Relative Validity and Reproducibility of a Short Semi-quantitative Food Frequency Questionnaire for Chinese Athletes

Overview

Journal PLoS One

Date 2025 Jan 9

PMID 39787110

Authors

Qian Xu

Yudan Chu

Huajun Tian

Guoqiang Ma

Jun Qiu

Qiuping Zhang

Affiliations

Soon will be listed here.

Abstract

A convenient but efficient tool for evaluating dietary intakes in Chinese professional athletes has yet to be established. The aim of this study was to assess the validity of a short semi-quantitative food frequency questionnaire (FFQ) through comparison with 3-day weighed food records (3DWFRs) and corresponding serum biomarkers from a cohort of 102 professional athletes, while also evaluating its reproducibility. The relative validity was assessed using Spearman correlation coefficients, cross-quintiles classification, weighted kappa, and Bland-Altman analysis, while reproducibility was evaluated using the Spearman correlation coefficients and intraclass correlation coefficient (ICC) between two FFQs. The results showed the median (range) crude correlation coefficients (CCs) between the first FFQ and 3DWFRs for energy and nutrients, and the food groups were 0.331 (0.219 to 0.568) and 0.292 (-0.035 to 0.455), respectively. Omega-3 polyunsaturated fatty acid (EPA, DHA, and EPA+DHA) intake estimated from the FFQ significantly correlated with corresponding serum biomarkers, with CCs ranging from 0.389 to 0.520. Weighted kappa statistics, indicating acceptable consistency (> 0.2) for most items, varied from -0.076 to 0.581, except for vitamin C, vegetables, and oils. Misclassification of nutrients and food groups into extreme quartiles was rare, with a median misclassification rate of 2% (ranging from 1% to 12%) and 3% (ranging 0 to 10%), respectively. Bland-Altman analysis revealed good agreement between FFQ and 3DWFRs, with over 90% of data points falling within the limits of agreement (LOA) for all assessed nutrients and food groups. In the reproducibility analysis, the median (range) crude CC and ICC for energy and nutrients were 0.574 (0.423 to 0.643) and 0.668 (0.558 to 0.763), respectively, while for food groups, they were 0.681 (0.242 to 0.764) and 0.640 (0.371 to 0.787), respectively. In conclusion, the short FFQ demonstrated acceptable relative validity and reproducibility for most nutrients and food groups, suggesting its potential as a valuable tool for assessing dietary intake and nutrition status among young Chinese athletes.

References

Pedisic Z, Bender D, Misigoj Durakovic M . Construction and reproducibility of a questionnaire aimed for evaluation of dietary habits in physically active individuals. Coll Antropol. 2009; 32(4):1069-77. View

Masson L, McNeill G, Tomany J, Simpson J, Peace H, Wei L . Statistical approaches for assessing the relative validity of a food-frequency questionnaire: use of correlation coefficients and the kappa statistic. Public Health Nutr. 2003; 6(3):313-21. DOI: 10.1079/PHN2002429. View

Thomas D, Erdman K, Burke L . American College of Sports Medicine Joint Position Statement. Nutrition and Athletic Performance. Med Sci Sports Exerc. 2016; 48(3):543-68. DOI: 10.1249/MSS.0000000000000852. View

Ahmed S, Rahman T, Ripon M, Rashid H, Kashem T, Md Ali M . A Food Frequency Questionnaire for Hemodialysis Patients in Bangladesh (BDHD-FFQ): Development and Validation. Nutrients. 2021; 13(12). PMC: 8707927. DOI: 10.3390/nu13124521. View

Malsagova K, Kopylov A, Sinitsyna A, Stepanov A, Izotov A, Butkova T . Sports Nutrition: Diets, Selection Factors, Recommendations. Nutrients. 2021; 13(11). PMC: 8619485. DOI: 10.3390/nu13113771. View

Jenab M, Slimani N, Bictash M, Ferrari P, Bingham S . Biomarkers in nutritional epidemiology: applications, needs and new horizons. Hum Genet. 2009; 125(5-6):507-25. DOI: 10.1007/s00439-009-0662-5. View

