Validation of an FFQ to assess dietary protein intake in type 2 diabetic subjects attending primary health-care services in Mali

Development of a Semi-Quantitative Food Frequency Questionnaire to Estimate Macronutrient Intake among Type 2 Diabetes Mellitus Patients in Malaysia

The Food Frequency Questionnaire (FFQ) is one of the most frequently used instruments in epidemiological studies for evaluating dietary intake. Because of the variety of dietary habits within different populations, an FFQ must be tailored to the specific group. To date, no specific FFQ has been developed for type 2 diabetes mellitus (T2DM) patients in Malaysia. In this study, we developed a semi-quantitative FFQ to estimate macronutrient intake among T2DM patients. The development of the FFQ was based on the data acquired from 150 respondents with T2DM from the southern part of Peninsular Malaysia who completed the three-day 24-h dietary recalls. The respondents were selected by convenience sampling. The mean intake from each food item and the proportions of macronutrients were calculated. The approach from a previous study was used to compile a list of foods items with a cumulative 90% macronutrient contribution that is significant for the nutrient of interest. In conclusion, we have successfully developed a new semi-quantitative FFQ with a total of 79 food items and nine food groups. The frequencies of the FFQ were divided into nine categories and this FFQ represents the usual food intake of T2DM patients in Malaysia. However, this tool has yet to be validated in patients with T2DM in Malaysia.

Design, development and validation of Food Frequency Questionnaires for the diabetic population: protocol for a systematic review and meta-analysis

INTRODUCTION

The Food Frequency Questionnaire is one of the most widely used tools for estimating nutritional intake in epidemiological studies. No study has been systematically performed to comprehensively explore Food Frequency Questionnaires designed, developed and validated specifically for the diabetic population (FFQs-DDV-DiaP). Therefore, a systematic review and meta-analysis will be carried out in order to identify and describe FFQs-DDV-DiaP; to examine their design, development, validity and reproducibility; as well as to estimate the overall degree of correlation and agreement; and to evaluate the factors that affect them.

METHODS AND ANALYSIS

A systematic literature review will be performed in PubMed/MEDLINE, Scopus and Web of Science to find potentially relevant studies. Original studies related to the design, development, as well as the assessment of the validity and reproducibility of FFQs-DDV-DiaP; reported in English or Romance languages will be selected. Independent reviewers will select studies, extract relevant data and assess FFQs-DDV-DiaP quality. Data will be pooled using the generic inverse-variance method with random-effects models and expressed as correlation coefficients or mean differences with 95% CIs to examine the global validity and reproducibility of FFQs-DDV-DiaP. Heterogeneity will be evaluated by the Cochran Q-statistic and quantified by the I² statistic. Stratified analyses and random-effects meta-regressions will be performed to explore heterogeneity and whether any covariate influences the effect sizes. Finally, publication bias will be assessed through the Begg's and Egger's tests.

ETHICS AND DISSEMINATION

This systematic review and meta-analysis will not use confidential personal data. Therefore, the requirement of ethical approval or informed consent is not necessary. The results of this review will be disseminated only in peer-reviewed publications or at relevant scientific conferences.

PROSPERO REGISTRATION NUMBER

CRD42021268575.

Diet Data Collected Using 48-h Dietary Recall: Within-and Between-Person Variation

Background and Aims: Forty-eight-hour dietary recall is a valuable source of information regarding food consumption in a population-based sample. This method covers 2 consecutive days in a single interview. Nevertheless, the number of assessments and the sample size necessary to estimate usual intake are unknown. We aimed to assess sources of variation, sample sizes, and numbers of days necessary to estimate usual nutrient intake using the 48-h dietary recall.

Methods: This was a population-based cross-sectional study including 237 participants, 11–90 years old, selected using multistage probabilistic sampling to obtain data using 48-h dietary recall. Analysis of variance was used to calculate within- and between-person variation and determine the statistical parameters necessary to calculate sample size and the number of days required to calculate the usual energy and nutrient intake.

