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Cited by 210Nutritional Studies and DietNutrition, Health and Food BehaviorNutrition, Genetics, and Disease

Online dietary intake estimation: reproducibility and validity of the Food4Me Food frequency questionnaire against a 4-day weighed food record

Open access
Fallaize, Rosalind, Forster, Hannah, Macready, Anna L, Walsh, Marianne C, Mathers, John C, Brennan, Lorraine, Gibney, Eileen R, Gibney, Michael J +1 more·2014·Journal of Medical Internet Research
DOI 10.2196/jmir.3355PMC PMC4147714
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Abstract

BACKGROUND: Advances in nutritional assessment are continuing to embrace developments in computer technology. The online Food4Me food frequency questionnaire (FFQ) was created as an electronic system for the collection of nutrient intake data. To ensure its accuracy in assessing both nutrient and food group intake, further validation against data obtained using a reliable, but independent, instrument and assessment of its reproducibility are required. OBJECTIVE: The aim was to assess the reproducibility and validity of the Food4Me FFQ against a 4-day weighed food record (WFR). METHODS: Reproducibility of the Food4Me FFQ was assessed using test-retest methodology by asking participants to complete the FFQ on 2 occasions 4 weeks apart. To assess the validity of the Food4Me FFQ against the 4-day WFR, half the participants were also asked to complete a 4-day WFR 1 week after the first administration of the Food4Me FFQ. Level of agreement between nutrient and food group intakes estimated by the repeated Food4Me FFQ and the Food4Me FFQ and 4-day WFR were evaluated using Bland-Altman methodology and classification into quartiles of daily intake. Crude unadjusted correlation coefficients were also calculated for nutrient and food group intakes. RESULTS: In total, 100 people participated in the assessment of reproducibility (mean age 32, SD 12 years), and 49 of these (mean age 27, SD 8 years) also took part in the assessment of validity. Crude unadjusted correlations for repeated Food4Me FFQ ranged from .65 (vitamin D) to .90 (alcohol). The mean cross-classification into "exact agreement plus adjacent" was 92% for both nutrient and food group intakes, and Bland-Altman plots showed good agreement for energy-adjusted macronutrient intakes. Agreement between the Food4Me FFQ and 4-day WFR varied, with crude unadjusted correlations ranging from .23 (vitamin D) to .65 (protein, % total energy) for nutrient intakes and .11 (soups, sauces and miscellaneous foods) to .73 (yogurts) for food group intake. The mean cross-classification into "exact agreement plus adjacent" was 80% and 78% for nutrient and food group intake, respectively. There were no significant differences between energy intakes estimated using the Food4Me FFQ and 4-day WFR, and Bland-Altman plots showed good agreement for both energy and energy-controlled nutrient intakes. CONCLUSIONS: The results demonstrate that the online Food4Me FFQ is reproducible for assessing nutrient and food group intake and has moderate agreement with the 4-day WFR for assessing energy and energy-adjusted nutrient intakes. The Food4Me FFQ is a suitable online tool for assessing dietary intake in healthy adults.

AI snapshot

Written from the paper’s full text.

TL;DR

The online Food4Me FFQ showed good reproducibility over 4 weeks and moderate validity against a 4-day weighed food record for energy and energy-adjusted nutrient intakes in healthy adults. It was considered suitable for assessing dietary intake in healthy adults, although agreement varied by nutrient and food group.