Gibson-Smith D, Bot M, Brouwer I, Visser M, Giltay E, Penninx B . Association of food groups with depression and anxiety disorders. Eur J Nutr. 2019; 59(2):767-778. PMC: 7058560. DOI: 10.1007/s00394-019-01943-4. View

Ishikawa-Takata K, Okamoto K, Taguchi M . Development and validation of a food frequency questionnaire for Japanese athletes (FFQJA). J Int Soc Sports Nutr. 2021; 18(1):34. PMC: 8111758. DOI: 10.1186/s12970-021-00433-5. View

Philippou E, Demetriou C, Loucaides G, Solomonidou N, Critselis E, Polykarpou M . Relative validity and reproducibility of the CyFFQ semiquantitative food frequency questionnaire for assessing dietary intake in Cypriot adults. J Hum Nutr Diet. 2022; 36(1):139-153. PMC: 10084044. DOI: 10.1111/jhn.13032. View

10.

Gammone M, Riccioni G, Parrinello G, DOrazio N . Omega-3 Polyunsaturated Fatty Acids: Benefits and Endpoints in Sport. Nutrients. 2018; 11(1). PMC: 6357022. DOI: 10.3390/nu11010046. View

11.

Capling L, Beck K, Gifford J, Slater G, Flood V, OConnor H . Validity of Dietary Assessment in Athletes: A Systematic Review. Nutrients. 2017; 9(12). PMC: 5748763. DOI: 10.3390/nu9121313. View

12.

Nielsen D, Boucher B, Da Costa L, Jenkins D, El-Sohemy A . Reproducibility and validity of the Toronto-modified Harvard food frequency questionnaire in a multi-ethnic sample of young adults. Eur J Clin Nutr. 2022; 77(2):246-254. DOI: 10.1038/s41430-022-01209-z. View

13.

Sublette M, Segal-Isaacson C, Cooper T, Fekri S, Vanegas N, Galfalvy H . Validation of a food frequency questionnaire to assess intake of n-3 polyunsaturated fatty acids in subjects with and without major depressive disorder. J Am Diet Assoc. 2010; 111(1):117-123.e1-2. PMC: 3012380. DOI: 10.1016/j.jada.2010.10.007. View

14.

Subar A . Developing dietary assessment tools. J Am Diet Assoc. 2004; 104(5):769-70. DOI: 10.1016/j.jada.2004.02.007. View

15.

Thielecke F, Blannin A . Omega-3 Fatty Acids for Sport Performance-Are They Equally Beneficial for Athletes and Amateurs? A Narrative Review. Nutrients. 2020; 12(12). PMC: 7760705. DOI: 10.3390/nu12123712. View

16.

Godois A, Coelho-Ravagnani C, Raizel R, Verly-Junior E . Development of a Food Frequency Questionnaire for Brazilian athletes. Nutr Diet. 2018; 77(2):260-267. DOI: 10.1111/1747-0080.12456. View

17.

Belle F, Schindera C, Guessous I, Beck Popovic M, Ansari M, Kuehni C . Sodium and Potassium Intakes and Cardiovascular Risk Profiles in Childhood Cancer Survivors: The SCCSS-Nutrition Study. Nutrients. 2019; 12(1). PMC: 7019213. DOI: 10.3390/nu12010057. View

18.

Steinemann N, Grize L, Ziesemer K, Kauf P, Probst-Hensch N, Brombach C . Relative validation of a food frequency questionnaire to estimate food intake in an adult population. Food Nutr Res. 2017; 61(1):1305193. PMC: 5404419. DOI: 10.1080/16546628.2017.1305193. View

19.

Harmouche-Karaki M, Mahfouz M, Obeyd J, Salameh P, Mahfouz Y, Helou K . Development and validation of a quantitative food frequency questionnaire to assess dietary intake among Lebanese adults. Nutr J. 2020; 19(1):65. PMC: 7339409. DOI: 10.1186/s12937-020-00581-5. View

20.

Rabic D, Sindik J, Missoni S . Development and validation of a self-administered food frequency questionnaire to assess habitual dietary intake and quality of diet in healthy adults in the Republic of Croatia. . Coll Antropol. 2014; 38(3):1017-26. View