A meta-analysis of the reproducibility of food frequency questionnaires in nutritional epidemiological studies

A Systematized Review of the Relationship Between Obesity and Vitamin C Requirements

Obesity rates have increased globally in recent decades. Body weight is used as a modifiable factor in determining vitamin requirements. Accordingly, vitamin C requirements are volumetrically scaled from data for healthy weight males to other age- and sex-based categories. Likewise, it is possible that increases in body weight due to obesity may affect vitamin C needs. A systematized literature review was performed to summarize evidence on whether obesity affects vitamin C intake or status. The literature was also scanned for potential mechanisms for the relationship. Many observational studies showed that vitamin C status is lower in overweight and obese children and adults; this may be explained by lower vitamin C intakes. Nevertheless, a reanalysis of carefully conducted intervention studies has demonstrated a lower vitamin C status in participants who were overweight or obese when given the same dose of vitamin C as subjects of normal weight. Several mechanisms have been proposed to potentially explain why vitamin C status is lower in people with obesity: changes in vitamin C partitioning between lean and adipose tissue, volumetric dilution, metabolic alterations due to obesity, and gut microbial dysbiosis. Depletion-repletion or pharmacokinetic studies that include individuals of diverse body weights and ages would be helpful to further investigate whether obesity increases requirements for vitamin C. The current evidence base supports a lower vitamin C status in people who are overweight or obese; however, the association may be attenuated by lower vitamin C intakes.

Validity and Reproducibility of a Semiquantitative Food Frequency Questionnaire and Food Picture Book in Nigeria

Background

Increasing noncommunicable diseases in Nigeria are partly related to dietary factors. However, the lack of validated nutrition assessment tools hinders the conduct of nutritional epidemiology research in this population.

Objectives

To develop a Food Frequency Questionnaire (FFQ) and Food Picture Book (FPB) for Nigerian adults, and to assess its reproducibility and validity compared with 24-h dietary recalls (24DRs) during different seasons in the year.

Methods

We compiled 202 foods for the FFQ through focus groups and consultations with local dietitians. We created an FPB with standardized food portion images to enhance the accuracy of reports of dietary intakes. We administered the FFQs to 205 purposively selected adults in Ibadan, Nigeria at ∼6 monthly intervals between November 2018 and October 2020. We evaluated the FFQ's reproducibility and validity compared with 24DR across the dry and rainy seasons by examining the consumption of common food and mixed dishes. We computed the Spearman's correlation coefficients (SCC), intraclass correlation coefficients (ICC), and Wilcoxon signed-rank tests, and generated Bland and Altman plots.

Results

Overall, we studied 110 women (53.7%) and 95 men (46.3%) with a mean age of 45.0 ± 13.4 y (mean ± SD). The reproducibility tests showed a mean ± SD SCC of 0.39 ± 0.14 and mean ± SD ICC of 0.32 ± 0.12. Higher mean ± SD SCC values were noted for cereal products (0.43 ± 0.09), starchy roots and tubers (0.45 ± 0.17), and soups (0.44 ± 0.20). Conversely, lower mean ± SD SCC values were observed for milk products (0.29 ± 0.02), solid fats (0.29 ± 0.26), and fish (0.22 ± 0.19). Regarding validity tests, the overall mean ± SD SCC was 0.27 ± 0.16 and mean ± SD ICC was 0.26 ± 0.16. We observed seasonal variations in intakes of fruits, cassava flour-based products, and nuts, although most foods did not show significant differences in intakes between seasons.

Conclusions

Our FFQ and FPB demonstrated moderate correlations and seasonal variations in intakes of certain foods, emphasizing the need to account for seasonality in dietary intakes in nutritional studies in Nigeria and similar countries.

Effect of maternal diet on the frequency of micronuclei in pregnant women and newborns: A protocol for systematic review and meta-analysis

BACKGROUND

The effects of diet on maternal and child genetic levels have been previously reported. Diet-associated DNA damage, such as the presence of micronuclei (MN), may be related to an increased risk of developing chronic diseases, such as cancer. Such damage is particularly concerning during pregnancy as it can affect the newborn.

AIM

This review will aim to summarize the primary evidence of the impact of diet during pregnancy on micronucleus frequency in the maternal-newborn population.

METHODS

This protocol was developed based on the Preferred Reporting Items guidelines for Systematic Reviews and Meta-analyses Protocol. The review was registered with the International Register of Prospective Systematic Reviews on February 17, 2022 (registration number: CRD42022302401). We will use PubMed, Embase, Web of Science, Scopus, Science direct, and Google databases to search for observational studies. This review will include studies that investigate the diet consumed by pregnant women and its effect on the frequency of MN in mothers and newborns without any time or language limitations. For data extraction, researchers will independently review the full text and collect information that characterizes the study and its findings. We will analyze the results by calculating the odds ratio for each type of diet evaluated, accompanied by a 95% confidence interval. We will perform a quantitative synthesis of homogeneous studies to perform a meta-analysis. Micronucleus frequency quantifies the effect and will be presented as the mean and standard deviation or median and interquartile range.

EXPECTED RESULTS

This review will aim to identify which dietary patterns during pregnancy may be associated with an increase in the frequency of MN in mothers and their newborns. Understanding the impact of diet on the frequency of MN is essential to deepen studies and to propose strategies that aim to protect the health of the public through food.

An Unhealthy Dietary Pattern during Pregnancy is Associated with Neurodevelopmental Disorders in Childhood and Adolescence

Despite the high prevalence of neurodevelopmental disorders, there are a lack of clinical studies examining the impact of pregnancy diet on child neurodevelopment. This observational clinical study examined the associations between pregnancy dietary patterns and neurodevelopmental diagnoses, as well as their symptoms, in a prospective cohort of 10-year-old children (n=508). Data-driven dietary patterns were derived from self-reported food frequency questionnaires. An Unhealthy dietary pattern in pregnancy (per SD change) was significantly associated with attention deficit hyperactivity disorder (ADHD) OR 1.66 [1.21 - 2.27], p=0.002 and autism diagnosis OR 2.22 [1.33 - 3.74], p=0.002 and associated symptoms p<0.001. Findings for ADHD were validated in two large (n=656, n=348), independent mother-child cohorts via blood metabolome modelling. Objective metabolite scores, assessed at five timepoints in mothers and children in two independent mother-child cohorts, indicated that the strongest association with ADHD was during early-to mid-pregnancy. These results provide evidence for targeted prenatal dietary interventions to prevent neurodevelopmental disorders in children.

Cross-cultural adaptation and reproducibility of the EPIC-Norfolk food frequency questionnaire in young people living in Croatia

AIM

To translate and adapt the European Prospective Investigation of Cancer (EPIC)-Norfolk food frequency questionnaire (FFQ) for use in Croatia, and to assess the reliability and reproducibility of the Croatian version of the EPIC-Norfolk FFQ.

METHODS

Translation and cross-cultural adaptation were performed according to published recommendations. Reliability was assessed in 140 respondents (61 men; age range 8-40 years) divided into three groups: young adults, pregnant women, and children and adolescents. Reproducibility was assessed in the group of young adults (32/61 men), who completed the questionnaire on two occasions three months apart.

RESULTS

The EPIC-Norfolk FFQ showed good reliability (Cronbach alpha=0.874). Most nutrient intakes showed good reproducibility (intraclass correlation coefficient [ICC] between 0.7 and 0.9). Poor reproducibility was observed for alcohol (ICC=0.337), and moderate reproducibility was observed for beta-carotene (ICC=0.692) and total carbohydrates (ICC=0.698). Nutrient intakes measured by FFQ on two occasions did not significantly differ.

CONCLUSION

The Croatian version of the EPIC-Norfolk FFQ can be a useful tool for assessing dietary intakes in young people in Croatia and possibly in neighboring countries with similar languages and dietary habits.

