Validity and reproducibility of a food frequency questionnaire among Lebanese children (5 - 10 years old) for the assessment of energy and nutrient intake

Abstract

Valid tools for the assessment of dietary intake are critical to assess nutritional intake and to evaluate the association between diet and disease. Childhood is emerging as a critical window for intervention to delineate the risk of many nutrition-related non communicable diseases later in life. Limited validated tools exist for the assessment of dietary intake in children less than 10 years of age in the Middle East and North Africa Region and in Lebanon. The main objectives of this study were to develop and validate an FFQ to assess dietary intake among Lebanese children aged 5-10 years. Methods: Children aged 5 to 10 years were recruited from public and private schools in Beirut area. Mothers (used as proxy) completed a brief socio-demographic questionnaire and the FFQ (FFQ-1) in the first visit. During the following 4 weeks, 4 Multiple Pass 24 hour recalls were collected by phone. At Week 4, the FFQ (FFQ-2) was completed a second time. Descriptive statistics, Spearman and intraclass correlation (ICC), Bland Altman plots, percent agreement and weighted kappa were used to assess the validity and reproducibility of the developed FFQ. SPSS was used in the analysis and a p0.05 indicated significance. Results: Out of 95 children, 90 completed the study (dropout rate: 5percent). Spearman correlation coefficients between the FFQ and the mean of the MPRs for energy, protein, carbohydrates and total fat intakes were 0.60, 0.32, 0.32, 0.32, p0.05; respectively. Other nutrients correlation coefficients ranged between 0.11 and 0.60. Bland and Altman’s LOAs showed acceptable agreement between the FFQ and the mean of MPRs. The ICC between FFQ-1 and FFQ-2 for energy, protein, carbohydrates and total fat intakes were 0.88, 0.77, 0.75, 0.78, p0.05; respectively. Other nutrients ICC ranged between 0.14 and 0.88. The percent agreement and κ coefficients between FFQ-1 and FFQ-2 ranged between substantial and moderate agreement. This study’s findings indicated that the developed FFQ is a valid and reliable