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. 2018 Sep 1;10(9):1206.
doi: 10.3390/nu10091206.

Cross-Cultural Adaptation, Validity, and Reproducibility of the Mediterranean Islands Study Food Frequency Questionnaire in the Elderly Population Living in the Spanish Mediterranean

Ana Zaragoza-Martí  1 , Rosario Ferrer-Cascales  2 , José Antonio Hurtado-Sánchez  3 , Ana Laguna-Pérez  4 , María José Cabañero-Martínez  5
Affiliations

Cross-Cultural Adaptation, Validity, and Reproducibility of the Mediterranean Islands Study Food Frequency Questionnaire in the Elderly Population Living in the Spanish Mediterranean

Ana Zaragoza-Martí et al. Nutrients. .

Abstract

The objective of this study was to perform cross-cultural adaptation of the Mediterranean Islands Study Food Frequency Questionnaire (MEDIS-FFQ) and to evaluate its reproducibility and validity in a population over 60 years of age in the Spanish Mediterranean. Three hundred forty-one people completed the food frequency questionnaire (FFQ), which was administered twice (FFQ1 and FFQ2) with nine 24-h dietary recalls (24-HDRs) over a nine-month period to assess its reproducibility and validity. Cross-cultural translation and adaptation were performed according to the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines and included direct translation, back-translation, and a pilot comprehension test. Reproducibility was evaluated with Pearson's and interclass correlation coefficients. Validity was estimated using correlations between the FFQ food groups and the 24-HDR mean. The levels of agreement and misclassification were expressed as the proportions of individuals classified by comparing the estimated information from the FFQ2 and the 24-HDR. Reproducibility correlation coefficients ranged from r = 0.44 to r = 0.90. Validity indices ranged from 0.71 to 0.99. More than 80% of the subjects were classified in the same quartile on both instruments. The kappa statistic showed a moderate to high level of agreement (0.70⁻0.95) between the two instruments. In conclusion, the MEDIS-FFQ showed good reproducibility and validity in estimating the nutrient intake of the elderly population in the Spanish Mediterranean.

Keywords: FFQ; elderly; nutrition; reproducibility; validity.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study design. 24-HDR: 24-h dietary recall; FFQ: food frequency questionnaire.
Figure 2
Figure 2
Cross-cultural adaptation of the Mediterranean Islands Study Food Frequency Questionnaire (MEDIS-FFQ).
Figure 3
Figure 3
Example image of the photo album.
Figure 4
Figure 4
Bland–Altman plots showing the relationship between mean and differences in the daily intake of (a) energy, (b) lipids, (c) vitamin E, and (d) vitamin B12 estimated with the second FFQ (FFQ2) and three 24-HDR and the corresponding mean intake estimated by the two methods.
See this image and copyright information in PMC

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