Deficient butyrate metabolism in the intestinal microbiome is a potential risk factor for recurrent kidney stone disease

Intestinal microbiome dysbiosis is a known risk factor for recurrent kidney stone disease (KSD) with prior data suggesting a role for dysfunctional metabolic pathways other than those directly utilizing oxalate. To identify alternative mechanisms, the current study analyzed differences in the metabolic potential of intestinal microbiomes of patients (n = 17) and live-in controls (n = 17) and determined their relevance to increased risk for KSD using shotgun metagenomic sequencing. We found no differences in the abundance of genes associated with known oxalate degradation pathways, supporting the notion that dysfunction in other metabolic pathways plays a role in KSD. Further analysis showed decreased abundance of key enzymes involved in butyrate biosynthesis in patient intestinal microbiomes. Furthermore, de novo construction of microbial genomes showed that the majority of genes significantly enriched in non-stone formers are affiliated with Faecalibacterium prausnitzii, a major butyrate producer. Specifically pertaining to butyrate metabolism, the majority of abundant genes mapped back to F. prausnitzii, Alistipes spp., and Akkermansia muciniphila. No differences were observed in ascorbate or glyoxylate metabolic pathways. Collectively, these data suggest that impaired bacterial-associated butyrate metabolism may be an oxalate-independent mechanism that contributes to an increased risk for recurrent KSD. This indicates that the role of the intestinal microbiome in recurrent KSD is multi-factorial, which is representative of the highly intertwined metabolic nature of this complex environment. Future bacteria-based treatments must not be restricted to targeting only oxalate metabolism.

A scoping review of dietary assessment questionnaires potentially suitable for assessing habitual dietary intake in the National Health and Nutrition Survey, Japan

This scoping review aimed to identify questionnaire-based dietary assessment methods for use in the National Health and Nutrition Survey (NHNS) in Japan. The search was conducted in three databases (PubMed, Web of Science, and Ichushi) to identify questionnaire such as food frequency questionnaire and dietary history questionnaire validated against dietary recalls or food records for the intakes of both food groups and nutrients among Japanese adults. Study quality was assessed based on previously developed criteria. We extracted the questionnaire characteristics and the design and results of the validation studies. We identified 11 questionnaires, with the number of food items ranging from 40 to 196, from 32 articles of good quality. In the validation studies, participants were aged 30-76 years and 90% of the articles used ≥3 d dietary records as reference. The number of nutrients and food groups with a group-level intake difference within 20% against the reference method ranged from 1 to 30 and 1 to 11, respectively. The range of mean correlation coefficients between questionnaire and reference methods were 0.35-0.57 for nutrients and 0.28-0.52 for food groups. When selecting a survey instrument in the NHNS from the 11 existing questionnaires identified in this study, it is important to select one with high group-level comparison and correlation coefficient values on the intended assessment items after scrutinizing the design and results of the validation study. This review may serve as a reference for future studies that explore dietary assessment tools used for assessing dietary intake in specific representative populations.

Maternal Diet Associates with Offspring Bone Mineralization, Fracture Risk and Enamel Defects in Childhood and Influences the Prenatal Effect of High-Dose Vitamin D Supplementation

We previously demonstrated a beneficial effect of high-dose vitamin D in pregnancy on offspring bone and dental health. Here, we investigated the effect of maternal dietary patterns during pregnancy on the risk of bone fractures, bone mineralization and enamel defects until age 6 years in the offspring. Further, the influence of diet on the effect of high-dose vitamin D was analyzed in the COPSAC2010 mother-child cohort including 623 mother-child pairs. A weighted network analysis on FFQs revealed three specific maternal dietary patterns that associated (Bonferroni p < 0.05) with both offspring bone and dental health. The effect of prenatal high-dose (2800 IU/day) vs. standard-dose (400 IU/day) vitamin D on offspring bone mineral content (adjusted mean difference (aMD): 33.29 g, 95% CI: 14.48-52.09, p < 0.001), bone mineral density (aMD: 0.02 g/cm2 (0.01-0.04), p < 0.001), fracture risk (adjusted incidence rate ratio: 0.36 (0.16-0.84), p = 0.02), and enamel defects in primary (adjusted odds ratio (aOR): 0.13 (0.03-0.58), p < 0.01) and permanent molars (aOR: 0.25; (0.10-0.63), p < 0.01) was most pronounced when mothers had lower intake of fruit, vegetables, meat, eggs, sweets, whole grain, offal and fish. This study suggests that prenatal dietary patterns influence offspring bone and dental development, and should be considered in order to obtain the full benefits of vitamin D to enhance personalized supplementation strategy.

Using nutrigenomics to guide personalized nutrition supplementation for bolstering immune system

Immunity refers to the ability of the human immune system to resist pathogen infection. Immune system has the basic functions of immune defense, immune self stabilization and immune surveillance. Balanced nutrition is the cornerstone of the immune system to play its immune function, and nutritional intervention is also an important means to maintain and improve immunity. Previous studies have confirmed that T cells have individual differences in recognizing viral antigens of virus infected cells, and the body's response to antigens is controlled by a variety of genetic genes, such as human leukocyte antigen (HLA) genes, immune response (Ir) genes, etc. In this paper, through immunity genetic testing, we screen out genetically susceptible people with low immunity and people with the risk of nutrient metabolism disorders; through using lifestyle questionnaire and physical examination results, we analyze people's physical condition, dietary habits, and exercise habits to evaluate people's nutrient deficiency degree. Then, combining multi-dimensional health data, we evaluate users' immune status and nutritional deficiency risk comprehensively, further, we implemented personalized nutrition intervention on the types and doses of nutritional supplements to improve immunity. We also validated the effectiveness of our personalized nutrition solution through a population-based cohort study.

Food frequency questionnaires developed and validated in Brazil: A scoping review protocol

A food frequency questionnaire (FFQ) is used to assess habitual food and nutrient intake. The choice of a FFQ should consider the study objectives, instrument particularities, target population, and geographic region. Over the past few years, FFQs have been constructed and validated in Brazil for children, adolescents, adults, athletes, and individuals with specific clinical conditions. The aim of this scoping review is to map the food frequency questionnaires developed and validated in Brazil. The Population-Concept-Context (PCC) framework was used for search strategy and defined as P-not applicable (open), C-food frequency questionnaire, and C-Brazil. FFQ validation studies performed with healthy or sick people will be included, regardless of clinical condition, age, sex, or region in the country. Studies with populations from other countries will be excluded. The review will be conducted in accordance with JBI (formerly known as Joanna Briggs Institute) methodology for scoping reviews. Search databases will include PubMed/MEDLINE, LILACS, Embase, Web of Science (ISI), Scopus, and Google Scholar. Data extraction will be performed by two independent reviewers and discrepancies resolved by a third reviewer. In order to improve the understanding and contextualization of the studies, a description of the results and presentation in tables and figures will be provided. Applications and implications for future research, practices, and policies will be discussed. Our protocol is registered through the Open Science Framework (doi 10.17605/OSF.IO/G5J3K).

