Dickinson Kacie M, Delaney Christopher L, Allan Richard, Spark Ian, Miller Michelle D
a Department of Nutrition and Dietetics , Flinders University , Adelaide , AUSTRALIA.
J Am Coll Nutr. 2015;34(4):333-9. doi: 10.1080/07315724.2014.962191. Epub 2015 Apr 11.
Short food frequency questionnaires (FFQs) are powerful screening instruments for estimating nutrient intakes and play an important role in risk stratification in vulnerable populations. Omega-3 fatty acids are of increasing importance in the prevention of chronic and degenerative disease, especially in older adults who are at higher risk of these chronic conditions. A short FFQ exists to rapidly assess omega-3 intake from marine sources, however it has not previously been validated for agreement with total omega-3 intake and ability to identify suboptimal omega-3 intakes in older adults or for use in Australia.
The aim of the study was to validate a 9-item marine omega-3 FFQ (MFQ) for assessment of omega-3 intake against a validated 74-item semiquantitative FFQ.
One hundred and eight participants (mean age 67 ± 10 years, 47% male) completed the MFQ designed to estimate omega-3 intake from marine sources and the 74-item FFQ designed to estimate usual omega-3 and total energy intake in addition to other nutrients. To test agreement between the two questionnaires for estimating total omega-3 intake, mean bias and 95% limits of agreement (LOA) were calculated. Sensitivity and specificity were assessed using 2 × 2 contingency tables based on whether participants did or did not meet National Heart Foundation (NHF) recommendations for omega-3 intake per day.
Mean intake of omega-3 estimated from the MFQ was 210 ± 235 mg/day compared with 295 ± 260 mg/day as estimated by the FFQ. Mean bias (95% LOA) for omega-3 assessed by the two questionnaires was 89 mg/day (-475 mg to 653 mg). The MFQ achieved 98% sensitivity and 31% specificity for the omega-3 cut-off of 500 mg/day. When nutrient composition of the marine products were replaced with Australian data, mean intake of omega-3 was 230 ± 253 mg and the mean bias improved to 64 mg (-681 mg to 553 mg) and achieved 93% sensitivity and 40% specificity.
The MFQ shows promise as a rapid screening tool for identifying older adults with intakes of omega-3 fatty acids likely to be below recommendations for chronic and degenerative disease risk reduction. Given the clinically meaningful mean bias and wide LOA, it cannot be recommended as an appropriate tool for the purpose of reporting average intake of individuals. Use of Australian nutrient data improved the mean bias of the tool in estimating total omega-3 intake. The values should be replaced and the MFQ could then be a useful tool for research purposes at the population level.
简短食物频率问卷（FFQ）是用于估计营养素摄入量的有力筛查工具，在弱势群体的风险分层中发挥着重要作用。ω-3脂肪酸在预防慢性和退行性疾病方面的重要性日益增加，尤其是在患这些慢性病风险较高的老年人中。有一种简短FFQ可用于快速评估海洋来源的ω-3摄入量，但此前尚未针对与总ω-3摄入量的一致性以及识别老年人中ω-3摄入不足的能力进行验证，也未在澳大利亚使用过。
本研究的目的是针对一份经过验证的74项半定量FFQ，验证一份9项海洋ω-3 FFQ（MFQ）用于评估ω-3摄入量。
108名参与者（平均年龄67±10岁，47%为男性）完成了旨在估计海洋来源ω-3摄入量的MFQ以及旨在估计通常ω-3和总能量摄入量以及其他营养素摄入量的74项FFQ。为了测试两份问卷在估计总ω-3摄入量方面的一致性，计算了平均偏差和95%一致性界限（LOA）。根据参与者是否达到国家心脏基金会（NHF）每日ω-3摄入量建议，使用2×2列联表评估敏感性和特异性。
MFQ估计的ω-3平均摄入量为210±235毫克/天，而FFQ估计的为295±260毫克/天。两份问卷评估的ω-3平均偏差（95% LOA）为89毫克/天（-475毫克至653毫克）。对于500毫克/天的ω-3临界值，MFQ的敏感性为98%，特异性为31%。当用澳大利亚数据替换海产品的营养成分时，ω-3的平均摄入量为230±253毫克，平均偏差改善至64毫克（-681毫克至553毫克），敏感性为93%，特异性为40%。
MFQ有望作为一种快速筛查工具，用于识别ω-3脂肪酸摄入量可能低于降低慢性和退行性疾病风险建议水平的老年人。鉴于临床上有意义的平均偏差和较宽的LOA，不建议将其作为报告个体平均摄入量的合适工具。使用澳大利亚营养数据改善了该工具在估计总ω-3摄入量方面的平均偏差。这些值应予以更新，然后MFQ可能成为人群水平研究的有用工具。
