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Open Access Methodology

Reproducibility and comparative validity of a food frequency questionnaire for Australian children and adolescents

Jane F Watson1*, Clare E Collins1, David W Sibbritt2, Michael J Dibley3 and Manohar L Garg4

Author Affiliations

1 School of Health Sciences, Faculty of Health, University of Newcastle, Newcastle NSW, Australia

2 School of Medicine and Public Health, Faculty of Health, University of Newcastle, Newcastle NSW, Australia

3 School of Public Health and The George Institute for International Health, Faculty of Medicine, University of Sydney, Sydney NSW, Australia

4 School of Biomedical Sciences, Faculty of Health, University of Newcastle, Newcastle NSW, Australia

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International Journal of Behavioral Nutrition and Physical Activity 2009, 6:62  doi:10.1186/1479-5868-6-62

Published: 11 September 2009

Abstract

Background

Dietary intake during childhood and adolescence is of increasing interest due to its influence on adult health, particularly obesity, cardiovascular disease and diabetes. There is a need to develop and validate dietary assessment methods suitable for large epidemiologic studies of children and adolescents. Limited large scale dietary studies of youth have been undertaken in Australia, due partly to the lack of a suitable dietary intake tool. A self-administered, semi-quantitative food-frequency questionnaire (FFQ), the 'Australian Child and Adolescent Eating Survey' (ACAES), was developed for youth aged 9-16 years. This study evaluated reproducibility and comparative validity of the ACAES FFQ using assisted food records (FRs) as the reference method.

Methods

The ACAES FFQ was completed twice (FFQ1 and FFQ2) at an interval of 5 months, along with four one-day assisted FRs. Validity was evaluated by comparing the average of the FRs with FFQ2 (n = 113) as well as with the average of FFQ1 and FFQ2 (n = 101). Reproducibility was evaluated by comparing FFQ1 and FFQ2 (n = 101). The two methods were compared using correlations, Kappa statistics and Bland-Altman plots.

Results

Correlation coefficients for comparative validity ranged from 0.03 for retinol to 0.56 for magnesium for transformed, energy-adjusted, deattenuated nutrient data, with correlation coefficients greater than 0.40 for total fat, saturated fat, monounsaturated fat, carbohydrate, sugars, riboflavin, vitamin C, folate, beta-carotene, magnesium, calcium and iron. Correlation coefficients for reproducibility ranged from 0.18 for vitamin A to 0.50 for calcium for transformed, energy-adjusted, deattenuated nutrient data. The ACAES FFQ ranked individuals reasonably accurately, with the comparative validity analysis showing that over 50% of participants were classified within one quintile for all nutrients, with only a small percentage grossly misclassified (0-7%).

Conclusion

The ACAES FFQ is the first child and adolescent specific FFQ available for ranking the dietary intakes of Australian children and adolescents for a range of nutrients in epidemiologic research and public health interventions.