Department of Nutrition, Faculty of Pharmacy, Saint Joseph University of Beirut, Lebanon B.P. 11-5076 - Riad el Solh, Beirut, 1107 2180, Lebanon.
Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadath, Lebanon.
Nutr J. 2020 Jul 6;19(1):65. doi: 10.1186/s12937-020-00581-5.
The food frequency questionnaire (FFQ) is the most frequently used method to assess dietary intake in epidemiological studies evaluating diet-disease association. The objective of this study was to validate a FFQ for use among Lebanese adults by evaluating various facets of validity and reproducibility.
The quantitative 164-items FFQ was validated against the average of six 24-h dietary recalls (DRs) in a sample of 238 Lebanese adults. Reproducibility of the FFQ was assessed by administering it twice within 1 month' time interval.
Positive statistically significant Pearson correlations were observed in most macro and micronutrients between the FFQ and the six 24-h DRs, ranging from 0.16 to 0.65, with two thirds of the correlation coefficients exceeding 0.3. Energy, gender, and age-adjusted statistically significant Pearson correlation coefficients ranged from 0.14 to 0.64, with two thirds of the coefficients exceeding 0.2. Intakes from the FFQ were mostly higher than those of the 24-h DRs. Mean percent difference between nutrient intakes from both dietary methods decreased remarkably after using energy-adjusted mean intakes. Values were acceptable to good for all macronutrients and several micronutrients. Cross-classification analysis revealed that around 64.3 to 83.9% of participants were classified into the same and adjacent quartile whereas grossly misclassified proportions ranged from 3.7 to 12.2%. Weighted kappa values ranged from 0.02 to 0.36 with most of them exceeding 0.2. In indirect validity analysis, key nutrient mean intakes estimated from the six 24-h DRs were significantly positively associated with tertiles of food groups derived from the FFQ. Bland Altman plots showed that the majority of data points fell within the limits of agreement (LOA) for all nutrients. As for reproducibility analysis, ICC values were all statistically significant ranging from 0.645 to 0.959 and Bland Altman plots confirmed these results.
Based on various aspects of validity and reproducibility, and an extensive range of statistical tests, the present FFQ developed for a Lebanese community is an acceptable tool for dietary assessment and is useful for evaluating diet-disease associations in future studies.
在评估饮食与疾病关联的流行病学研究中，食物频率问卷（FFQ）是最常使用的评估饮食摄入的方法。本研究的目的是通过评估各种有效性和再现性方面来验证一种适用于黎巴嫩成年人的 FFQ。
在 238 名黎巴嫩成年人的样本中，将定量的 164 项 FFQ 与 6 份 24 小时膳食回顾（DR）的平均值进行了验证。在 1 个月的时间间隔内两次进行 FFQ 以评估其再现性。
FFQ 与 6 份 24 小时 DR 之间在大多数宏量和微量营养素之间观察到正的具有统计学意义的 Pearson 相关性，范围从 0.16 到 0.65，三分之二的相关系数超过 0.3。经能量、性别和年龄调整后，具有统计学意义的 Pearson 相关系数范围从 0.14 到 0.64，其中三分之二的系数超过 0.2。FFQ 的摄入量大多高于 24 小时 DR 的摄入量。在用能量调整后的平均摄入量后，两种饮食方法的营养素摄入量之间的平均百分比差异显著降低。所有宏量营养素和几种微量营养素的值都可以接受或良好。交叉分类分析显示，大约 64.3%至 83.9%的参与者被分类到相同和相邻的四分位数，而粗分类比例范围从 3.7%到 12.2%。加权 Kappa 值范围从 0.02 到 0.36，其中大多数超过 0.2。在间接有效性分析中，从 6 份 24 小时 DR 估计的关键营养素平均摄入量与从 FFQ 得出的食物组三分位数呈显著正相关。Bland-Altman 图显示，对于所有营养素，大多数数据点都落在了可接受范围（LOA）内。至于再现性分析，ICC 值均具有统计学意义，范围从 0.645 到 0.959，Bland-Altman 图证实了这些结果。
根据有效性和再现性的各个方面，以及广泛的统计测试，为黎巴嫩社区开发的这种 FFQ 是一种可接受的饮食评估工具，并且在未来的研究中有助于评估饮食与疾病的关联。