Key findings

  • Reproducibility: repeated Food4Me FFQ correlations ranged from .65 (vitamin D) to .90 (alcohol), mean .75; mean cross-classification into “exact agreement plus adjacent” was 92% for both nutrient and food group intakes; Bland-Altman plots showed good agreement for energy-adjusted macronutrient intakes.
  • Validity: Food4Me FFQ vs 4-day WFR correlations ranged from .23 (vitamin D) to .65 (protein, % total energy) for nutrients, mean .47; food group SCC ranged from .11 (soups, sauces and miscellaneous foods) to .73 (yogurts), mean .2; mean “exact agreement plus adjacent” was 80% for nutrients and 78% for food groups.
  • There were no significant differences between energy intakes estimated by the Food4Me FFQ and 4-day WFR; Bland-Altman plots showed good agreement for energy and energy-controlled nutrient intakes. SFA and MUFA intakes were significantly higher, and carbohydrate (%TE) significantly lower, for the FFQ than the WFR (P<.001 and P=.01, respectively).
  • Usability: the Food4Me FFQ was rated significantly easier and less time consuming to complete than the 4-day WFR (P<.001), but the WFR was rated as significantly more interesting (P=.006) and made participants reflect more on intake (P=.002).

Methods

  • Design: reproducibility assessed by test-retest Food4Me FFQ completed 2 occasions 4 weeks apart; validity assessed in half the sample who completed a 4-day WFR 1 week after the first FFQ; participants asked not to change their diet.
  • Sample: 121 recruited, 113 eligible, final analysis included 100 participants for reproducibility (mean age 31.5, SD 11.9 years; 31 males, 69 females) and 49 for validity (mean age 26.9, SD 8.4 years; 15 males, 34 females), recruited from the University of Reading, UK, aged ≥18 years and healthy.
  • Analysis: SPSS v20; paired t tests, general linear models controlling for energy and gender where appropriate, Pearson/Spearman correlations, quartile cross-classification, and Bland-Altman plots; underreporters identified using Henry equation BMR × PAL 1.1, and energy intakes >4500 kcal excluded.

Limitations

  • Stated: validation used a convenient university sample rather than a nationally representative one, potentially with higher education; those recruited first completed the WFR and may have been more motivated; nonconsecutive WFR days may have led participants to make up intake on non-recording days; the 4-week repeat interval may allow memory/replication, though this was considered unlikely with 157 food items.
  • Evident: the validation subsample was younger (mean 26.9 vs 31.5 years) and smaller (n=49) than the reproducibility sample, and BMI was based on self-reported weight and height, which may limit generalizability.
  • Evident: food group validity correlations were highly variable and low on average (mean .2), with only 22 of 35 food groups showing significant correlations, indicating weaker ranking agreement for food groups than for nutrients.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.2196/jmir.3355

Cites

44 of 44 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 47 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    For repeated Food4Me FFQ food group intakes, exact agreement ranged from 46% (fats and oils) to 86% (tinned fruit or vegetables).

    “The percentage of participants classified into quartiles of exact agreement ranged from 46% (fats and oils) to 86% (tinned fruit or vegetables).”
    Quote in the paperSubstantial claim
  • Findingown data

    When underreporters had been removed (n=19), a significant difference in energy intake between the 4-day WFR and Food4Me FFQ1 was observed (P<.05).

    “However, when underreporters had been removed (n=19), a significant difference in intake was observed (P<.05) (Table 5).”
    Quote in the paperNot a substantial claim
  • Findingown data

    The percentage of participants classified into quartiles of exact agreement for repeated Food4Me FFQ ranged from 45% (polyunsaturated fatty acids %TE) to 74% (vitamin A retinol equivalents, RE).

    “The percentage of participants classified into quartiles of exact agreement ranged from 45% (polyunsaturated fatty acids %TE) to 74% (vitamin A retinol equivalents, RE).”
    Quote in the paperSubstantial claim
  • Findingown data

    Agreement between the Food4Me FFQ and 4-day WFR varied, with crude unadjusted correlations ranging from .23 (vitamin D) to .65 (protein, % total energy) for nutrient intakes.

    “Agreement between the Food4Me FFQ and 4-day WFR varied, with crude unadjusted correlations ranging from .23 (vitamin D) to .65 (protein, % total energy) for nutrient intakes”
    Quote in the paperSubstantial claim
  • Findingown data

    The mean cross-classification into exact agreement plus adjacent was 92% for both nutrient and food group intakes for repeated Food4Me FFQ.

