Abstract
The assessment of diets in multi-ethnic cosmopolitan settings is challenging. A semi-quantitative 163-item food frequency questionnaire (FFQ) was developed for the adult Singapore population, and this study aimed to assess its reproducibility and relative validity against 24-h dietary recalls (24 h DR) and biomarkers. The FFQ was administered twice within a six-month interval in 161 adults (59 Chinese, 46 Malay, and 56 Indian). Fasting plasma, overnight urine, and 24 h DR were collected after one month and five months. Intra-class correlation coefficients between the two FFQ were above 0.70 for most foods and nutrients. The median correlation coefficient between energy-adjusted deattenuated FFQ and 24 h DR nutrient intakes was 0.40 for FFQ1 and 0.39 for FFQ2, highest for calcium and iron, and lowest for energy and carbohydrates. Significant associations were observed between urinary isoflavones and soy protein intake (r = 0.46), serum carotenoids and fruit and vegetable intake (r = 0.34), plasma eicosapentaenoic acid and docosahexaenoic acid (EPA + DHA) and fish/seafood intake (r = 0.36), and plasma odd chain saturated fatty acids (SFA) and dairy fat intake (r = 0.25). Associations between plasma EPA + DHA and fish/seafood intake were consistent across ethnic groups (r = 0.28–0.49), while differences were observed for other associations. FFQ assessment of dietary intakes in modern cosmopolitan populations remains feasible for the purpose of ranking individuals’ dietary exposures in epidemiological studies.
Highlights
The prevalence of obesity and chronic diseases is rising rapidly in Asia [1,2]
Nutrients 2017, 9, 1059 populations reside in multi-ethnic cosmopolitan settings, where meals prepared outside the home are frequently consumed
Long-term dietary exposures in chronic disease epidemiology are usually assessed by self-report methods such as food frequency questionnaires (FFQ)
Summary
The prevalence of obesity and chronic diseases is rising rapidly in Asia [1,2]. In every Asian country, diet-related risk factors such as overweight, hypertension, and hyperglycemia are among the top contributors to early death and disability [3]. Effective interventions require a clear understanding of food consumption trends and diet-disease relationships. The reliable assessment of dietary intakes is increasingly challenging, as Asian diets become increasingly varied, consisting of both traditional fresh foods and ultra-processed products [4,5]. Nutrients 2017, 9, 1059 populations reside in multi-ethnic cosmopolitan settings, where meals prepared outside the home are frequently consumed. Singapore is one such Asian multi-ethnic cosmopolitan setting (74% Chinese, 13% Malay, 9% Indian, and 3% others) [6], with a wide variety of traditional ethnic and international cuisines, and a strong eating-out culture [7]. Long-term dietary exposures in chronic disease epidemiology are usually assessed by self-report methods such as food frequency questionnaires (FFQ). Other FFQs developed for multi-ethnic populations in the Asia region did not stratify by ethnic group in either
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