Results: Within-person variation was generally lower than between-person variation, except for calcium (CVw2 = 40.8; CVb2 = 38.4%), magnesium (CVw2 = 27.4; CVb2 = 18.7%), and monounsaturated fat (CVw2 = 20.0; CVb2 = 17.3%) for the entire group and magnesium for women (CVw2 = 28.3; CVb2 = 91.8%). The number of days and sample size required to determine usual energy and nutrient intake varied substantially with gender and age (e.g., vitamin C in women N = 9, in men N = 1,641).

Conclusions: Energy and nutrient intake assessment using the 48-h dietary recall misrepresents within-person variation but can generate acceptable results for between-person variation. The calculation of sample size and number of days required to determine usual energy and nutrient intake might have been affected by inadequate assessment of the within-person variation.

Nutritional Status Measurement Instruments for Diabetes: A Systematic Psychometric Review

Background: Diabetes is a serious chronic disease associated with a large number of complications and an increased risk of premature death. A dietary evaluation is of utmost importance for health promotion, disease prevention and individual treatment plans in patients with diabetes. Methods: An exhaustive search was carried out in various databases—Medline, Web of Science, Open Gray Cochrane Library and Consensus-based Standards for the selection of health status Measurement Instruments (COSMIN)—for systematic review of the measurement properties of instruments that evaluate the dietary intake of people with diabetes mellitus type 1 and/or 2 according to COSMIN standards. Results: Seven instruments were identified. There was no instrument measuring nutritional status for which all the psychometric properties were evaluated. The methodological quality for each of the psychometric properties evaluated was ‘inadequate’ or ‘doubtful’ for all instruments. The Food Frequency Questionnaire (FFQ) evaluated the most psychometric characteristics and with a better score in terms of quality of the evidence. Conclusions: Several instruments have been developed for the evaluation of dietary intake in people with diabetes. Evaluation of this construct is very useful, both in clinical practice and in research, requiring new knowledge in this area. The FFQ is the best instrument available to assess dietary intake in people with diabetes.

Reproducibility and validity of a quantitative FFQ designed for patients with type 2 diabetes mellitus from southern Brazil

OBJECTIVE

To evaluate the reproducibility and validity of a previously constructed FFQ to assess the usual diet of patients with type 2 diabetes mellitus (T2DM).

DESIGN

Cross-sectional survey using two quantitative FFQ (1-month interval) supported by a food photograph portfolio, a 3 d weighed diet record (WDR) and urinary N output measurement (as a biomarker of protein intake).

SETTING

Group of Nutrition in Endocrinology, southern Brazil.

SUBJECTS

Out-patients with T2DM.

RESULTS

From a total of 104 eligible T2DM patients, eighty-eight were included in the evaluation of FFQ reproducibility and seventy-two provided data for the validity study. The intakes estimated from the two FFQ did not differ (P > 0·05) and the correlation coefficients were significant (P < 0·01) for energy and nutrients, ranging from 0·451 (soluble fibre) to 0·936 (PUFA). Regarding the validity evaluation, data from the FFQ were higher than those from the WDR for total (28·3%), soluble (27·4%) and insoluble fibres (29·1%), and SFA (13·5%), MUFA (11·1 %) and total lipids (9·2%; all P < 0·05). There were significant correlation coefficients between the FFQ and WDR for most nutrients, when adjusted for energy intake and de-attenuated. Also, the Bland-Altman plots between the FFQ and WDR for energy and macronutrient intakes showed that the FFQ may be used as alternative method to the WDR. The validity coefficient (using the method of triads) for the FFQ protein intake was 0·522 (95% CI 0·414, 0·597).

CONCLUSIONS

This quantitative FFQ was valid and precise to assess the usual diet of patients with T2DM, according to its validity and reproducibility.

The relative validity and repeatability of an FFQ for estimating intake of zinc and its absorption modifiers in young and older Saudi adults

OBJECTIVE

To assess the relative validity and repeatability of a sixty-four-item FFQ for estimating dietary intake of Zn and its absorption modifiers in Saudi adults. In addition, we used the FFQ to investigate the effect of age and gender on these intakes.

