Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Methods

The reliability and validity of a short food frequency questionnaire among 9–11-year olds: a multinational study on three middle-income and high-income countries

Abstract

Objective:

The main aim of this study was to assess the reliability and validity of a food frequency questionnaire with 23 food groups (I-FFQ) among a sample of 9–11-year-old children from three different countries that differ on economical development and income distribution, and to assess differences between country sites. Furthermore, we assessed factors associated with I-FFQ’s performance.

Methods:

This was an ancillary study of the International Study of Childhood Obesity, Lifestyle and the Environment. Reliability (n=321) and validity (n=282) components of this study had the same participants. Participation rates were 95% and 70%, respectively. Participants completed two I-FFQs with a mean interval of 4.9 weeks to assess reliability. A 3-day pre-coded food diary (PFD) was used as the reference method in the validity analyses. Wilcoxon signed-rank tests, intraclass correlation coefficients and cross-classifications were used to assess the reliability of I-FFQ. Spearman correlation coefficients, percentage difference and cross-classifications were used to assess the validity of I-FFQ. A logistic regression model was used to assess the relation of selected variables with the estimate of validity. Analyses based on information in the PFDs were performed to assess how participants interpreted food groups.

Results:

Reliability correlation coefficients ranged from 0.37 to 0.78 and gross misclassification for all food groups was <5%. Validity correlation coefficients were below 0.5 for 22/23 food groups, and they differed among country sites. For validity, gross misclassification was <5% for 22/23 food groups. Over- or underestimation did not appear for 19/23 food groups. Logistic regression showed that country of participation and parental education were associated (P0.05) with the validity of I-FFQ. Analyses of children’s interpretation of food groups suggested that the meaning of most food groups was understood by the children.

Conclusion:

I-FFQ is a moderately reliable method and its validity ranged from low to moderate, depending on food group and country site.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Willett W . Food Frequency Methods. In: Willet W (ed.). Nutritional Epidemiology, 3rd edn. Oxford University Press: New York, NY, USA 2013, pp 70–95.

    Google Scholar 

  2. Livingstone MBE, Robson PJ, Wallace JMW . Issues in dietary intake assessment of children and adolescents. Br J Nutr 2004; 92 (Suppl 2): S213–S222.

    Article  CAS  Google Scholar 

  3. Willett W, Lenart E . Reproducibility and validity of food-frequency questionnaires. In: Willet W (ed.). Nutritional Epidemiology, 3rd edn. Oxford University Press: New York, NY, USA, 2013, pp 96–141.

    Google Scholar 

  4. Kolodziejczyk JK, Merchant G, Norman GJ . Reliability and validity of child/adolescent food frequency questionnaires that assess foods and/or food groups. J Pediatr Gastroenterol Nutr 2012; 55: 4–13.

    Article  Google Scholar 

  5. Cassidy CM . Walk a mile in my shoes: culturally sensitive food-habit research. Am J Clin Nutr 1994; 59 (Suppl 1): S190–S197.

    Article  Google Scholar 

  6. Jaceldo-Siegl K, Fan J, Sabaté J, Knutsen SF, Haddad E, Beeson WL et al. Race-specific validation of food intake obtained from a comprehensive FFQ: the Adventist Health Study-2. Public Health Nutr 2011; 14: 1988–1997.

    Article  Google Scholar 

  7. Maurer J, Taren DL, Teixeira PJ, Thomson CA, Lohman TG, Going SB et al. The psychosocial and behavioral characteristics related to energy misreporting. Nutr Rev 2006; 64: 53–66.

    Article  Google Scholar 

  8. Moore GF, Tapper K, Moore L, Murphy S . Cognitive, behavioral, and social factors are associated with bias in dietary questionnaire self-reports by schoolchildren aged 9 to 11 years. J Am Diet Assoc 2008; 108: 1865–1873.

