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

Abstract

Valid tools for the assessment of dietary intake are critical to assess nutritional intake and study diet- disease relations. Childhood is a critical life stage in which dietary habits are formed and interventions can define the risk of many child- and adult-onset non-communicable diseases. Limited validated dietary assessment tools for school-aged children are available in the Middle East and North Africa Region as well as in Lebanon, especially tools measuring food group intake that can be used to evaluate dietary intake against guidelines and clearly relay nutritional messages to the public. Objectives: The main objectives of this study were to develop and validate a Food Frequency Questionnaire (FFQ) by food groups in order to assess dietary intake among Lebanese children aged 5-10 years. Methods: Lebanese children aged 5 to 10 years were recruited from public and private schools in Beirut area. Mothers (used as proxy) completed a socio-demographic questionnaire and the FFQ (FFQ-1) in the first visit. Anthropometric measurements (weight, height, waist circumference and percent body fat) were obtained for both mother and child. During the following 4 weeks, 4 Multiple Pass 24-hour recalls (MPRs) were randomly collected by phone. At Week 4, the FFQ (FFQ-2) was completed a second time. Descriptive statistics, Spearman correlations, mean differences, and Bland-Altman plots were used to assess the validity of the developed FFQ. Intraclass Correlation (ICC), percent agreement, and weighted kappa were used to assess its reproducibility. SPSS was used in the analysis and a p0.05 indicated significance. Results: Out of the 125 children, 120 completed the study (dropout rate: 4percent). Spearman correlation coefficients of food groups mean dietary intake ranged from 0.270 for pulses and 0.539 for salty snacks. The FFQ was valid in measuring the intake of all food groups, with a Spearman correlation coefficient of 0.324 for breads and cereals, 0.378 for dairy products, 0.476 for fruits, 0.410 for vegetables 0.270 for p