Relative Validity and Reproducibility of a Food Frequency Questionnaire for Assessing Dietary Intakes in a Multi-Ethnic Asian Population Using 24-h Dietary Recalls and Biomarkers

Relative validity and reproducibility of dietary quality scores from a short diet screener in a multi-ethnic Asian population

Objective

Short screeners for assessing dietary quality are lacking in Asia. We recently developed a short thirty-seven-item diet screener (DS). The present study aimed to evaluate reproducibility and relative validity of the DS in assessing a priori dietary quality indices (DQI; i.e. the Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean Diet (aMed) and Dietary Approaches to Stop Hypertension (DASH) diet) and intakes of selected foods.

Design

DS administration and biomarker measurement took place twice within a 4-month interval. A 163-item FFQ was administered one month after the second DS administration.

Setting

Singapore, a multi-ethnic urban Asian country.

Subjects

Singapore residents (n 161) aged 18–79 years, of Chinese, Malay and Indian ethnicity.

Results

Reproducibility coefficients for the two DS were 0·71 (DQI) and 0·65 (food groups). Correlations (ρ) between mean DS and FFQ DQI scores were 0·51 (AHEI-2010), 0·50 (aMed) and 0·61 (DASH; all P<0·05). Cohen’s weighted kappa indicated moderate agreement between the two measures (κw=0·48–0·58). DS DQI scores were associated with concentrations of β-cryptoxanthin (AHEI-2010, ρ=0·26; P<0·05), odd-chain SFA (aMed, ρ=0·24; DASH, ρ=0·25; both P<0·05), and enterolactone, total carotenoids, PUFA and α-linolenic acid (all scores, ρ=0·17–0·30; all P<0·05). Scores were not associated with isoflavone or long-chain n-3 PUFA concentrations.

Conclusions

A short screener can be used to assess DQI with good reproducibility and relative validity compared with a longer FFQ in an Asian population.

Maternal Nutrition during Early Pregnancy and Cardiometabolic Status of Neonates at Birth

OBJECTIVE

To explore the impact of maternal body weight on maternal nutrition and micronutrient status in early pregnancy and potential impact on metabolic status in newborns.

METHODOLOGY

The EU FP7 project GIFTS was conducted from Jan 2012 to May 2014. Demographic details and anthropometric measurements of women in the first trimester of pregnancy were obtained. Blood samples were collected for OGTT, insulin, lipid profile, serum folate, ferritin, vitamin D, vitamin B12, and red cell folate. Newborn anthropometric characteristics were observed. Cord blood samples were collected after delivery for glucose, insulin, and lipid profile of newborns.

RESULTS

A total of 301 pregnant mothers, 108 overweight, 63 underweight, and 130 normal weight were included. Prevalence of vitamin D deficiency (<30 ng/mL) and low vitamin B12 (<190 ng/l) were high, 44% and 42%, respectively, in the first trimester. Anemic women (due to B12 or iron deficiency) were 79%, while 72% had low ferritin levels. Gestational diabetes was 16%. Differences were observed between underweight and overweight mothers (P < 0.05) for fasting blood glucose, insulin levels, and serum ferritin were observed. No significant difference was observed between vitamin D, serum B12, and red cell folate levels.

CONCLUSION

Prevalence of multiple micronutrient deficiencies was common among Pakistani women during early pregnancy despite the nonvegetarian diet that has important implications for pregnancy care in Pakistan and potentially in expatriate communities living abroad. This trial is registered with ISRCTN number 83599025.