Association between Total Dietary Phytochemical Intake and Cardiometabolic Health Outcomes-Results from a 10-Year Follow-Up on a Middle-Aged Cohort Population

Dietary phytochemical intake associations with cardiovascular health and mortality remain unknown. We studied the relations between total dietary phytochemical intake and cardiovascular health outcomes in a middle-aged Swiss population. We analyzed data spanning 2009 to 2021 from a prospective cohort study in Lausanne, Switzerland, including 3721 participants (54.8% women, 57.2 ± 10.3 years) without cardiovascular disease (CVD) history. Dietary intake was assessed using a validated self-reported food frequency questionnaire. The Dietary Phytochemical Index (DPI) and the healthy Dietary Phytochemical Index (hDPI) were calculated as the total energy intake percentage obtained from phytochemical-rich food consumption. The Healthy Plant-Based Diet Index (hPBD) was estimated by scoring healthy plant foods positively and less-healthy plant foods negatively. Indices tertiles and cardiometabolic outcome associations were determined using Cox proportional hazard models. Over 30,217 person-years of follow-up, 262 CVD events, and 178 deaths occurred. Unadjusted analyses found 36%, 33%, and 32% lower CVD risk for the highest hDPI, DPI, and hPBD tertiles, respectively. After adjustment, only the second hDPI tertile showed a 30% lower CVD risk (HR 0.70, 95% CI 0.51-0.95; P for trend 0.362). No other associations emerged. In this middle-aged Swiss cohort, no associations between dietary indices reflecting a phytochemical-rich dietary pattern and incident CVD, all-cause, or CVD mortality were observed.

Recall of residential history and dietary habits during pregnancy and lactation in the distant past: reliability of questionnaire-based radiation doses for persons exposed in utero and early life

This study evaluates the reliability of information obtained by standardized questionnaires used in by personal interviews for estimation of radiation thyroid doses of 1065 individuals in the Belarusian cohort of individuals who were exposed in utero and early life following the Chernobyl accident in April 1986. Data from two interviews conducted in 2012-2017 and in 2018-2022 with mothers, who were pregnant or gave birth shortly after the Chernobyl accident, were analysed. The most reliable answers dealt with various attributes related to residential history. In contrast, the reliability of answers regarding consumption rates of milk from privately owned cows or trade network was moderate, while the agreement in responses for consumption of milk products and leafy vegetables was fair. Information from the two interviews was used to calculate thyroid doses received by the cohort members. Specifically, 'model-based' thyroid doses due to 131I were estimated using input data on individual residential history and food consumption reported during the personal interviews and ecological data (131I ground deposition in the corresponding settlements). In addition, for a subset of cohort subjects (n = 205) whose mothers were measured for 131I thyroid activity, 'measurement-based' thyroid doses were calculated by adjusting the model-based dose using a scaling factor that is defined as the ratio of measured 131I thyroid activity to model-based 131I thyroid activity calculated for the date of measurement. A moderate agreement was observed for total (prenatal and postnatal) model-based thyroid doses due to 131I intake, the arithmetic mean ± standard deviation for the Jaccard similarity coefficient ([Formula: see text]) was 0.45 ± 0.34 (median = 0.39), while measurement-based doses showed a much better agreement with a [Formula: see text] of 0.78 ± 0.29 (median = 0.93). For model-based thyroid doses from external irradiation and from ingestion of 134Cs and 137Cs, [Formula: see text] was 0.82 ± 0.23 (median = 0.90) and 0.84 ± 0.24 (median = 0.96), respectively. Measurement-based doses due to ingestion of radiocaesium isotopes resulted in an almost perfect agreement, [Formula: see text] was 0.91 ± 0.19 (median = 1.0). The present findings suggest that long-term memory recall can be reliable, if a person is asked about unique or important life events, such as pregnancy and childbirth occurring around the time of a nuclear reactor accident. However, the substantial difference (more than 10 times) observed for model-bases doses calculated using the two questionnaires represents an important source of human factor uncertainties that needs to be considered in any dose response analyses. Other lessons learned from this study are that (i) individual measurements of radionuclides in the human body are the most valuable source of information for estimating radiation doses, and (ii) whenever a radiation accident occurs, a sample of affected people should be asked to keep a diary, if at all possible.

Association between dietary total antioxidant capacity and semen quality among men attending an infertility clinic: a cross-sectional study

STUDY QUESTION

Is dietary non-enzymatic antioxidant capacity related to semen quality?

SUMMARY ANSWER

The only statistically significant association of semen quality parameters with dietary total antioxidant capacity (DTAC) detected was an inverse association between DTAC and ejaculate volume.

WHAT IS KNOWN ALREADY

Growing interest exists regarding the role of diet in influencing semen quality. While DTAC is linked to favorable health outcomes, its association with semen quality, especially among men attending infertility clinics, remains understudied.

STUDY DESIGN SIZE DURATION

This cross-sectional study was carried out between June and December of 2020. In total, 1715 participants were included in the final analysis.

PARTICIPANTS/MATERIALS SETTING METHODS

Men who attended an infertility clinic in China were enrolled. Experienced clinical technicians performed the semen analysis. The DTAC indices included the ferric-reducing ability of plasma, oxygen radical absorbance capacity, total reactive antioxidant potential, and Trolox equivalent antioxidant capacity. The quantile regression model was used for multivariate analysis.

MAIN RESULTS AND THE ROLE OF CHANCE

After adjustment for a variety of confounding variables, a significant inverse association was identified between DTAC and ejaculate volume (βcontinuous FRAP = -0.015, 95% CI = -0.023, -0.006, βT3 vs T1 = -0.193, 95% CI = -0.379, -0.006, Ptrend = 0.007; βcontinuous TRAP = -0.019, 95% CI = -0.041, 0.002, βT3 vs T1 = -0.291, 95% CI = -0.469, -0.112, Ptrend = 0.002). The majority of DTAC indices have no statistically significant association with semen quality parameters.

LIMITATIONS REASONS FOR CAUTION

We cannot infer causality because of the nature of the cross-sectional study design. The robustness of the conclusion may be compromised by the exactness of non-enzymatic antioxidant capacity estimation.

WIDER IMPLICATIONS OF THE FINDINGS

Our findings demonstrated no association between DTAC indices and semen quality parameters among men attending an infertility clinic, except for ejaculate volume. Even though our findings are mostly non-significant, they contribute novel knowledge to the field of study while also laying the groundwork for future well-designed studies.

STUDY FUNDING/COMPETING INTERESTS

This work was supported by the JieBangGuaShuai Project of Liaoning Province [grant number 2021JH1/10400050], the Clinical Research Cultivation Project of Shengjing Hospital [grant number M1590], and the Outstanding Scientific Fund of Shengjing Hospital [grant number M1150]. The sponsors had no role in study design, or in the collection, analysis, and interpretation of data, or in the writing of the report, or in the decision to submit the article for publication. There are no conflicts of interest to declare.

TRIAL REGISTRATION NUMBER

N/A.

Reliability and validity of a semi-quantitative food frequency questionnaire: dietary intake assessment among multi-ethnic populations in Northwest China

BACKGROUND

Few multi-ethnic dietary culture-sensitive food frequency questionnaires (FFQ) have been developed due to the complexity and diversity of cooking methods and styles. This study aimed to develop and validate a specific FFQ among multi-ethnic groups in Northwest China.

METHODS

In the reliability study, 139 participants aged 20-65 completed two identical FFQs separated by 3 months. The relative validation of the FFQ was assessed by three 24-h recalls (24HR) employed in the interval of two FFQs, as a reference. Stratified analyses were also conducted by the major ethnic groups (Han nationality or Ethnic minority).

RESULTS

For reproducibility, the median (range) of Spearman's correlation coefficients (SCC) was 0.71 (0.43-0.84) for nutrients. The intra-class correlation coefficients (ICC) covered a spectrum from 0.39 to 0.78 (median: 0.64). Meanwhile, the weighted kappa values ranged from 0.11 to 0.64. For validity, the median (range) of Pearson's correlation coefficients derived from the energy unadjusted and the adjusted values between FFQ and 24HR were 0.61 (0.12-0.79) and 0.56 (0.12-0.77), respectively. The results of correlation coefficients were similar between the two ethnic groups. Moreover, the Bland-Altman plots likewise demonstrated a satisfactory level of agreement between the two methods.

CONCLUSIONS

The FFQ showed acceptable reproducibility and moderate relative validity for evaluating dietary intake among multi-ethnic groups in northwest China. It could be a credible nutritional screening tool for forthcoming epidemiological surveys of these populations.

