Abstract
The objective of this study was to perform cross-cultural adaptation of the Mediterranean Islands Study Food Frequency Questionnaire (MEDIS-FFQ) and to evaluate its reproducibility and validity in a population over 60 years of age in the Spanish Mediterranean. Three hundred forty-one people completed the food frequency questionnaire (FFQ), which was administered twice (FFQ1 and FFQ2) with nine 24-h dietary recalls (24-HDRs) over a nine-month period to assess its reproducibility and validity. Cross-cultural translation and adaptation were performed according to the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines and included direct translation, back-translation, and a pilot comprehension test. Reproducibility was evaluated with Pearson’s and interclass correlation coefficients. Validity was estimated using correlations between the FFQ food groups and the 24-HDR mean. The levels of agreement and misclassification were expressed as the proportions of individuals classified by comparing the estimated information from the FFQ2 and the 24-HDR. Reproducibility correlation coefficients ranged from r = 0.44 to r = 0.90. Validity indices ranged from 0.71 to 0.99. More than 80% of the subjects were classified in the same quartile on both instruments. The kappa statistic showed a moderate to high level of agreement (0.70–0.95) between the two instruments. In conclusion, the MEDIS-FFQ showed good reproducibility and validity in estimating the nutrient intake of the elderly population in the Spanish Mediterranean.
Highlights
The dietary habits of the elderly population directly influence disease development and progression as well as prevention and treatment [1,2]
The mean nutrient and food intakes obtained by the FFQ1 and FFQ2 were similar
The correlation coefficients for reproducibility in our study range from r = 0.44–0.90, with the lowest values for vitamin A and iron and the highest for vitamin B12, sodium, and vitamin C. These results are comparable to those found in other studies that have examined the reproducibility of food frequency questionnaire (FFQ) designed for specific populations, such as those developed for the elderly population (r = 0.50–0.82) [16], adult population (r = 0.49–0.96) [1], and pregnant women (r = 0.2–0.70) [15]
Summary
The dietary habits of the elderly population directly influence disease development and progression as well as prevention and treatment [1,2]. The Mediterranean diet is associated with a lower risk of suffering chronic degenerative diseases, such as obesity, cardiovascular diseases, some types of cancer, and cognitive decline [4,5,6] For this reason, quantifying food intake in this population group is vitally important for clarifying their dietary habits and nutrient intake and the relationships of these factors with health markers [1,7]. In this sense, food frequency questionnaires (FFQs) are essential tools in epidemiological studies to determine the relationship between diet and diseases over a long period of time [8,9]. FFQs are easy to use, with relatively low, and can be administered to large population groups [11]
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