    “The mean cross-classification into “exact agreement plus adjacent” was 92% for both nutrient and food group intakes”
    Quote in the paperSubstantial claim
  • May combine two claims. 44
  • Classified as probably not a substantial claim. 25

  • May combine two claims.

    Findingown data

    The mean percentage of participants classified into quartiles of disagreement for repeated Food4Me FFQ was 7%, with less than 1% of participants on average classified into extreme disagreement.

    “The mean percentage of participants classified into quartiles of disagreement was 7% with less than 1% of participants on average classified into extreme disagreement.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Variation between estimates of energy increased with higher mean energy intakes, suggesting poorer reproducibility for those participants reporting higher energy intakes.

    “In contrast with the energy-adjusted macronutrient intakes, variation between estimates of energy increased with higher mean energy intakes (Figure 3), suggesting poorer reproducibility for those participants reporting higher energy intakes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The mean percentage of participants classified into quartiles of disagreement for repeated Food4Me FFQ food group intakes was 7%, and for extreme disagreement was 1%.

    “The mean percentage of participants classified into quartiles of disagreement was 7% and for extreme disagreement was 1%.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    For energy and total fat intake, 6% of cases fell outside of the limits of agreement, and for carbohydrate 7%, indicating similar reproducibility.

    “For energy and total fat intake, 6% of cases fell outside of the limits of agreement and for carbohydrate 7%, indicating similar reproducibility.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The mean correlation coefficient for energy and nutrient intakes between repeated Food4Me FFQ was .75, and correlations were significant for all nutrients (P<.01).

    “Correlation coefficients ranged from .65 (vitamin D) to .90 (alcohol) with a mean value of .75. Correlations were significant for all nutrients (P<.01).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The Food4Me FFQ showed good reproducibility for the estimation of daily protein intake, with less than 5% of cases falling outside of the limits of agreement.

    “The Food4Me FFQ showed good reproducibility for the estimation of daily protein intake, with less than 5% of cases falling outside of the limits of agreement.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    SCC for food group intakes between repeated Food4Me FFQ ranged from .55 (tinned fruit or vegetables) to .92 (alcoholic beverages) with a mean value of .75, and correlations were significant for all food groups (P<.01).

    “SCC ranged from .55 (tinned fruit or vegetables) to .92 (alcoholic beverages) with a mean value of .75. Correlations were significant for all food groups (P<.01).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The mean cross-classification into exact agreement plus adjacent was 80% for nutrient intake and 78% for food group intake between Food4Me FFQ and 4-day WFR.

    “The mean cross-classification into “exact agreement plus adjacent” was 80% and 78% for nutrient and food group intake, respectively.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Estimates of energy-adjusted protein and total fat intake were higher at FFQ2 with biases of -0.22 %TE and -1.23 %TE, respectively.

    “Conversely, estimates of energy-adjusted protein and total fat intake were higher at FFQ2 with biases of –0.22 %TE and –1.23 %TE, respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The mean difference (bias) between energy intakes was relatively small (135 kcal/day), with greater values being estimated at FFQ1.

    “The mean difference (bias) between energy intakes was relatively small (135 kcal/day) with greater values being estimated at FFQ1.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The mean difference (bias) between energy intakes was relatively small (178 kcal/day), with greater values estimated in the Food4Me FFQ, as was the case for energy derived from total fat and protein.

    “The mean difference (bias) between energy intakes was relatively small (178 kcal/day) with greater values being estimated in the Food4Me FFQ, as was the case for energy derived from total fat and protein.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Overall, less than 5% of cases fell outside of the limits of agreement for all Bland-Altman plots, indicating good agreement between the methods.

    “Overall, less than 5% of cases fell outside of the limits of agreement for all plots indicating good agreement between the methods.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Correlation was significant for the majority of nutrients at the P<.01 level, with the exception of total fat (%TE), PUFA (%TE), and vitamin D.

    “Correlation was significant for the majority of nutrients at the P<.01 level, with the exception of total fat (%TE), PUFA (%TE), and vitamin D.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The Food4Me FFQ was considered significantly easier and less time consuming to complete than the 4-day WFR.

