Alawadhi Balqees, Fallaize Rosalind, Franco Rodrigo Zenun, Hwang Faustina, Lovegrove Julie
Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Reading, United Kingdom.
School of Life and Medical Science, University of Hertfordshire, Hertfordshire, United Kingdom.
JMIR Form Res. 2021 Mar 2;5(3):e13591. doi: 10.2196/13591.
The web-based EatWellQ8 food frequency questionnaire (FFQ) was developed as a dietary assessment tool for healthy adults in Kuwait. Validation against reliable instruments and assessment of its reproducibility are required to ensure the accuracy of the EatWellQ8 FFQ in computing nutrient intake.
This study aims to assess the reproducibility and relative validity of the EatWellQ8 146-item FFQ, which included images of food portion sizes based on The Composition of Foods by McCance and Widdowson and food composition tables from Kuwait and the Kingdom of Bahrain, against a paper-based FFQ (PFFQ) and a 4-day weighed food record (WFR).
Reproducibility of the EatWellQ8 FFQ was assessed using a test-retest methodology. Participants were required to complete the FFQ at 2 time points, 4 weeks apart. To assess the relative validity of the EatWellQ8 FFQ, a subset of the participants were asked to complete a PFFQ or a 4-day WFR 1 week after the administration of the EatWellQ8 FFQ. The level of agreement between nutrient and food group intakes was estimated by repeated EatWellQ8 FFQ administration. The EatWellQ8 FFQ, PFFQ, and 4-day WFR were also evaluated using the Bland-Altman methodology and classified into quartiles of daily intake. Crude unadjusted correlation coefficients were also calculated for nutrients and food groups.
A total of 99 Kuwaiti participants (64/99, 65% female and 35/99, 35% male) completed the study-53 participated in the reproducibility study and the 4-day WFR validity study (mean age 37.1 years, SD 9.9) and 46 participated in the PFFQ validity study (mean age 36.2 years, SD 8.3). Crude unadjusted correlations for repeated EatWellQ8 FFQs ranged from 0.37 to 0.93 (mean r=0.67, SD 0.14; 95% CI 0.11-0.95) for nutrients and food groups (P=.01). Mean cross-classification into exact agreement plus adjacent was 88% for nutrient intakes and 86% for food groups, and Bland-Altman plots showed good agreement for energy-adjusted macronutrient intakes. The association between the EatWellQ8 FFQ and PFFQ varied, with crude unadjusted correlations ranging from 0.42 to 0.73 (mean r=0.46, SD 0.12; 95% CI -0.02 to 0.84; P=.046). Mean cross-classification into exact agreement plus adjacent was 84% for nutrient intake and 74% for food groups. Bland-Altman plots showed moderate agreement for both energy and energy-controlled nutrient intakes. Crude unadjusted correlations for the EatWellQ8 FFQ and the 4-day WFR ranged from 0.40 to 0.88 (mean r=0.58, SD 0.13; 95% CI 0.01-0.58; P=.01). Mean cross-classification into exact agreement plus adjacent was 85% for nutrient intake and 83% for food groups. Bland-Altman plots showed moderate agreement for energy-adjusted macronutrient intakes.
The results indicate that the web-based EatWellQ8 FFQ is reproducible for assessing nutrient and food group intake and has moderate agreement compared with a PFFQ and a 4-day WFR for measuring energy and nutrient intakes.
基于网络的EatWellQ8食物频率问卷（FFQ）被开发用作科威特健康成年人的饮食评估工具。需要与可靠工具进行验证并评估其可重复性，以确保EatWellQ8 FFQ在计算营养摄入量时的准确性。
本研究旨在评估包含基于麦坎斯和威多森所著《食物成分》中的食物份量图片以及科威特和巴林王国食物成分表的146项EatWellQ8 FFQ相对于纸质FFQ（PFFQ）和4天食物称重记录（WFR）的可重复性和相对有效性。
采用重测法评估EatWellQ8 FFQ的可重复性。参与者需在两个时间点完成FFQ，间隔4周。为评估EatWellQ8 FFQ的相对有效性，一部分参与者被要求在完成EatWellQ8 FFQ 1周后完成PFFQ或4天WFR。通过重复进行EatWellQ8 FFQ评估来估计营养和食物组摄入量之间的一致性水平。还使用布兰德 - 奥特曼方法对EatWellQ8 FFQ、PFFQ和4天WFR进行评估，并按每日摄入量四分位数进行分类。还计算了营养素和食物组的粗未调整相关系数。
共有99名科威特参与者（64/99，65%为女性，35/99，35%为男性）完成了研究——53人参与了可重复性研究和4天WFR有效性研究（平均年龄37.1岁，标准差9.9），46人参与了PFFQ有效性研究（平均年龄36.2岁，标准差8.3）。重复的EatWellQ8 FFQ的粗未调整相关系数对于营养素和食物组范围为0.37至0.93（平均r = 0.67，标准差0.14；95%置信区间0.11 - 0.95）（P = 0.01）。营养摄入量的精确一致加相邻的平均交叉分类为88%，食物组为86%，布兰德 - 奥特曼图显示能量调整后的宏量营养素摄入量一致性良好。EatWellQ8 FFQ与PFFQ之间的关联各不相同，粗未调整相关系数范围为0.42至0.73（平均r = 0.46，标准差0.12；95%置信区间 - 0.02至0.84；P = 0.046）。营养摄入量的精确一致加相邻的平均交叉分类为84%，食物组为74%。布兰德 - 奥特曼图显示能量和能量控制营养素摄入量的一致性为中等。EatWellQ8 FFQ与4天WFR的粗未调整相关系数范围为0.40至0.88（平均r = 0.58，标准差0.13；95%置信区间0.01 - 0.58；P = 0.01）。营养摄入量的精确一致加相邻的平均交叉分类为85%，食物组为83%。布兰德 - 奥特曼图显示能量调整后的宏量营养素摄入量一致性为中等。
结果表明，基于网络的EatWellQ8 FFQ在评估营养素和食物组摄入量方面具有可重复性，并且在测量能量和营养素摄入量方面与PFFQ和4天WFR相比具有中等一致性。
