highest quartile or vice versa ranged from 0% (energy, carbohydrate, or fat) to 16.7% (Vitamin C). Therefore the FFQ-A has a reasonable ability to assess the energy, carbohydrate, protein and fat intakes as estimated from a three-day dietary record of Korean adolescents.

Development and Validation of a Computerized Semi-Quantitative Food Frequency Questionnaire Program for Evaluating the Nutritional Status of the Korean Elderly / 대한지역사회영양학회지

The purpose of this study was to develop a semi-quantitative food frequency questionnaire (SQ-FFQ) for subjects aged 50yr and over and to evaluate the validity of this SQ-FFQ. Dietary intake was assessed using SQ-FFQ that included 98 commonly consumed flood items selected from the results of the Korean Health and Nutritional Survey, 1998. Subjects (n = 2,660) aged 50yr and over were recruited from 7 metropolitan cities and 8 small cities. Each subject was interviewed using this SQ-FFQ developed in our laboratory and 24hr-recall method. Excluding incomplete data, Data from 1,149 subjects were used in this validity study. The nutrient intakes assessed by this SQ-FFQ were validated by comparing with the results from 1 day 24-hour recalls. Pearson's correlation coefficients between two methods were 0.71, 0.64, 0.53, and 0.43 for energy, carbohydrate, protein, and fat, respectively for all subjects. Spearman's correlation coefficients were higher than those of Pearson's correlation coefficients. Kappa values for energy, carbohydrate, protein, and fat were 0.79, 0.72, 0.70, and 0.64, respectively. The percentage for misclassification of the lowest quartile into the highest quartile or vice versa was 1.25-1.39% for all nutrients. Therefore, this SQ-FFQ seems to be useful in assessing the nutritional status of the middle-aged and elderly subjects in Korea.