    “The Food4Me FFQ was considered significantly easier and less time consuming to complete than the 4-day WFR.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The mean percentage of participants classified into quartiles of disagreement for food groups was 17%, and for extreme disagreement was 5%.

    “The mean percentage of participants classified into quartiles of disagreement was 17% and for extreme disagreement was 5%.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Estimated intakes of calcium, total carotene, riboflavin, vitamin B12, vitamin C, retinol, and vitamin D were significantly different between the 4-day WFR and FFQ1, with all higher for the FFQ.

    “Estimated intakes of calcium, total carotene, riboflavin, vitamin B12, vitamin C, retinol, and vitamin D intakes were significantly different between 4-day WFR and FFQ1 (all were higher for the FFQ).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Removing underreporters from the dataset improved agreement for energy-controlled carbohydrate and vitamin D, with no significant differences observed between estimates of these nutrients.

    “Removing underreporters from the dataset reduced the agreement between the 2 methods for folate, vitamin B6, and vitamin E, but improved agreement for energy-controlled carbohydrate and vitamin D, with no significant differences observed between estimates of these nutrients (data not shown).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In total, 12 participants underreported in the 4-day WFR and 15 underreported in the Food4Me FFQ1, with 8 of these underreporting in both methods.

    “In total, 12 participants underreported in the 4-day WFR and 15 underreported in the Food4Me FFQ1, with 8 of these underreporting in both methods.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    No significant differences were observed between age and body mass index (BMI) for males and females.

    “No significant differences were observed between age and body mass index (BMI) for males and females.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Spearman correlation coefficients for food group intakes between the Food4Me FFQ and 4-day WFR ranged from .11 (soups, sauces and miscellaneous foods) to .73 (yogurts) with a mean value of .2.

    “SCC ranged widely from .11 (soups, sauces and miscellaneous foods) to .73 (yogurts) with a mean value of .2.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The mean percentage of participants classified into quartiles of disagreement was 16%, with less than 4% classified into extreme disagreement.

    “The mean percentage of participants classified into quartiles of disagreement was 16% with less than 4% of participants classified into extreme disagreement.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Participants who completed the WFR (validation study) were, on average, 4.6 years younger than the participant group as a whole.

    “Participants who completed the WFR (validation study) were, on average, 4.6 years younger than the participant group as a whole.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Findingown data

    The final dataset for analysis included 100 participants, of whom 49 had also completed the 4-day WFR.

    “The final dataset for analysis included 100 participants, of whom 49 had also completed the 4-day WFR, as illustrated in Figure 2.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Ranks of energy and nutrient intake estimated using the Food4Me FFQ were highly comparable to the 4-day WFR, with the percentage of individuals classified into quartiles of exact agreement and exact agreement plus adjacent averaging 40% and 80%, respectively.

    “Ranks of energy and nutrient intake estimated using the Food4Me FFQ were highly comparable to the 4-day WFR with the percentage of individuals classified into quartiles of exact agreement and exact agreement plus adjacent averaging 40% and 80%, respectively.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the present study, 22 of 30 nutrients assessed had a correlation coefficient greater than the .4 threshold proposed by Cade et al., and 13 of 30 achieved a correlation greater than or equal to the .5 proposed by Masson et al.

    “In the present study, 22 of 30 nutrients assessed had a correlation coefficient greater than the .4 threshold that was proposed by Cade at al. [23], and 13 of 30 achieved a correlation greater than or equal to the “desirable” .5 proposed by Masson et al [42].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [23] source

      Not checked in the free run.

    • cites [42] source

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  • May combine two claims.

    Findingown data

    The degree of underreporting between the Food4Me FFQ and 4-day WFR varied, with 12 (24%) and 15 (15%) participants deemed to be underreporting in the 4-day WFR and Food4Me FFQ, respectively.