Trajectories of dietary patterns from pregnancy to 12 years post-pregnancy and associated maternal characteristics: evidence from the Avon Longitudinal Study of Parents and Children

PURPOSE

Dietary patterns (DPs) during pregnancy have been well researched. However, little is known about maternal diet after pregnancy. The aim of the study was to explore maternal DPs longitudinally, examine trajectories over 12 years after pregnancy and identify associated factors.

METHODS

Of 14,541 pregnant women enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC) complete dietary information was available for 5336 women. Principal components analysis (PCA) was used to derive DPs. DP scores at each time point were used to create DP trajectories using group-based trajectory modelling (GBTM). Multinomial logistic regression assessed the association with maternal factors.

RESULTS

A total of six distinct DPs were identified over time with different numbers of DPs at each time point. The "healthy" and "processed" DPs persisted over the 12-year post-pregnancy. Three trajectories of "healthy" and "processed" DPs were identified from GBTM. Half the women were on the moderately healthy DP trajectory with 37% on the lower trajectory and 9% on the higher healthy DP trajectory. 59% of women were on the lower processed DP trajectory with 38% on the moderate trajectory and 3.3% on the higher processed DP trajectory. Low educational attainment, low social class and smoking in pregnancy were independently associated with being on a less favourable DP trajectory over the 12 years.

CONCLUSION

Health professionals should provide support on smoking cessation along with healthy eating advice during ante-natal counselling. Continued support on eating healthily after pregnancy would be beneficial for mothers and families.

Characterizing nutrient patterns of food items in adolescent diet using data from a novel citizen science project and the US National Health and Nutrition Examination Survey (NHANES)

Introduction

A healthy diet is essential for promoting good health during adolescence and mitigating disease risks in adulthood. This underscores the need for improved nutrition education and increased access to healthier food choices. However, the accuracy of dietary data poses a significant challenge in nutritional research.

Methods

We utilized and analyzed a novel dietary record dataset collected through a high school citizen science project to address this issue. We focused on nutrients rather than food groups to characterize adolescent dietary patterns. The same analyses were performed on the 2019-2021 National Health and Nutrition Examination Survey data for comparison.

Results

Based on the U.S. Food and Drug Administration's recommended daily value (DV) for nutrients, the majority of food items in our citizen science dataset are low (i.e., <5% DV) in lipids, fiber, potassium, calcium, iron, sugar, and cholesterol. Only a minority of items are high (i.e., >20% DV) in macro and micronutrients. The clustering analysis identified nine food clusters with distinct nutrient profiles that vary significantly in size. The analyses on the NHANES data yielded similar findings, but with higher proportions of foods high in energy, lipids, carbohydrates, sugar, iron, and sodium compared with those of the citizen science dataset.

Discussion

This study demonstrates the potential of citizen science projects in gathering valuable dietary data and understanding adolescent nutrient intake. Identifying critical nutrient gaps can guide targeted nutrition education and the provision of accessible healthier food options, leading to positive health outcomes during adolescence and beyond.

A Comparison Study of Nutritional Assessment, Diet and Physical Activity Habits, Lifestyle and Socio-Demographic Characteristics in Individuals with and without Dizziness/Vertigo

Dizziness and vertigo are growing health problems and have become responsible for increases in health expenditures. In this context, a case-control study has been conducted by nutritional assessment, including dietary and physical activity habits, lifestyle, and socio-demographic characteristics in adults with (patient group) and without (control group) dizziness or vertigo, and the outcomes were compared between these groups. The patient (n = 150) and control (n = 150) groups included 300 participants. The 24-h Dietary Recall and the food frequency questionnaire (FFQ-21) were conducted in order to gain detailed information about foods and beverages consumed by the participants. Additionally, a questionnaire was completed, assessing general socio-demographic (age, gender, etc.) and lifestyle (smoking, alcohol consumption, and obesity) characteristics, anthropometric measurements, and dietary and physical activity habits. The results revealed that there is an association between dizziness/vertigo and female gender and increasing age. Smoking status and alcohol consumption did not differ between the groups, whereas differences in body mass index and obesity were significantly higher in the patient group (65%; n = 98) than the control group (46%; n = 69) (p = 0.001). Skipping meals "everyday" was significantly high (p = 0.044), and lunch was the most skipped meal in the patient group. The three most preferred cooking methods were oven baking, boiling, and frying for both groups. Daily water intake in the patient group was lower than in the control group (p = 0.026). Dietary intake for carotene and vitamin K were significantly lower in the patient group than the control group, but the opposite was true for vitamin D intake (p < 0.05). Daily consumption of bread and dairy products were highest in the patient group (p < 0.05). The physical activity rate was 35% (n = 53) in the control group and 28% (n = 42) in the patient group. Regular walking was the most preferred activity in both groups (p = 0.037). Active monitoring of individual diet and hydration along with supporting professional counseling are advisable. In addition, a healthy lifestyle including weight control and regular physical activity can be helpful to reduce symptoms of dizziness/vertigo.

High Dietary Phosphorus Is Associated with Increased Breast Cancer Risk in a U.S. Cohort of Middle-Aged Women

Research has shown that high amounts of dietary phosphorus that are twice the amount of the U.S. dietary reference intake of 700 mg for adults are associated with all-cause mortality, phosphate toxicity, and tumorigenesis. The present nested case-control study measured the relative risk of self-reported breast cancer associated with dietary phosphate intake over 10 annual visits in a cohort of middle-aged U.S. women from the Study of Women's Health Across the Nation. Analyzing data from food frequency questionnaires, the highest level of daily dietary phosphorus intake, >1800 mg of phosphorus, was approximately equivalent to the dietary phosphorus levels in menus promoted by the United States Department of Agriculture. After adjusting for participants' energy intake, this level of dietary phosphorus was associated with a 2.3-fold increased risk of breast cancer incidence compared to the reference dietary phosphorus level of 800 to 1000 mg, which is based on recommendations from the U.S. National Kidney Foundation, (RR: 2.30, 95% CI: 0.94-5.61, p = 0.07). Despite the lack of statistical significance, likely due to the small sample size of the cohort, the present nested case-control study's clinically significant effect size, dose-response, temporality, specificity, biological plausibility, consistency, coherence, and analogy with other research findings meet the criteria for inferred causality in observational studies, warranting further investigations. Furthermore, these findings suggest that a low-phosphate diet should be tested on patients with breast cancer.

Identifying Novel Data-Driven Dietary Patterns via Dimensionality Reduction and Associations with Socioeconomic Profile and Health Outcomes in Ireland

Dietary patterns and body mass index (BMI) play a significant role in the development of noncommunicable diseases (NCDs), which are the leading cause of mortality worldwide, including Ireland. A cross-sectional survey was conducted across Ireland to collate respondents' socioeconomic profiles, health status, and dietary patterns with a representative sample size of 957 adult respondents. Principal component analysis (PCA) and statistical analyses were subsequently employed. To the author's knowledge, this is the first study to use recent (2021) nationally representative data to characterise dietary patterns in Ireland via dimensionality reduction. Five distinct dietary patterns ("meat-focused", "dairy/ovo-focused", "vegetable-focused", "seafood-focused", and "potato-focused") were identified and statistically characterised. The "potato-focused" group exhibited the highest mean BMI (26.88 kg/m²), while the "vegetable-focused" group had the lowest (24.68 kg/m²). "Vegetable-focused" respondents were more likely to be associated with a categorically healthy BMI (OR = 1.90) and urban residency (OR = 2.03). Conversely, "meat-focused" respondents were more likely to have obesity (OR = 1.46) and rural residency (OR = 1.72) along with the "potato-focused" group (OR = 2.15). Results show that data-derived dietary patterns may better predict health outcomes than self-reported dietary patterns, and transitioning to diets focusing on vegetables, seafood, and lower meat consumption may improve health.