    Article  Google Scholar 

  9. Klesges LM, Baranowski T, Beech B, Cullen K, Murray DM, Rochon J et al. Social desirability bias in self-reported dietary, physical activity and weight concerns measures in 8- to 10-year-old African-American girls: results from the Girls Health Enrichment Multisite Studies (GEMS). Prev Med 2004; 38 (Suppl 1): S78–S87.

    Article  Google Scholar 

  10. Ferguson EL, Gibson RS, Opare-Obisaw C . The relative validity of the repeated 24h recall for estimating energy and selected nutrient intakes of rural Ghanaian children. Eur J Clin Nutr 1994; 48: 241–252.

    CAS  Google Scholar 

  11. Mouratidou T, Miguel ML, Androutsos O, Manios Y, De Bourdeaudhuij I, Cardon G et al. Tools, harmonization and standardization procedures of the impact and outcome evaluation indices obtained during a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study. Obes Rev 2014; 15 (Suppl 3): S53–S60.

    Article  Google Scholar 

  12. Bel-Serrat S, Mouratidou T, Pala V, Huybrechts I, Börnhorst C, Fernández-Alvira JM et al. Relative validity of the Children’s Eating Habits Questionnaire-food frequency section among young European children: the IDEFICS study. Public Health Nutr 2013; 17: 266–276.

    Article  Google Scholar 

  13. Vereecken CA, Rossi S, Giacchi MV, Maes L . Comparison of a short food-frequency questionnaire and derived indices with a seven-day diet record in Belgian and Italian children. Int J Public Health 2008; 53: 297–305.

    Google Scholar 

  14. Sharma S . Development and use of FFQ among adults in diverse settings across the globe. Proc Nutr Soc 2011; 70: 232–251.

    Article  Google Scholar 

  15. Katzmarzyk PT, Barreira TV, Broyles ST, Champagne CM, Chaput JP, Fogelholm M et al. The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE): design and methods. BMC Public Health 2013; 30: 900.

    Article  Google Scholar 

  16. World Bank: World Bank Gini Index. Available at http://data.worldbank.org/indicator/SI.POV.GINI/. 2012.

  17. De Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J . Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 2007; 85: 660–667.

    Article  Google Scholar 

  18. Vereecken CA, Maes L . A Belgian study on the reliability and relative validity of the Health Behaviour in School-Aged Children food-frequency questionnaire. Public Health Nutr 2003; 6: 581–588.

    Article  Google Scholar 

  19. Livingstone MB, Robson PJ . Measurement of dietary intake in children. Proc Nutr Soc 2000; 59: 279–93.

    Article  CAS  Google Scholar 

  20. Mikkilä V, Vepsäläinen H, Saloheimo T, Gonzalez SA, Meisel JD, Hu G et al An international comparison of dietary patterns in 9—11-y-old children: the 12-country ISCOLE-study. Int J Obes Suppl 2015 (this issue).

Download references

Acknowledgements

We thank the ISCOLE External Advisory Board and the ISCOLE participants and their families who made this study possible. JDM has received funding from the ‘Programa nacional de formación doctoral Francisco Jose de Caldas’ from Colciencias’ (Convocatorias 511-2010). Carlos Mario Pedraza, David Ricardo Leal and Luis Guillermo Gomez are acknowledged for their contribution to this study. A membership list of the ISCOLE Research Group and External Advisory Board is included in Katzmarzyk et al. (this Issue). ISCOLE was funded by The Coca-Cola Company. The funder had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

Author information

Authors and Affiliations

Authors

Consortia

Corresponding author

Correspondence to T Saloheimo.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Supplementary Information accompanies this paper on International Journal of Obesity Supplements website

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Saloheimo, T., González, S., Erkkola, M. et al. The reliability and validity of a short food frequency questionnaire among 9–11-year olds: a multinational study on three middle-income and high-income countries. Int J Obes Supp 5 (Suppl 2), S22–S28 (2015). https://doi.org/10.1038/ijosup.2015.15

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijosup.2015.15

This article is cited by

Search

Quick links