    “The degree of underreporting between the Food4Me FFQ and 4-day WFR varied, with 12 (24%) and 15 (15%) participants deemed to be underreporting in the 4-day WFR and Food4Me FFQ, respectively.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Cross-classifications of estimates of food group intake were similar to that of the nutrients, with classification into quartiles of exact agreement plus adjacent averaging 78%, and Bland-Altman plots demonstrated good agreement between the 2 methods for estimates of energy and energy-adjusted macronutrient intakes.

    “Cross-classifications of estimates of food group intake were similar to that of the nutrients, with classification into quartiles of exact agreement plus adjacent averaging 78% and Bland-Altman plots demonstrated good agreement between the 2 methods for estimates of energy and energy-adjusted macronutrient intakes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Participants in the present study reported that the Food4Me FFQ was easier to use and less time consuming compared with the 4-day WFR.

    “Our observation that participants in the present study reported that the Food4Me FFQ was easier to use and less time consuming compared with the 4-day WFR, is promising given the movement of health service delivery toward Web-based interventions.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    The Henry equation can be used to calculate basal metabolic rate, and BMR multiplied by a physical activity level of 1.1 can calculate the lowest possible estimated energy requirements for each participant.

    “The Henry equation [25] was used to calculate basal metabolic rate (BMR), and BMR was multiplied by a physical activity level (PAL) of 1.1 to calculate the lowest possible estimated energy requirements (EER) for each participant [26].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [25] Henry, CJ, 2005, Public Health Nutr source

      Not checked in the free run.

    • cites [26] Goldberg, GR, 1991, Eur J Clin Nutr

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    A daily energy intake greater than 4500 kcal is considered implausibly high.

    “Participants reporting a daily energy intake greater than 4500 kcal, which is considered implausibly high, were excluded from the analysis [27].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [27] Hébert, JR, 2001, Ann Epidemiol source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    The WFR is often considered the most accurate measure of intake and has been referred to as the imperfect gold standard.

    “The WFR, which involves weighing all foods and drinks consumed over a 3-7 day period, is often considered the most accurate measure of intake and has been referred to as the imperfect gold standard [10].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [10] Coulston, AM, 2008, Nutrition in the Prevention and Treatment of Disease

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    FFQ are generally validated against existing dietary assessment methods, such as WFR.

    “FFQ are generally validated against existing dietary assessment methods, such as WFR [19], and several FFQ have been validated for electronic and online use recently [14,20-22].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Good agreement between cross-classifications of daily energy and nutrient intakes estimated using the Food4Me and EPIC-Norfolk FFQ demonstrated the utility of the Food4Me FFQ for ranking individuals based on their nutrient intake.

    “Good agreement between cross-classifications of daily energy and nutrient intakes, estimated using the 2 FFQ, demonstrated the utility of the Food4Me FFQ for ranking individuals based on their nutrient intake.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    Further testing of the Food4Me FFQ was required to establish its wider utility.

    “However, it was noted that further testing of the Food4Me FFQ was required to establish its wider utility [18].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Previous validation of the Food4Me FFQ has demonstrated good agreement with the printed EPIC-Norfolk FFQ for the estimation of food and nutrient intake.

    “Previous validation of the Food4Me FFQ has demonstrated good agreement with the printed EPIC-Norfolk FFQ for the estimation of food and nutrient intake.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Tsubono et al found that correlation coefficients tended to be lower when FFQ were repeated after a long time interval (6 months to 1 year) compared with a shorter time interval (1 to 6 months).

    “Tsubono et al [40] found that correlation coefficients tended to be lower when FFQ were repeated after a long time interval (6 months to 1 year) compared with a shorter time interval (1 to 6 months), and proposed that the temporal difference may be due to changes in dietary habits which are more likely to occur with longer time intervals.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [40] Tsubono, Y, 1995, Am J Epidemiol source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Given that the WFR is described as the gold standard for assessing intake, the observation that estimates of energy intake were similar between the Food4Me FFQ and the 4-day WFR and that a smaller proportion of participants appeared to underreport with the Food4Me FFQ suggests that the Food4Me FFQ is a promising tool for estimating habitual food intake.