Metabolic Syndrome Screening and Nutritional Status of Patients with Psoriasis: A Scoping Review

Background: Patients with plaque psoriasis have an increased risk of metabolic syndrome. However, no studies have assessed the nutritional status or screening methods of this population. Aims: This review aimed to identify and summarise metabolic syndrome screening criteria and the tools/methods used in nutrition assessment in patients with plaque psoriasis. Data synthesis: PubMed, Web of Science, Ovid and Scopus were searched from inception to March 2023, following the Arkensey and O'Malley framework, to identify articles that report nutritional assessment methods/tools and metabolic screening criteria. Twenty-one studies were identified. Overall, these studies used four different screening criteria to define metabolic syndrome. Patients with psoriasis had a high prevalence of metabolic syndrome and had a poor nutritional status compared to controls. However, only anthropometric measures such as weight, height and waist circumference were employed to determine the nutritional status. Only two studies assessed the vitamin D status. Conclusions: Patients with psoriasis have a poor nutritional status, and they are at risk of nutrient deficiencies. However, these health aspects are not routinely assessed and may increase the risk of malnutrition among these patients. Therefore, additional assessments, such as body composition and dietary assessment, are needed to determine the nutritional status to provide a suitable intervention.

Be aware of the sodium intake outside student canteens: development and validation of a sodium food frequency questionnaire in Chinese undergraduates

Background

Chinese college students used to eat in student canteens, making dietary consumption outside the cafeterias the main reason for the difference in sodium intake. This study aims to develop and validate a food frequency questionnaire (Sodium-FFQ) targeting dietary sodium intake outside the canteens among undergraduates in China.

Methods

This cross-sectional study included 124 and 81 college students from comprehensive universities in the development and validation stage. A 24 h dietary recall and a food frequency questionnaire were used to develop the Sodium-FFQ. Food items were selected according to the foods that contributed more to the total sodium intake. Test-retest correlation coefficients with an interval of 14 days were employed to evaluate reproducibility. Validity was assessed against a single 24 h urine collection and a 3-day dietary record using correlation coefficients, Bland-Altman analyses, and cross-classification analysis of Kappa coefficients.

Results

The Sodium-FFQ consists of 12 groups of foods with 48 items. The Spearman correlation coefficient of test-retest on sodium intake was 0.654 (p < 0.05), and that between the Sodium-FFQ, 3 × 24 h dietary record, and 24-h urinary sodium were 0.393 (p < 0.05) and 0.342 (p < 0.05), respectively. The Sodium-FFQ was correlated to 24 h urinary sodium-to-potassium ratio, with a Spearman coefficient of 0.370 (p < 0.05). The classification agreement of the Sodium-FFQ and 24 h urinary sodium was 68.4%, and the Kappa coefficient was 0.371 (p < 0.001).

Conclusion

The Sodium-FFQ developed in this study presented an acceptable reproducibility, validity, and classification agreement. It indicates that the Sodium-FFQ could be a potential tool for promoting sodium restriction in college students.

Development and validity of a short web-based semi-quantitative Food Frequency Questionnaire applicable in both clinical and research setting: an evolution over time

Background

Assessing dietary intake is valuable both in clinical practice and in research. In research and in clinical practice, long-term habitual dietary intake is most often of interest. Therefore, a web-based semi-quantitative Food Frequency Questionnaire (FFQ) was developed to measure habitual intake of nutrients and foods.

Aim

This study aimed to assess content validity, convergent validity, and reliability of a 32-item semi-quantitative FFQ for adults.

Methods

A total of three different cohorts of Flemish adults were recruited in the past 10 years. The first cross-sectional validation study took place in 2013, consequently in 2019 and 2021. Content validity was assessed in 2019 through a semi-structured cognitive interview. Convergent validity was assessed by examining mean differences, Wilcoxon signed-rank test, Spearman's correlation coefficients (SCC), and Bland-Altman analysis for energy, nutrient, and food group intake compared with a 3-day food record (FR). Additionally, consumers-only analysis was performed together with cross-classification analysis by assessing the ranking capabilities of the FFQ into quartiles and weighted kappa. Reliability was assessed through the evaluation of SCC and intra-class correlation (ICC) of test-retest assessment of the FFQ.

Results

Spearman's correlation coefficient (SCC) for energy and absolute nutrient intake between the FFQ and the FR ranged from 0.02 to 0.54. Compared with absolute macronutrients, higher SCC was found for the majority of the relative macronutrient intake and most food groups. Bland-Altman plots showed improved agreement and decreasing bias between the FFQ and the FR over time. Misclassification of the FFQ for nutrients was acceptable and decreased over time (7.4, 7.5, and 6.8% in 2013, 2019, and 2021, respectively), but weighted kappa remained mostly fair (κ ≤ 0.20). The reliability of the FFQ was good and improved over time (mean SCC of 0.65 and 0.66 p <0.001 in 2013 and 2019).

Conclusion

The short web-based FFQ is an easy, low-cost, and feasible tool with good reliability, low misclassification, and acceptable validity to compare nutrient densities and food group intake at the population level. The measurement of absolute intake remains debatable.

A step towards harmonising human biomonitoring study setup on European level: Materials provided and lessons learnt in HBM4EU

Internal exposure of the human body to potentially harmful chemical substances can be assessed by Human Biomonitoring (HBM). HBM can be used to generate conclusive data that may provide an overview of exposure levels in entire or specific population groups. This knowledge can promote the understanding of potential risks of the substances of interest or help monitoring the success of regulatory measures taken on the political level. Study planning and design are key elements of any epidemiologic study to generate reliable data. In the field of HBM, this has been done using differing approaches on various levels of population coverage so far. Comparison and combined usage of the resulting data would contribute to understanding exposure and its factors on a larger scale, however, the differences between studies make this a challenging and somewhat limited endeavour. This article presents templates for documents that are required to set up an HBM study, thus facilitating the generation of harmonised HBM data as a step towards standardisation of HBM in Europe. They are designed to be modular and adaptable to the specific needs of a single study while emphasising minimum requirements to ensure comparability. It further elaborates on the challenges encountered during the process of creating these documents during the runtime of the European Joint Programme HBM4EU in a multi-national expert team and draws up lessons learnt in the context of knowledge management.

Food frequency questionnaire for dietary assessment among adults at a risk of coronary heart disease: A mixed-methods study

AIMS AND OBJECTIVES

To develop and psychometrically test a food frequency questionnaire for adults at risk of coronary heart disease (Cardio-FFQ).

BACKGROUND

Comprehensive dietary assessment is critical for the prevention of cardiovascular disease, but appropriate instruments to perform this work are lacking.

DESIGN

A sequential mixed-methods study followed the COREQ and STROBE guidelines.

METHODS

This study was conducted between April 2016 and November 2017. It started with dietary history interviews (Phase 1) to identify candidate food items of the Cardio-FFQ, which validity and reliability were assessed (Phase 2) through expert consultation and four seasonal measurements, including test and retest with a 2-week gap every season. Physical activity and blood glucose and lipids were assessed seasonally, while another FFQ was administered during the fourth measurement. Content analysis was used to analyse verbatim interview transcripts, while descriptive and inferential analyses were used to simplify the Cardio-FFQ and examine its psychometric properties.

RESULTS

Phase I involved 34 participants during their first onset of acute coronary syndrome and generated 176 candidate food items (consumed by at least three participants) under 12 food categories. These food items were simplified to form the 133-item Cardio-FFQ after discarding items with trivial contributions to food commonalities or between-person variance. Further analysis showed that the simplified questionnaire had satisfactory content validity, concurrent validity, convergent validity, predictive validity, known-group validity and test-retest reliability.

CONCLUSION

The 133-item Cardio-FFQ is a valid and reliable tool for a comprehensive dietary assessment appropriate for adults at risk of coronary heart disease.

