Relative validity and reproducibility of a quantitative FFQ for assessing nutrient intakes of vegetarians in Taiwan
Open accessAbstract
Objective: To assess the relative validity and reproducibility of the quantitative FFQ used in the Tzu Chi Health Study (TCHS). Design: The reproducibility was evaluated by comparing the baseline FFQ with the 2-year follow-up FFQ. The validity was evaluated by comparing the baseline FFQ with 3 d dietary records and biomarkers (serum folate and vitamin B 12). Median comparison, cross-classification and Spearman correlation with and without energy adjustment and deattenuation for day-to-day variation were assessed. Setting: TCHS is a prospective cohort containing a high proportion of true vegetarians and part-time vegetarians (regularly consuming a vegetarian diet without completely avoiding meat). Subject: Subsets of 103, seventy-eight and 1528 TCHS participants were included in the reproducibility, dietary record-validity and biomarker-validity studies, respectively. Results: Correlations assessing the reproducibility for repeat administrations of the FFQ were in the range of 0·46–0·65 for macronutrients and 0·35–0·67 for micronutrients; the average same quartile agreement was 40%. The correlation between FFQ and biomarkers was 0·41 for both vitamin B 12 and folate. Moderate to good correlations between the baseline FFQ and dietary records were found for energy, protein, carbohydrate, saturated and monounsaturated fat, fibre, vitamin C, vitamin A, K, Ca, Mg, P, Fe and Zn (average crude correlation: 0·47 (range: 0·37–0·66); average energy-adjusted correlation: 0·43 (range: 0·38–0·55); average energy-adjusted deattenuated correlation: 0·50 (range: 0·44–0·66)) with same quartile agreement rate of 39% (range: 35–45%), while misclassification to the extreme quartile was rare (average: 4% (range: 0–6%)). Conclusions: The FFQ is a reliable and valid tool to rank relative intake of major nutrients for TCHS participants.
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Previous studies comparing FFQ with food records have reported average exact agreement classifications between 34% and 49% and exact agreement plus adjacent quartile classifications of 77%.
“Previous studies comparing FFQ with food records have reported average exact agreement classifications between 34% and 49% [32,38,41] and exact agreement plus adjacent quartile classifications of 77% [21].”
From Online dietary intake estimation: reproducibility and validity of the Food4Me Food frequency questionnaire against a 4-day weighed food record (2014) · cites this paper as [38]
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- Authors
- Chiu, T. H., Huang, H.-Y., Chen, K.-J., Wu, Y.-R., Chiu, J. P., Li, Y.-H., Chiu, B. C.-H., Lin, C.-L., & Lin, M.-N.
- Affiliations
- Tzu Chi Foundation (TW)
- Chung Hwa University of Medical Technology (TW)
- Dalin Tzu Chi Hospital (TW)
- University of British Columbia (CA)
- Tzu Chi University (TW)
- University of Chicago (US)
- Corresponding author
- Lin, Ming-Nan
- Venue
- Public Health Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2013-06-20
- Volume
- 17
- Issue
- 7
- Pages
- 1459-1466
- ISSN
- 1368-9800 (ISSN-L)
- 1475-2727
- PMC
- PMC10282333
- OpenAlex
- W2321550677
- Cited by
- 47
- References
- 27
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 5 · 2023: 6 · 2022: 6 · 2021: 2 · 2020: 5 · 2019: 4 · 2018: 6 · 2017: 2 · 2014: 4
- FWCI
- 1.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Public Health Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Keywords
- food frequency questionnaire, dietary assessment validity, reproducibility, vegetarians, dietary records, serum folate, vitamin B12, nutrient intake, energy adjustment, day-to-day variability, micronutrient intake
- MeSH terms
- Adult, Aged, Diet Surveys, Feeding Behavior, Female, Humans, Male, Middle Aged, Nutritive Value, Prospective Studies, Surveys and Questionnaires, Taiwan, Diet, Vegetarian, Reproducibility of Results, Biomarkers, Nutrition Assessment, Diet Records
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