    “Given that the WFR is described as the gold standard for assessing intake, our observation that estimates of energy intake were similar between the Food4Me FFQ and the 4-day WFR and that a smaller proportion of participants appeared to underreport with the Food4Me FFQ suggests that the Food4Me FFQ is a promising tool for estimating habitual food intake.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The 4-day WFR is the gold standard for assessing intake.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationreasoning

    With a large FFQ containing 157 food items, as used in the present study, it is unlikely that many participants would be able to remember their earlier responses.

    “However, with a large FFQ containing 157 food items, as used in the present study, it is unlikely that many participants would be able to remember their earlier responses.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The above-average reproducibility of the Food4Me FFQ could be attributed to the addition of food photographs to the FFQ for the estimation of portion size intake.

    “The above-average reproducibility of the Food4Me FFQ could be attributed to the addition of food photographs to the FFQ for the estimation of portion size intake.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    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].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [32] source

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    • cites [38] source

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    • cites [41] source

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  • May combine two claims.

    Interpretationown data

    Estimates of intake showing disagreement between measurement tools in the present study were small and were comparable with the aforementioned studies.

    “Estimates of intake showing disagreement between measurement tools in the present study were small and were comparable with the aforementioned studies.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    It has been suggested that for very short time intervals between administrations, respondents may remember and replicate their entries rather than reporting their diet intake accurately.

    “In addition, it has also been suggested that for very short time intervals between administrations, respondents may remember and replicate their entries rather than reporting their diet intake accurately [23].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationnone given

    It is difficult to compare results from these studies because the type of food records and time intervals between dietary assessments differed substantially and there may be substantial differences in the food items included in particular food groups in each of the studies.

    “However, it is difficult to compare results from these studies because the type of food records and time intervals between dietary assessments differed substantially and there may be substantial differences in the food items included in particular food groups in each of the studies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Similar studies have reported correlations ranging from .09 to .83, .17 to .95, and .09 to .58 with mean values of .38, .63, and .58, respectively.

    “Similar studies have reported correlations ranging from .09 to .83 [37], .17 to .95 [36], and .09 to .58 [41] with mean values of .38, .63, and .58, respectively.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [37] Hu, FB, 1999, Am J Clin Nutr source

      Not checked in the free run.

    • cites [36] Feskanich, D, 1993, J Am Diet Assoc source

      Not checked in the free run.

    • cites [41] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The pattern of higher estimated energy and nutrient intakes on the first administration of the Food4Me FFQ has been observed in numerous other reproducibility studies.

    “This pattern has been observed in numerous other reproducibility studies [21,31-32], and is proposed to result from learning effects and questionnaire fatigue [39].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [21] source

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    • cites [31] source

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    • cites [32] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    The pattern of higher estimated energy and nutrient intakes on the first administration of the Food4Me FFQ is proposed to result from learning effects and questionnaire fatigue.

    “This pattern has been observed in numerous other reproducibility studies [21,31-32], and is proposed to result from learning effects and questionnaire fatigue [39].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [39] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    A potential criticism of the assessment of reproducibility is the short duration between repeated measures.

    “A potential criticism of the assessment of reproducibility is the short duration between repeated measures.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The self-administered online Food4Me FFQ demonstrates good reproducibility for the estimation of energy, nutrient, and food group intakes and moderate agreement for the assessment of energy and nutrient intakes when compared with a 4-day WFR in an adult population.

    “In conclusion, the self-administered online Food4Me FFQ demonstrates good reproducibility for the estimation of energy, nutrient, and food group intakes and moderate agreement for the assessment of energy and nutrient intakes when compared with a 4-day WFR in an adult population.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    A further limitation is the use of nonconsecutive days in the 4-day WFR, which may have resulted in participants making up food intake on the days they do not record.

    “A further limitation is the use of nonconsecutive days in the 4-day WFR, which may have resulted in participants making up food intake on the days they do not record (eg, eating healthy for the record days and overconsuming between record days).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The use of a convenient university population, with a potentially higher education level, may have implications on the ability of the wider population to complete the online Food4Me FFQ.