RELEVANCE TO CLINICAL PRACTICE

Nurses may use the Cardio-FFQ to conduct a dietary assessment to better support people to commit to healthy diets, aiming to reduce the risk of coronary heart disease.

Is It Feasible to Predict Cardiovascular Risk among Healthy Vegans, Lacto-/Ovo-Vegetarians, Pescatarians, and Omnivores under Forty?

Guidelines for cardiovascular (CV) risk assessment among young adults are uncertain. Researchers are still looking for new tools for earlier diagnosis of cardiovascular diseases (CVD), the leading cause of mortality in the modern world. This study aimed to assess whether CV risk estimation is possible in groups of healthy individuals under the age of 40 on different dietary patterns (vegans-VEGAN (n = 48), lacto-/ovo-vegetarians-VEGE (n = 49), pescatarians-PESCA (n = 23), and omnivores-OMN (n = 35)) during the pandemic period. Four metrics containing selected risk classifiers were created, and participants were assessed using them. Groups including meat consumption showed increased CV risk predictions in the metrics assessment. The next analyzes showed statistically significant relationships between the results from the created metrics and selected non-basic biomarkers for ApoA1 (OMN group, p = 0.028), IL-6 (PESCA group, p = 0.048), HCY (VEGAN group, p = 0.05), and hsCRP (OMN + PESCA groups, p = 0.025). We found that predicting CV risk among healthy people under 40 adhering to different dietary patterns, taking into account basic and non-basic laboratory assessments and created metrics, is challenging but feasible. Furthermore, the OMN group appeared to be at the highest risk of increased CV risk in the future, while risk tended to be the lowest in the VEGAN group.

Vitamin and Carotenoid Intake and Outcomes of In Vitro Fertilization in Women Referring to an Italian Fertility Service: A Cross-Sectional Analysis of a Prospective Cohort Study

BACKGROUND

Nutrition may impact reproductive health and fertility potential. The role of dietary antioxidants in affecting conception and birth outcomes is a topic of emerging interest.

METHODS

This cross-sectional analysis from a prospective cohort study aims to explore the relationship between the intake of antioxidants, vitamins, and carotenoids and the outcomes of assisted reproduction techniques. Information on the socio-demographic characteristics, health histories, lifestyle habits, and diet information of subfertile couples referred to a fertility center was obtained.

RESULTS

A total of 494 women were enrolled. According to the four IVF outcomes considered, 95% of women achieved good quality oocytes, 87% achieved embryo transfer, 32.0% achieved clinical pregnancies, and 24.5% achieved pregnancy at term. Associations were found between age and the number of good quality oocytes (p = 0.02). A moderate level of physical activity in the prior 5 years was associated with a better rate of achieving clinical pregnancy (p = 0.03). Smoking habits, alcohol intake, and caffeine consumption did not show associations with any outcome. No associations were found, even after accounting for potential confounders, with the intake of vitamins C, D, E, and α-carotene, β-carotene, beta-cryptoxanthin, lutein, and folate.

CONCLUSION

Further research is needed to understand how antioxidant intake may have a role in modulating fertility.

Food frequency questionnaires developed and validated for pregnant women: Systematic review

OBJECTIVES

Assessing food intake by pregnant women is extremely important, because maternal dietary patterns can influence fetal development as well as have either a positive or negative effects on both the mother and fetus. Thus, the aim of the present study was to carry out a systematic review of the literature on food frequency questionnaires developed and validated for pregnant women, in order to assess their methodological quality and validation process.

METHODS

A systematic review of studies focused on validating food frequency questionnaires for pregnant women was carried out in the PubMed, Embase, Scopus, LILACS, and OpenGrey databases. The selected studies were assessed based on their correlation coefficient in validation and reproducibility analyses, whereas their methodological quality was assessed based on the scoring system proposed by the EURopean micronutrient RECommendations Aligned Network of Excellence.

RESULTS

In total, 10 965 articles were identified in these databases; among them, 14 studies, with sample sizes ranging from 46 to 221 participants, and with participants (pregnant women) at a mean age of 28.68 ± 4.34 y, were selected. Most of the included studies used the 24-h food recall as the method for developing the food list (n = 6), with composition ranging from 46 to 255 items. With respect to the methodological assessment of the selected articles, half of the assessed tools were classified as having excellent methodological quality; their validation and reproducibility correlation coefficients were classified as moderate and high (r ≥ 0.40).

CONCLUSIONS

Food frequency questionnaires developed for pregnant women appear to be reliable tools to assess food intake by this group. Overall, they had good methodological quality and adequate correlation coefficients compared with reference methods.

Diet-related inflammation increases the odds of multiple sclerosis: Results from a large population-based prevalent case-control study in Jordan

Background

Multiple sclerosis, a chronic inflammatory disease in young and middle-aged adults, is one of the leading causes of non-traumatic disability in adults. Diet is known to have an important role in the modulating inflammatory processes and influencing molecular pathways.

Purpose

This study aims to examine the association of the inflammatory capacity of diet measured by DII with MS in Jordan.

Methods

This prevalent case-control study included participants of both sexes, aged between 20 and 60 years. The cases (n = 541) had a confirmed diagnosis of prevalent Multiple Sclerosis (MS) in the previous 3 years, and controls (n = 607) were apparently healthy individuals matched on sex and age (42 ± 4 years). A validated Arabic food frequency questionnaire (FFQ) was utilized to obtain estimated dietary intake. Dietary data from the FFQ were analyzed using ESHA's Food Processor^® nutrition analysis software, and the results were used to calculate the DII scores. Logistic regression analyses, controlling for covariates such as age, sex, body mass index, and smoking status, were used to measure the association between DII score and MS outcomes.

Results

Cases represent a mixed sample of MS phenotypes and controls were comparable on age and sex. However, controls tended to be taller, lighter, had a lower BMI, and had a lower smoking rate. After controlling for age, BMI, sex, and smoking status, there was a consistent increase in MS risk according to DII score, with a 10-fold increase in odds in quartile 4 vs. quartile 1 [OR_{quartile 4vs1} = 10.17 (95% CI: 6.88; 15.04)]. For each point increase in DII score, there was nearly a doubling of odds [OR₁ = 1.75 (95% CI: 1.59; 1.92)]. Individual nutrients and food values aligned according to their contribution to the DII score calculations.

Conclusion

The findings of this study, obtained in MS patients with varied illness duration over the previous 3 years, are consistent with an association between the overall inflammatory potential of diet and MS odds. Our findings among MS participants showed a significantly more pro-inflammatory DII scores than age- and sex-matched controls. Our results also suggest that MS group had a diet rich in pro-inflammatory foods and nutrients.

Development and validation of a computerized web-based quantitative food frequency questionnaire

BACKGROUND & AIMS

Epidemiological research is progressing towards digital data collection. This study aimed to evaluate the validity and reproducibility of our new computerized, and easy-to-use Food Frequency Questionnaire (FFQ).

METHODS

Participants' dietary intake was assessed using 24-h Dietary Recalls (DRs) and our FFQ, consisting of 133 food items and beverages. The software allows users to choose between three visualized portion sizes, categorizes the selections into food groups with three degrees of food processing levels, and produces a visualized output of the results. The reproducibility of the FFQ was evaluated based on two user submissions, and its validity was measured by comparing its calculated caloric intake and macro and micro-nutrient consumption to the equivalent mean values from three 24-h DRs. Thirty-nine women of fertility age [18-45] were recruited to the study, of whom twenty-six qualified for reproducibility testing and thirty-one qualified for validity testing.

