Cheng Lu, Chen Yuhang, Luo Zhijie, Wang Qingying, Zou Fengqin, Lin Yulan
Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, China.
Nutrients. 2025 Jul 9;17(14):2270. doi: 10.3390/nu17142270.
This study aimed to evaluate the reliability and validity of a Food Frequency Questionnaire (FFQ) designed for use in epidemiological studies among populations in Fujian, China. From September to December 2023, adults aged 18 years and above residing in Fujian Province, southeastern China, were recruited via online survey promotion. Participants completed the FFQ twice with a one-month interval and also completed a 3-day 24 h dietary recall (3d-24HDR), covering two weekdays and one weekend day, during the same period. The reliability of the FFQ was assessed by comparing the average intake of food groups and nutrients between the two FFQs, using Spearman correlation coefficients, intraclass correlation coefficients (ICCs), and weighted Kappa coefficients based on tertile classification. Validity was evaluated by comparing the average intake values from the FFQs and the 3d-24HDR using similar methods, including Spearman correlation, weighted Kappa statistics, and Bland-Altman analysis. A total of 152 participants completed two FFQs (for reliability assessment), and 142 participants completed the 3d-24HDR (for validity assessment). Spearman correlation coefficients for food group intake between the two FFQs ranged from 0.60 to 0.80, with ICCs ranging from 0.53 to 0.91. For energy and nutrient intake, Spearman coefficients ranged from 0.66 to 0.96, and ICCs ranged from 0.57 to 0.97. After tertile classification, less than 15% of participants were misclassified into distant categories. The weighted Kappa coefficients for food groups and nutrients ranged from 0.37 to 0.71 and 0.43 to 0.88, respectively. In comparison with the 3d-24HDR, Spearman correlations for food groups and nutrients ranged from 0.41 to 0.72 and 0.40 to 0.70, respectively. The proportion of participants classified into the same or adjacent tertile was 78.8-95.1%. Weighted Kappa coefficients and Bland-Altman plots indicated acceptable agreement between the FFQ and 3d-24HDR for most nutrients. The FFQ used in this study demonstrated good reliability and moderate-to-good validity. It is suitable for use in dietary assessment in gastric cancer epidemiological studies in Fujian, China.
本研究旨在评估一份为中国福建人群的流行病学研究设计的食物频率问卷（FFQ）的可靠性和有效性。2023年9月至12月，通过在线调查推广招募了居住在中国东南部福建省的18岁及以上成年人。参与者在一个月的间隔内完成两次FFQ，并在同一时期完成一次为期3天的24小时膳食回顾（3d - 24HDR），涵盖两个工作日和一个周末日。通过使用Spearman相关系数、组内相关系数（ICC）以及基于三分位数分类的加权Kappa系数，比较两次FFQ之间食物组和营养素的平均摄入量，来评估FFQ的可靠性。通过使用类似方法，包括Spearman相关性、加权Kappa统计和Bland - Altman分析，比较FFQ和3d - 24HDR的平均摄入量值，来评估有效性。共有152名参与者完成了两次FFQ（用于可靠性评估），142名参与者完成了3d - 24HDR（用于有效性评估）。两次FFQ之间食物组摄入量的Spearman相关系数范围为0.60至0.80，ICC范围为0.53至0.91。对于能量和营养素摄入量，Spearman系数范围为0.66至0.96，ICC范围为0.57至0.97。经过三分位数分类后，不到15%的参与者被错误分类到较远的类别。食物组和营养素的加权Kappa系数分别为0.37至0.71和0.43至0.88。与3d - 24HDR相比，食物组和营养素的Spearman相关性分别为0.41至0.72和0.40至0.70。分类到相同或相邻三分位数的参与者比例为78.8 - 95.1%。加权Kappa系数和Bland - Altman图表明，对于大多数营养素，FFQ和3d - 24HDR之间具有可接受的一致性。本研究中使用的FFQ显示出良好的可靠性和中等至良好的有效性。它适用于中国福建胃癌流行病学研究中的膳食评估。