    “The use of a convenient university population, with a potentially higher education level, may have implications on the ability of the wider population to complete the online Food4Me FFQ.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    The validation of the Food4Me FFQ was assessed in a convenient rather than a nationally representative sample of the population, although the inclusion/exclusion criteria used were the same as those intended for the Food4Me study.

    “It should be noted that the validation of the Food4Me FFQ was assessed in a convenient rather than a nationally representative sample of the population, although the inclusion/exclusion criteria used were the same as those intended for the Food4Me study [16].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Food4Me2011http://www.food4me.org6J5McFpZv

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    It is encouraging that estimates of fish products were well correlated, as these foods are eaten less frequently and may be prone to underrepresentation in 4-day WFR.

    “It is also encouraging that estimates of fish products were well correlated, as these foods are eaten less frequently and may be prone to underrepresentation in 4-day WFR.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    Cade et al suggested that the time interval between repeated measures using a dietary instrument should be chosen to minimize changes in dietary intake and our use of 4 weeks fits that criterion.

    “Cade et al [23] suggested that the time interval between repeated measures using a dietary instrument should be chosen to minimize changes in dietary intake and our use of 4 weeks fits that criterion.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [23] source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    Strengths of the present study include the comparison of the Food4Me FFQ with the gold standard, a WFR, and the use of multiple methods to assess the validation and reproducibility of the Food4Me FFQ.

    “Strengths of the present study include the comparison of the Food4Me FFQ with the gold standard, a WFR, and the use of multiple methods to assess the validation and reproducibility of the Food4Me FFQ.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    It has been suggested that for very short time intervals, respondents may remember and replicate their entries rather than accurately reporting their dietary intake, but this is unlikely to be a significant problem in the present study where the Food4Me FFQ contained 157 food items.

    “It has been suggested that for very short time intervals, respondents may remember and replicate their entries rather than accurately reporting their dietary intake [23], but this is unlikely to be a significant problem in the present study where the Food4Me FFQ contained 157 food items.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [23] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationreasoning

    Remembering their responses to such a long list of questions after a period of 4 weeks is a memory challenge beyond most people's abilities.

    “Remembering their responses to such a long list of questions after a period of 4 weeks is a memory challenge beyond most people’s abilities.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    This validation study had an adequate sample size similar to those used in previous studies.

    “In addition, this validation study had an adequate sample size [15] similar to those used in previous studies [30,45-46].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [15] Willett, W, 1998, Nutritional Epidemiology source

      Not checked in the free run.

    • cites [30] source

      Not checked in the free run.

    • cites [45] Munger, RG, 1992, Am J Epidemiol source

      Not checked in the free run.

    • cites [46] Riley, MD, 1995, Diabetes Care source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    Nonconsecutive recording does have the advantage of capturing a greater diversity of food intake over a week's period.

    “However, nonconsecutive recording does have the advantage of capturing a greater diversity of food intake over a week’s period.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Limitations of the study include the use of those recruited first to complete the 4-day WFR because these individuals may have been more motivated to comply with the guidelines.

    “Limitations of the study include the use of those recruited first to complete the 4-day WFR because these individuals may have been more motivated to comply with the guidelines.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    Because they refer to just 4 days' intake, WFR provide a limited snapshot of an individual's diet only and are less able to assess patterns of dietary intake than the Food4Me FFQ, which attempts to capture intakes over the previous month.

    “Furthermore, because they refer to just 4 days’ intake, WFR provide a limited snapshot of an individual’s diet only and are less able to assess patterns of dietary intake than the Food4Me FFQ, which attempts to capture intakes over the previous month.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    The average reported correlation coefficient for crude total fat intake using FFQs repeated after 1 month or less was .68, which compares very favorably with the correlation coefficient of .81 in the present study, showing above-average performance for the Food4Me FFQ.

