Validity and Reliability of a Food Frequency Questionnaire (FFQ) to Assess Dietary Intake of Preschool Children

Wan Nurul Najwa,Fendy Yap,Farra Aidah Jumuddin,Carolyn Summerbell,Julia Ai Cheng Lee,Denise Koh,Lee Choo Ang,Cecilia A Essau,Edward Leigh Gibson,Bee Koon Poh,Abd Talib Ruzita,Yatiman Noor Hafizah,Sue Reeves,Whye Lian Cheah

doi:10.3390/ijerph16234722

Abstract

As there are few food frequency questionnaires (FFQ) to assess the dietary intake of preschool children, this study examined the validity and reliability of an FFQ for this purpose. A total of 210 preschoolers aged 4 to 6 years participated in the validation study, while a subsample of 66 participants joined the reliability study. The FFQ is modified from the ToyBox-study and South East Asian Nutrition Surveys (SEANUTS), and comprised 108 food items from 13 food groups. A three-day estimated dietary record (3DR) was used as reference and reliability was assessed through a second administration of the FFQ (FFQ2), four weeks after the first administration (FFQ1). For the validation study, Spearman’s correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ and 3DR. Cross-classification of quartile analysis showed moderate agreement between the two methods. As for reliability, Spearman’s correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ1 and FFQ2. Cronbach’s alpha values (0.708 to 0.824) and intraclass correlation coefficients (0.710 to 0.826) showed good agreement between repeated FFQs. The results suggest that the FFQ has acceptable validity and good reliability. Hence, the FFQ can be used to assess preschool children’s food intake.

Highlights

As childhood obesity increases alarmingly worldwide, it is more important than ever to accurately assess the food intake of children, especially from the early to preschool years
The ToyBox-study food frequency questionnaires (FFQ) food items were merged with those from the South East Asian Nutrition Surveys (SEANUTS) FFQ since it consists of food items that are usually consumed by Malaysia children
This study validation of an FFQ designed to assess the diet of Malaysian preschool children, when describes the validation of an FFQ designed to assess the diet of Malaysian preschool completed by their primary caregiver

Summary

Introduction

As childhood obesity increases alarmingly worldwide, it is more important than ever to accurately assess the food intake of children, especially from the early to preschool years. A nutritious diet is critical for children’s growth and development, including cognitive functions [1,2]. To be able to monitor the nutritional status of children, the accurate assessment of food and beverage intakes is crucial [3,4]. An accurate assessment of nutritional status can help identify unhealthy diets and childhood dietary problems that may contribute to both short- and long-term malnutrition [5,6]. In addition to a monitoring function, dietary assessment is an important first step in planning any type of individual or public health dietary intervention. Dietary assessment in preschoolers is challenging because their dietary patterns change more rapidly and more frequently compared to the dietary patterns of other age groups [7]

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Discussion

Conclusion