RESULTS

For most nutrient intakes, the FFQs yielded higher scores than the 24-h DRs, resulting in a less satisfactory agreement between them due to FFQs overestimation. The Intra Class Correlation (ICC) coefficient between the two FFQs ranged from moderate for calcium (0.55) to high for magnesium (0.83) (p < 0.05), indicating good reproducibility. Evaluation of food groups and processed food reproducibility scores yielded ICC coefficients ranging from moderate (0.53; super-processed foods) to high (0.83; non-processed foods) (p < 0.05). Spearman's correlation coefficient showed a moderate (sugar-sweetened beverages) to strong (non-processed foods) correlation (p < 0.05).

CONCLUSIONS

The FFQ we developed and validated in this study showed moderate to high reproducibility and acceptable validity in a group of thirty-nine women of fertility age. Moreover, it is highly adjustable and easy to use, and its digital-based delivery enables large-scale, multilingual nutritional research.

Reproducibility of the German and Slovakian Versions of the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN)

PURPOSE

The aim of this study was to assess the reproducibility and reliability of the KomPAN questionnaire among two groups of university students from Germany and Slovakia.

METHODS

A total of 422 individuals (mean age 21.4 years, SD 4.0), including 197 from Slovakia (men 26.2%) and 225 from Germany (men 22.3%), were tested using the self-administered (SA-Q) version of the KomPAN questionnaire and then retested two weeks later. A cross-classification analysis, kappa coefficients, Cronbach's ɑ coefficients, and a test-retest result comparison were conducted separately for each group of students to assess the reproducibility and reliability of the questionnaire.

RESULTS

The cross-classification values were higher than 46.2% among the German students and higher than 55.8% among the Slovakian students. The kappa coefficients ranged from 0.21 to 0.90 in the German students and from 0.38 to 0.94 in the Slovakian students. Cronbach's ɑ ranged from 0.58 to 0.78.

CONCLUSION

The questionnaire displayed a moderate to very good reproducibility, which was slightly higher in the Slovakian group than in the German group. Therefore, the questionnaire can be recommended for further analysis and comparison of the dietary habits among Germans and Slovakians on a larger scale.

Nutritional Status and Habits among People on Vegan, Lacto/Ovo-Vegetarian, Pescatarian and Traditional Diets

Background: This study assessed the possible dependencies between nutritional habits and body composition among subjects with different dietary habits. Materials: A total of 196 healthy (aged 18−50 yrs) participants were enrolled in the study and divided into 4 groups according to their diet: vegans-VEGAN (n = 53), lacto/ovo-vegetarians—VEGE (n = 52), pescatarians-PESCA (n = 28), and omnivores-OMN (n = 43). Methods: The Food Frequency Questionnaire (FFQ) was used, and body composition was assessed on the In-Body120 analyzer. Results: Our result revealed in OMN + PESCA groups a higher average consumption frequency of sweets (p = 0.024), cheese/plant cheese (p < 0.001), eggs and egg dishes/egg substitutes (p < 0.001), butter, margarine/plant margarine (p < 0.001), cream /plant cream (p = 0.018), wine and cocktails (p = 0.028), vodka (p = 0.039) and lower of natural cottage cheese/tofu/tempeh (p < 0.001), vegetable oils (p = 0.036), legumes (p < 0.001) and nuts and seeds(p < 0.001) compared to the VEGAN + VEGE groups. The body composition analysis showed significant differences in skeletal muscle mass (SMM) (p = 0.019) and the content of minerals (p = 0.048) between groups. VEGAN disclosed the lowest average values of body fat mass (BFM), percentage body fat (PBF), and visceral adipose tissue (VAT) than other studied groups. Conclusions: The body composition analysis showed mean values within normal ranges in all of the groups, but some average results of OMN, PESCA, and VEGE compared to VEGAN were not highly satisfactory (in addition to eating behavior outcomes).

Using a Short Food Frequency Questionnaire to Evaluate Macronutrients, Fiber, Phosphorus, Potassium, and Calcium in Adults with Stages 3-5 Chronic Kidney Disease

The progression of chronic kidney disease (CKD) can be directly or indirectly accelerated by a poor diet and the diet's influence on risk factors for this disease. There have been no food frequency questionnaires (FFQs) developed for the assessment of diet in patients with CKD in Taiwan. This study analyzed the validity of a short FFQ (SFFQ) with 42 items for estimating patient intake of macronutrients, fiber, phosphorus, potassium, and calcium against 3-day dietary records (3-day DRs) in Taiwanese patients with stages 3-5 CKD. In an interview, 107 participants with the help of a dietician filled out an SFFQ and reviewed a 3-day DR the patients had filled out prior to the interview. Partial Pearson correlation coefficients between SFFQ and 3-day DR were 0.722, 0.619, 0.593, 0.572, 0.450, 0.611 and 0.410 for protein, fat, carbohydrate, fiber, phosphorus, potassium, and calcium, respectively, after adjusting for energy intake. Cross-classification analysis revealed 63.5-83.2% similarity in cross-tool estimated intakes of macronutrients, fiber, phosphorus, potassium, and calcium in the same quartiles or adjacent ones. Bland-Altman plots revealed good agreement between the two tools along different intake levels. In conclusion, the newly developed SFFQ had moderate relative validity in estimating the usual intake of key nutrients related to nutrition management of patients with late-stage CKD, suggesting it can be used to assess dietary intakes in a population with CKD, especially in those residing in an Asian region.

The Assessment of a Personalized Nutrition Tool (eNutri) in Germany: Pilot Study on Usability Metrics and Users’ Experiences

Background

To address the epidemic burden of diet-related diseases, adequate dietary intake assessments are needed to determine the actual nutrition intake of a population. In this context, the eNutri web app has been developed, providing online automated personalized dietary advice, based on nutritional information recorded via an integrated and validated food frequency questionnaire (FFQ). Originally developed for a British population and their dietary habits, the eNutri tool has specifically been adapted to the German population, taking into account national eating habits and dietary recommendations.

Objective

The primary aim of this study is to evaluate the system usability and users’ experience and feedback on the eNutri app in a small-scale preliminary study. The secondary aim is to investigate the efficacy of personalized nutrition (PN) recommendations versus general dietary advice in altering eating habits.

Methods

The app was piloted for 4 weeks by 106 participants from across Germany divided into a PN group and a control group. The groups differed according to the degree of personalization of dietary recommendations obtained.

Results

An overall System Usability Scale (SUS) score of 78.4 (SD 12.2) was yielded, indicating an above average user experience. Mean completion time of the FFQ was 26.7 minutes (SD 10.6 minutes). Across subgroups (age, sex, device screen sizes) no differences in SUS or completion time were found, indicating an equal performance for all users independent of the assigned experimental group. Participants’ feedback highlighted the need for more personalized dietary advice for controls, while personalized nutritional recommendations improved the awareness of healthy eating behavior. Further improvements to the eNutri app were suggested by the app users.

Conclusions

In total, the eNutri app has proven to be a suitable instrument to capture the dietary habits of a German population sample. Regarding functionality, system usability, and handling, direct user feedback was quite positive. Nutritional advice given was rated ambivalent, pointing to several weaknesses in the eNutri app, minimizing the system’s full potential. A higher level of personalization within nutritional advice subjectively improved the app’s usability. The insights gained will be used as a basis to further develop and improve this digital diet assessment tool.

