Abstract
Measuring dietary intakes in a multi-ethnic and multicultural setting, such as Malaysia, remains a challenge due to its diversity. This study aims to develop and evaluate the relative validity of an interviewer-administered food frequency questionnaire (FFQ) in assessing the habitual dietary exposure of The Malaysian Cohort (TMC) participants. We developed a nutrient database (with 203 items) based on various food consumption tables, and 803 participants were involved in this study. The output of the FFQ was then validated against three-day 24-h dietary recalls (n = 64). We assessed the relative validity and its agreement using various methods, such as Spearman’s correlation, weighed Kappa, intraclass correlation coefficient (ICC), and Bland–Altman analysis. Spearman’s correlation coefficient ranged from 0.24 (vitamin C) to 0.46 (carbohydrate), and almost all nutrients had correlation coefficients above 0.3, except for vitamin C and sodium. Intraclass correlation coefficients ranged from −0.01 (calcium) to 0.59 (carbohydrates), and weighted Kappa exceeded 0.4 for 50% of nutrients. In short, TMC’s FFQ appears to have good relative validity for the assessment of nutrient intake among its participants, as compared to the three-day 24-h dietary recalls. However, estimates for iron, vitamin A, and vitamin C should be interpreted with caution.
Highlights
Noncommunicable diseases are increasing in prevalence and are the major causes of morbidity and mortality in Malaysia, a developing country, comparable to that of developed countries
In addressing the rising trends, The Malaysian Cohort (TMC) project, which was initiated by the government in 2006, took up the challenge to investigate the interaction between environmental factors, including diet, and noncommunicable diseases in this multi-ethnic population through a large prospective study involving 106,527 participants [2]
We have successfully developed a validated 203-item food frequency questionnaire (FFQ) based on the dietary intake of aWe considerably large sample of participants from
Summary
Noncommunicable diseases are increasing in prevalence and are the major causes of morbidity and mortality in Malaysia, a developing country, comparable to that of developed countries. The rising trends are most likely a consequence of the demographic and dietary transition and the globalization of economic processes. Within a span of five years (2011–2015), data from the National Health Morbidity Survey showed that the prevalence of noncommunicable diseases in Malaysia has increased, i.e., diabetes from 15.2%. In addressing the rising trends, The Malaysian Cohort (TMC) project, which was initiated by the government in 2006, took up the challenge to investigate the interaction between environmental factors, including diet, and noncommunicable diseases in this multi-ethnic population through a large prospective study involving 106,527 participants [2]. A dietary intake assessment tool suitable for a large-scale epidemiologic study is required
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