Validity and reproducibility of a food frequency questionnaire among Lebanese adults for the assessment of energy and nutrients intake.

Abstract

Scientific Background: Diet is a major modifiable risk factor in the etiology of chronic diseases. Dietary assessment is a critical step in the evaluation of diet-disease association and the formulation of recommendations for dietary interventions. Limited validated tools exist for the assessment of dietary intake of adults in the Middle East and North Africa Region. As for Lebanon, to our knowledge, there exists no valid long-term dietary assessment tool for Lebanese adults aged 18-65 years. Objectives: The aim of this study is to examine the validity and reliability of a food frequency questionnaire (FFQ) for the assessment of dietary intake among Lebanese adults. Methods: Healthy Lebanese faculty and staff members of both genders, aged between 18 and 65 years, were recruited from various faculties and offices at the American University of Beirut, Lebanon (n=120). Participants completed the FFQ twice, during a one-year interval. Within each of the four seasons of this one year, three 24-hour recalls (24-HR) representing two weekdays and one weekend were collected. Estimation of energy and nutrients’ intake was conducted using Nutritionist Pro software. For validity, dietary intake data collected via the FFQ was compared to the mean of repeated 24 hr recalls (MPRs). Percent difference in means, Spearman’s rank correlations and Bland-Altman plots were used to assess the validity of the developed FFQ. Intraclass Correlation Coefficient (ICC), weighted kappa (κ w) and same and adjacent percent agreement were used to evaluate the FFQ’s reproducibility. Statistical Package for Social Sciences (SPSS) was used in the analysis and a p0.05 indicated significance. Results: Out of the 120 adults, 110 completed the study (dropout rate: 8.3percent). The mean (±SD) age of subjects 41.28±9.88 years for males and 34.81±7.70 for females. Spearman’s correlation coefficients (r) for the association of the FFQ and mean 24-HR for the validity ranged from 0.239 for ‘alpha-carotene