Abstract

Dietary intake is an important predictor of health and disease outcomes. This cross-sectional study evaluated the relative validity and reproducibility of a semi-quantitative food frequency questionnaire (FFQ) for assessing energy and nutrient intake in older adults. Dietary data were collected 2018–2019 in Auckland, New Zealand from a convenience sample of community-dwelling adults (65–74 years, n = 294, 37% male) using a 109-item self-administered FFQ at baseline (FFQ1) and four weeks later to assess reproducibility. FFQ1 was compared to a four-day food record to determine relative validity. Agreement between dietary assessment tools was assessed for both raw and energy-adjusted nutrient intakes using paired t-tests, correlation coefficients, weighted kappa statistic, Bland–Altman plots, and linear regression analysis. Energy adjustments moderately improved the relative validity and reproducibility for most nutrients. For energy and energy-adjusted nutrient intakes, the mean correlation coefficients were 0.38 (validity) and 0.65 (reproducibility); the mean weighted kappa statistics were 0.27 (validity) and 0.51 (reproducibility). A significant slope of bias was present in 54% (validity) and 25% (reproducibility) of Bland–Altman plots. The Researching Eating, Activity, and Cognitive Health (REACH) FFQ has acceptable relative validity and good reproducibility for ranking nutrient intakes in older New Zealand adults, but is less suitable for assessing absolute nutrient intakes.

Highlights

  • IntroductionThe proportion of adults aged 65 years and over in New Zealand is expected to be more than 23% by 2043 (from 15%, 2016) [1,2]

  • Relative Validity of Energy and Nutrient Intakes Derived from the REACH food frequency questionnaire (FFQ)

  • Reproducibility of Energy and Nutrient Intakes Derived from the REACH FFQ

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Summary

Introduction

The proportion of adults aged 65 years and over in New Zealand is expected to be more than 23% by 2043 (from 15%, 2016) [1,2]. In New Zealand, older adults carry a heavier burden of chronic diseases such as coronary heart disease, bowel cancer, and musculoskeletal disorders, with vascular disease being a primary cause of health loss [3]. Low calcium intake is commonly observed in older adults and insufficient dietary intake of calcium may contribute to bone loss and a higher risk of fractures [7,8]. In older adults, inadequate protein intake may result in protein deficiency, causing changes in body composition, to the point that there is an increased risk of sarcopenia and muscle wasting [9,10]

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