DESIGN

To assess validity, all participants completed the FFQ (FFQ1) and a 3 d food record. After 1 month, the FFQ was administered for a second time (FFQ2) to assess repeatability.

SETTING

Jeddah, Saudi Arabia.

SUBJECTS

One hundred males and females aged 20-30 years and 60-70 years participated.

RESULTS

Mean intakes of Zn and protein from FFQ1 were significantly higher than those from the food record while there were no detectable differences between tools for measurement of phytic acid intake. Estimated intakes of Zn, protein and phytate by both approaches were strongly correlated (P<0·001). Bland-Altman analysis showed for protein that the difference in intake as measured by the two methods was similar across the range of intakes while for Zn and phytic acid, the difference increased with increasing mean intake. Zn and protein intakes from FFQ1 and FFQ2 were highly correlated (r>0·68, P<0·001) but were significantly lower at the second measurement (FFQ2). Older adults consumed less Zn and protein compared with young adults. Intakes of all dietary components were lower in females than in males.

CONCLUSIONS

The FFQ developed and tested in the current study demonstrated reasonable relative validity and high repeatability and was capable of detecting differences in intakes between age and gender groups.

Development of a quantitative food frequency questionnaire for Brazilian patients with type 2 diabetes

BACKGROUND

To investigate the association between dietary components and development of chronic diabetic complications, the dietary evaluation should include a long period, months or years. The present manuscript aims to develop a quantitative food frequency questionnaire (FFQ) and a portfolio with food photos to assess the usual intake pattern of Brazilian patients with type 2 diabetes to be used in future studies.

METHODS

Dietary data using 3-day weighed diet records (WDR) from 188 outpatients with type 2 diabetes were used to construct the list of usually consumed foods. Foods were initially clustered into eight groups: "cereals, tubers, roots, and derivatives"; "vegetables and legumes"; "fruits"; "beans"; "meat and eggs"; "milk and dairy products"; "oils and fats", and "sugars and sweets". The frequency of food intake and the relative contribution of each food item to the total energy and nutrient intakes were calculated. Portion sizes were determined according to the 25th, 50th, 75th, and 95th percentiles of intake for each food item.

RESULTS

A total of 62 food items were selected based on the 3-day WDR and another 27 foods or how they are prepared and nine beverages were included after the expert examination. Also, a portfolio with food photos of each included food item and portion sizes was made to assist the patients in identifying the consumed portion.

CONCLUSIONS

We developed a practical quantitative FFQ and portfolio with photos of 98 food items covering those most commonly consumed in the past 12 months, to assess the usual diet pattern of patients with type 2 diabetes in Southern Brazil.

Development and validation of a semi-quantitative food frequency questionnaire to assess diets of korean type 2 diabetic patients

Background

Our aim was to assess the validity of a semi-quantitative food frequency questionnaire (FFQ) by comparison with the 3-day diet record (DR) in patients with type 2 diabetes.

Methods

Eighty five type 2 diabetic patients (aged 33 to 70 years) from the Korean National Diabetes Program (KNDP) completed 3-day DR and FFQ. The FFQ was designed to reflect the eating pattern of Korean type 2 diabetic patients, and was based on the 2003 Korean National Health and Nutrition Examination Survey. The FFQ consists of 85 food items and 12 food groups. The validity of FFQ was assessed by comparison with the 3-day DR.

Results

The mean age was 49 ± 10 years. Clinical characteristic including body weight, diabetic duration, and HbA1c were not different from the total cohort subjects (n = 1,478). There were no significant differences in the mean intake of protein, fat and calcium estimated by the FFQ and the 3-day DR. Energy and carbohydrate estimated by the FFQ were higher than those estimated by the 3-day DR. The correlation coefficient was highest for energy (r = 0.740; P < 0.00) and lowest for iron (r = 0.269; P < 0.05). The Kappa values for energy, carbohydrate, protein, fat and calcium were 0.54, 0.37, 0.36, 0.46, and 0.19, respectively.

Conclusion

The FFQ is a reasonable instrument for assessing the intake of most macronutrients in Korean type 2 diabetes, although careful consideration is required for the food groups and nutrients for which the FFQ had low validity.