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. 2024 Nov 2;16(21):3772.
doi: 10.3390/nu16213772.

Validation of a Food Frequency Questionnaire: VioScreen-Allergy

Kaci Pickett-Nairne  1 , Deborah Glueck  1 , Jessica Thomson  2 , Rick Weiss  3 , Kelly N Z Fuller  3 , Stefka Fabbri  4 , Claudia Schaefer  1 , Courtney Evans  5 , Emily Bowhay  5 , Monica Martinez  4 , Wendy Moore  5 , David Fleischer  6 , Carina Venter  6
Affiliations

Validation of a Food Frequency Questionnaire: VioScreen-Allergy

Kaci Pickett-Nairne et al. Nutrients. .

Abstract

Background/objectives: An adapted version of an online pictorial food frequency questionnaire (FFQ), VioScreen-Allergy, assesses total dietary intake and intake of allergens and foods in the maternal diet index (MDI), linked to offspring allergy. This study assessed intermethod reliability, test-retest reliability, and external validity of the VioScreen-Allergy.

Methods: Females of childbearing age were recruited at Denver Health and Children's Hospital, Colorado, USA, and were asked to complete four 24 h recalls and two VioScreen-Allergy FFQs over the course of a month. All those with at least two 24 h dietary recalls and both VioScreen-Allergy assessments were analyzed. Energy-adjusted and non-adjusted linear mixed models (1) compared MDI scores and intake of nutrients and allergens as measures of intermethod reliability; (2) evaluated VioScreen-Allergy test-retest reliability as differences between repeated measurements; and (3) assessed external validity by modeling associations between VioScreen-Allergy-derived intake of beta-carotene and orange vegetables and Veggie Meter®-assessed skin carotenoids. Bonferroni corrections controlled multiple comparisons within the assessment.

Results: Of 53 participants enrolled, 25 demographically dissimilar participants were included in the analysis. There were no significant differences between 24 h recall and VioScreen-Allergy mean intakes of macronutrients, micronutrients, allergens, or MDI, except for Vitamin C, niacin, and cashew allergen protein. There were no significant differences between repeated measurements of VioScreen-Allergy, either energy-adjusted or unadjusted. Both beta-carotene and orange vegetable servings were significantly associated with Veggie Meter®.

Conclusions: Although non-significance could have been due to low power, clinical as well as statistical assessments of intermethod reliability, test-retest reliability, and external validity suggest that VioScreen-Allergy has reasonable utility for trials assessing food allergens and MDI in the context of overall intake. The VioScreen questionnaire can also be used in future studies to assess macro- and micronutrient intake. Additional validation studies assessing different portion sizes and foods eaten by infants and young children are currently undergoing.

Keywords: external validity; food frequency questionnaire; intermethod reliability; maternal diet index; test–retest reliability.

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Conflict of interest statement

David Fleischer has received research support from ARS Pharmaceuticals and DBV Technologies; serves as an unpaid advisory board member for the Food Allergy & Anaphylaxis Connection Team and the National Peanut Board; receives royalties from UpToDate; and received personal fees as a consultant to Aquestive, ARS Pharmaceuticals, Bryn Pharma, DBV Technologies, Genentech, and Nasus outside of the submitted work. Venter reports grants from Reckitt Benckiser, grants from Food Allergy Research and Education, and grants from the National Peanut Board during the conduct of the study; personal fees from Reckitt Benckiser, personal fees from Nestle Nutrition Institute, personal fees from Danone, personal fees from Abbott Nutrition, personal fees from Else Nutrition, and personal fees from Before Brands, outside the submitted work. Rick Weiss is the president and majority owner of Viocare, Inc., which was compensated for the development of the infant allergy food frequency questionnaire (FFQ) based on VioScreen. The FFQ was used and validated in the study described in this paper. This commercial relationship represents a conflict of interest. The other authors declare no interests. None of the support listed played any role in the design, execution, interpretation, or writing of the study.

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