Abstract
BackgroundDue to the absence of a current and validated food frequency questionnaire (FFQ) for use in New Zealand adolescents, there is a need to develop one as a cost-effective way to assess adolescents’ food patterns. This study aims to examine the test-retest reliability and relative validity of the New Zealand Adolescent FFQ (NZAFFQ) to assess food group intake in adolescents aged 14 to 18 years.MethodsA non-quantitative (without portion size), 72-item FFQ was developed and pretested. Fifty-two participants (aged 14.9 ± 0.8 years) completed the NZAFFQ twice within a two-week period for test-retest reliability. Forty-one participants (aged 15.1 ± 0.9 years) completed a four-day estimated food record (4DFR) in addition to the FFQs to enable assessment of validity. Spearman’s correlations and cross-classification analyses were used to examine relative validity while intra-class correlations were additionally used for test-retest reliability.ResultsWeekly intakes were estimated for each food item and aggregated into 34 food groups. The median Spearman’s correlation coefficient (SCC) between FFQ administrations was 0.71. SCCs ranged from 0.46 for fruit juice or cordial to 0.87 for non-standard milk. The median intra-class correlation coefficient (ICC) between FFQ administrations was 0.69. The median SCC between food groups from the FFQ and the 4DFR was 0.40 with the highest SCC seen for standard milk (0.70). The exact agreement between the methods in ranking participants into thirds was highest for meat alternatives (78%), but lowest for red or yellow vegetables and potatoes (27%). The mean percent of participants misclassified into extreme thirds for food group intake was 12%.ConclusionsDespite a small sample size, the NZAFFQ exhibited good to excellent short-term test-retest reliability and reasonable validity in ranking the majority of the food group intakes among adolescents aged 14 to 18 years. The comparability of the validity to that in the current literature suggests that the NZAFFQ may be used among adolescent New Zealanders to identify dietary patterns and rank them according to food group intake.
Highlights
Due to the absence of a current and validated food frequency questionnaire (FFQ) for use in New Zealand adolescents, there is a need to develop one as a cost-effective way to assess adolescents’ food patterns
As there is currently no reliable, valid and up to date FFQ for use in New Zealand adolescents the aims of this study were to: (i) adapt an FFQ to assess food group intakes in New Zealand adolescents aged 14 to 18 years for use in future studies; (ii) determine short-term reliability of this FFQ, and (iii) determine the relative validity of this FFQ compared to an estimated food record
The median s correlation coefficient (SCC) was 0.71, with all food groups achieving Spearman’s correlations above 0.46. This reliability fell within a range considered good for an FFQ (0.50–0.80) [27,41] and was similar to the reliability of the CNS02 FFQ, the only previous FFQ designed for New Zealand children [37]
Summary
Due to the absence of a current and validated food frequency questionnaire (FFQ) for use in New Zealand adolescents, there is a need to develop one as a cost-effective way to assess adolescents’ food patterns. Most adolescents possess the literacy skills necessary for reliable self-reporting, accuracy of dietary assessment in this age group is affected by factors such as motivation to complete assessments and reporting bias associated with unstructured eating patterns, concerns with body image and weight status [10,11,12]. Besides these adolescent-specific issues, the study design, outcomes of interest and available resources need to be taken into consideration when selecting an appropriate dietary assessment tool for a study [13,14]
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