Awwad Razan, Qasrawi Radwan, Alwafa Reem Abu, Kharaz Lubnah, Badrasawi Manal
Nutrition and food technology, Faculty of Agriculture and veterinary medicine, An-Najah National University, Nablus, Palestine.
Department of Computer Sciences, Al Quds University, Jerusalem, Palestine.
BMC Nutr. 2024 Sep 9;10(1):120. doi: 10.1186/s40795-024-00927-w.
High sodium intake has been linked to negative health effects, including cardiovascular and renal diseases. Traditional dietary sodium assessment methods are time-consuming and subjected to errors. Using technology may increase the efficiency and accuracy of dietary assessment. The objective of this study is to develop and validate a food frequency questionnaire (FFQ) screener using software to assess sodium intake among the Palestinian population.
The study was conducted in four phases. In Phase 1, Palestinian foods were categorized and subcategorized according to their mode of consumption, sodium content, and food groups. The sodium content values were calculated from Palestinian food composition database. Content validity was done in Phase 2, while in Phase 3, a pilot study was conducted to determine test-retest reliability. In Phase 4, the criterion validity of the screener was assessed by comparing the results of sodium intake from the FFQ screener with the results from a 24-hour urinary sodium test and a 3-day diet recall. Correlations between the sodium intake values from the three methods were analyzed using Pearson correlation tests, and the difference was assessed using the Bland-Altman test.
The developed FFQ screener sodium screener included 41 food items categorized into nine groups, with photo-based portion size estimation and frequency of consumption. The reliability test showed a Pearson correlation coefficient of 0.7, p < 0.01 using test and retest. For criterion validity, the correlation coefficient between dietary sodium intake using the FFQ screener software and the 24-hour urine sodium test was (0.6, p < 0.000). The correlation coefficient between dietary sodium intake using the FFQ screener software and dietary sodium intake using a 3-day recall was (0.3, p < 0.000). Sodium intake was significantly correlated with preferences for low-sodium food and previous salt reduction, p < 0.05.
Using the FFQ screener software was a valid and reliable method for assessing dietary sodium intake. Using the photo-based method to estimate portion size improved precision and accuracy in diet assessment.
高钠摄入与包括心血管疾病和肾脏疾病在内的不良健康影响有关。传统的膳食钠评估方法耗时且容易出错。使用技术可能会提高膳食评估的效率和准确性。本研究的目的是开发并验证一种使用软件的食物频率问卷（FFQ）筛查工具，以评估巴勒斯坦人群的钠摄入量。
该研究分四个阶段进行。在第一阶段，根据巴勒斯坦食物的食用方式、钠含量和食物类别进行分类和再分类。钠含量值根据巴勒斯坦食物成分数据库计算得出。第二阶段进行内容效度评估，而在第三阶段，进行一项试点研究以确定重测信度。在第四阶段，通过比较FFQ筛查工具的钠摄入量结果与24小时尿钠测试和3天饮食回顾的结果，评估该筛查工具的效标效度。使用Pearson相关检验分析三种方法的钠摄入量值之间的相关性，并使用Bland-Altman检验评估差异。
所开发的FFQ钠筛查工具包括41种食物，分为九组，具有基于图片的份量估计和食用频率。信度测试显示，重测时Pearson相关系数为0.7，p < 0.01。对于效标效度，使用FFQ筛查软件的膳食钠摄入量与24小时尿钠测试之间的相关系数为（0.6，p < 0.000）。使用FFQ筛查软件的膳食钠摄入量与使用3天饮食回顾的膳食钠摄入量之间的相关系数为（0.3，p < 0.000）。钠摄入量与对低钠食物的偏好和先前的减盐措施显著相关，p < 0.05。
使用FFQ筛查软件是评估膳食钠摄入量的一种有效且可靠的方法。使用基于图片的方法估计份量提高了饮食评估的精度和准确性。