    “The average reported correlation coefficient for crude total fat intake using FFQs repeated after 1 month or less was .68 [19], which compares very favorably with the correlation coefficient of .81 in the present study, showing above-average performance for the Food4Me FFQ.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] source

      Not checked in the free run.

61 of 61

  • The paper relies on this without support.

    Participants in the study are representative of healthy adults in general.

    “The Food4Me FFQ is a suitable online tool for assessing dietary intake in healthy adults.”

  • The paper relies on this without support.

    Participants complied with the instruction not to change their diet during the study.

    “Participants were asked not to change their diet during the study.”

  • The paper relies on this without support.

    The 4-day WFR is the gold standard for assessing intake.

    “Given that the WFR is described as the gold standard for assessing intake, our observation that estimates of energy intake were similar between the Food4Me FFQ and the 4-day WFR and that a smaller proportion of participants appeared to underreport with the Food4Me FFQ suggests that the Food4Me FFQ is a promising tool for estimating habitual food intake.”

  • The paper relies on this without support.

    Foods perceived as healthy, such as fruit and vegetables, are prone to overestimation in FFQ.

    “In addition, foods perceived as healthy, such as fruit and vegetables, are prone to overestimation in FFQ.”

  • The paper relies on this without support.

    Alcohol is often considered a confounder in nutrition research given that it constitutes the difference between food and total dietary energy intake.

    “Alcohol is often considered a confounder in nutrition research given that it constitutes the difference between food and total dietary energy intake; therefore, it is important that it is estimated reliably using the Food4Me FFQ.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Reported fat components exceed total fat

    Major

    For the FFQ in Table 5, saturated, monounsaturated and polyunsaturated fats total 88.1 g, exceeding the reported 79.6 g of total fat. These component and total means cannot all be correct for the same participants.

    Reported 79.6 · recomputed 88.1

  • Stated maximum food-group adjacent agreement excludes yogurt result

    Minor

    The text says exact-plus-adjacent agreement reaches at most 90%, but Table 7 reports 96% for yogurts.

2 of 2

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. Nelson, M, 1997, Food Portion Sizes: A Photographic Atlas
  2. Goldberg, GR, 1991, Eur J Clin Nutr, 45, 569

Cited by

Sorted by citations

Related

Authors
Fallaize, R., Forster, H., Macready, A. L., Walsh, M. C., Mathers, J. C., Brennan, L., Gibney, E. R., Gibney, M. J., & Lovegrove, J. A.
Affiliations
  • University of Reading (GB)
  • University College Dublin (IE)
  • Newcastle University (GB)
Corresponding author
Lovegrove, Julie A
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2014-08-11
Volume
16
Issue
8
Pages
e190
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/jmir.3355
PMC
PMC4147714
OpenAlex
W2043684639
Semantic Scholar
5e9affe5f2ed3c31c8ec4303f193250228513ecf
Cited by
210
References
44
Citations by year
2026: 8 · 2025: 11 · 2024: 10 · 2023: 8 · 2022: 17 · 2021: 49 · 2020: 16 · 2019: 11 · 2018: 18 · 2017: 27 · 2016: 23 · 2015: 10 · 2014: 2
FWCI
20.47
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • CentAUR (University of Reading) (submittedVersion, cc-by)
  • University of Hertfordshire Research Archive (University of Hertfordshire) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Newcastle University ePrints (Newcastle Univesity)
Funders
  • Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
  • NIHR Newcastle Biomedical Research Centre (BH111030)
  • FP7 Food, Agriculture and Fisheries, Biotechnology (265494)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Nutrition, Genetics, and Disease
Keywords
reproducibility, validity, weighed food records, nutrient intake estimation, food group intake, test-retest agreement, Bland-Altman agreement, vitamin D intake, alcohol consumption, validation studies, reproducibility coefficient
MeSH terms
Adolescent, Adult, Energy Intake, Diet, Female, Food, Humans, Male, Surveys and Questionnaires, Reproducibility of Results, Nutrition Assessment, Diet Records, Linear Models, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

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