Validity and reproducibility of a FFQ for assessing dietary intake among residents of northeast China: northeast cohort study of China

The study was to evaluate the reproducibility and validity of the FFQ for residents of northeast China. A total of 131 participants completed two FFQ (FFQ1 and FFQ2) within a 3-month period, 125 participants completed 8-d weighed diet records (WDR) and 112 participants completed blood biomarker testing. Reproducibility was measured by comparing nutrient and food intake between FFQ1 and FFQ2. The validity of the FFQ was assessed by WDR and the triad method. The Spearman correlation coefficients (SCC) and intraclass correlation coefficients (ICC) for reproducibility ranged from 0·41 to 0·69 (median = 0·53) and from 0·18 to 0·68 (median = 0·53) for energy and nutrients and from 0·37 to 0·73 (median = 0·59) and from 0·33 to 0·86 (median = 0·60) for food groups, respectively. The classifications of same or adjacent quartiles ranged from 73·64 to 93·80 % for both FFQ. The crude SCC between the FFQ and WDR ranged from 0·27 to 0·55 (median = 0·46) for the energy and nutrients and from 0·26 to 0·70 (median = 0·52) for food groups, and classifications of the same or adjacent quartiles ranged from 65·32 to 86·29 %. The triad method indicated that validation coefficients for the FFQ were above 0·3 for most nutrients, which indicated a moderate or high level of validity. The FFQ that was developed for residents of northeast China for the Northeast Cohort Study of China is reliable and valid for assessing the intake of most foods and nutrients.

Validity and reliability of a food frequency questionnaire for community dwelling older adults in a Mediterranean country: Lebanon

Background

Food frequency questionnaires (FFQ) is an easy and inexpensive tool that can be used to evaluate nutrient and dietary trends of groups and individuals. Few studies in the East Mediterranean region tailored FFQs to describe dietary intakes of older adults. The purpose of the study is therefore to assess the validity and reproducibility of a FFQ, designed for use with older adults living in a Mediterranean Arabic speaking country, Lebanon.

Methods

The FFQ is composed of a list of 90 food items, commonly consumed by adults above 60 years of age. Validity of the FFQ was tested using the mean of two 24-hours dietary recalls (24HDR), and reproducibility, by repeating the questionnaire within a one-month period, along the second dietary recall. Our study included 42 and 76 participants, for the repoducibility and validity analysis respectively. Subjects were randomly selected from 2 of the 8 governorates in the country.

Results

FFQ reproducibility showed a mean relative difference of 1.03% without any significant difference between all paired components of nutrients. Intra class correlation (ICC) showed good and excellent reliability for caloric intake and all macronutrients, moderate to good reliability for all remaining nutrients, except for poly-unsaturated fatty acids, vitamins A, B12 and fibers. Correlation coefficients for all nutrients were fair to strong. Both administrations of the FFQ showed good internal validity. Validation of FFQ showed a mean relative difference between FFQ and mean 24HDR at 19.5%. Agreements between the 2 methods, for classifying individuals in the same or adjacent quartile, for nutrient intake and nutrient adequacy, were 80 and 78.2% respectively. Mean Kappa coefficient was 0.56 and energy-adjusted correlations were within the recommended values for all items except for vitamin A and B12. Adjusting for nutrient-dense food intake improved the agreement for theses 2 vitamins to 0.49 and 0.56, respectively.

Conclusion

The proposed FFQ can be considered a valid tool to help describe nutrient intake of older individuals in an Arabic speaking Mediterranean country. It could serve for possible use in the East Mediterranean region for the evaluation of regular dietary intake of community-dwelling older adults.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12937-022-00788-8.

The Impact of Blockchain Technology Adoption on Tourism Industry: A Systematic Literature Review

The current COVID-19 pandemic has led to the acceleration of the digitization process and to a shifting to Industry 4.0. Blockchain (BC) is one of the technologies that has been introduced worldwide in recent years. It has been beneficial for the tourism industry, in addition to many other sectors. This article investigates the advantages and disadvantages of BC adoption in the tourism industry, as well as the possible solutions to overcome the challenges. This paper conducts a systematic literature review (SLR) that consists of the operations for detecting, selecting, categorizing, and analyzing relevant articles on a specified subject. It is evident from the results that the majority of the academic works illustrate the benefits of BC implementation and explain its potential by providing diverse models of BC-based systems. However, since BC is a young technology, numerous challenges have appeared on the path to its full adoption in the tourism industry. Possible solutions are the achievement of a collaborative approach among the stakeholders, the deepening of academic research in the field, testing more models of BC-based systems, and the establishment of relevant policies. Consequently, the implications for the theory, practice, policy, and research of this work are significant.

Validation of a food-frequency questionnaire to assess methyl-group donor intake in preschoolers

A good assessment of dietary methyl-group donor intake (folate, choline, betaine, methionine) is needed to investigate the effect of methyl-group donor intake on children's health. The aim is to develop and validate a food-frequency questionnaire (FFQ) to estimate the daily intake of methyl-group donors in preschoolers. For the relative validity and reproducibility of the FFQ, a 7-day estimated dietary record (7d EDR) and repeated measurements 6 weeks apart (n = 77) were used respectively. For the validity (n = 75), a moderate ranking ability was obtained (de-attenuated Pearson correlation = 0.43-0.70; weighted ƙ 0.10-0.40), but the FFQ tends to overestimate the real intake. Cross-classification analysis showed that 38% (choline) and 28% (betaine) of the subjects were misclassified. The FFQ shows a moderate to good reproducibility, intra-class correlation coefficients range between 0.67 (betaine) and 0.76 (choline) with a maximal misclassification of 6.5% for betaine (weighted ƙ 0.37-0.69) (n = 77).

CONCLUSION

The FFQ is a tool with a moderate validity and reproducibility to estimate the consumption of dietary methyl-group donors in preschoolers. This tool might be used in future research epidemiological studies including preschoolers.

WHAT IS KNOWN

• Poor dietary habits during childhood have been associated with chronic disease in adulthood. • Methyl-group donors are important for DNA methylation, which is the underlying mechanism of disease development.

WHAT IS NEW

• For the first time, a food-frequency questionnaire that can assess the intake of methione, folate, choline, and betaine has been developed and validated for the use in preschoolers.

Relation of the Dietary Approaches to Stop Hypertension Dietary Pattern to Heart Failure Risk and Socioeconomic Status (from the Southern Community Cohort Study)

The Dietary Approaches to Stop Hypertension (DASH) dietary pattern has been associated with a lower risk of incident heart failure (HF); however, previous studies were conducted in mostly middle-income White populations. The association between DASH and incident HF risk in lower income and Black individuals is less well understood. We analyzed 25,300 White and Black adults without a history of HF at enrollment (2002 to 2009) in the Southern Community Cohort Study receiving Centers for Medicare and Medicaid Services. Alignment with DASH was assessed at enrollment using a validated food frequency questionnaire. Incident HF was ascertained from Centers for Medicare and Medicaid Services claims through 2016. The association between DASH diet alignment and incident HF was examined in multivariable-adjusted Cox proportional hazards regression models, including an interaction term testing effect modification by income. The cohort was predominantly middle-aged (median 54 years), Black (68%), female (63%), and low-income (88% <$25,000/year/household). Socioeconomic factors, including education and annual income, were larger contributors to the variance in DASH score than were cardiovascular co-morbidities. The association between DASH dietary alignment and HF risk was not significant overall (hazard ratio [HR] 1.00; 95% confidence interval [CI] 0.96 to 1.04) or in race-sex groups. However, the association between alignment with the DASH diet and HF risk significantly varied by income (interaction p = 0.030), with neutral and inverse associations in lower (<$25,000/year) and higher ($≥25,000) income participants, respectively. In conclusion, income modified the association between healthier dietary patterns and risk of incident HF. In lower income participants, greater alignment with the DASH diet was not associated with lower HF risk.

Diet-Related Inflammation is Associated with Malnutrition-Inflammation Markers in Maintenance Hemodialysis Patients: Results of a Cross-Sectional Study in China Using Dietary Inflammatory Index

Purpose

This cross-sectional study aimed to explore the association between the inflammation potential of the diet and malnutrition-inflammation status in Chinese maintenance hemodialysis (MHD) patients.

Methods

Dietary Inflammatory Index (DII) was computed based on a semi-quantitative food frequency questionnaire. Malnutrition-inflammation status was assessed by six indexes, including C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), hemoglobin (HB), albumin (ALB) and malnutrition-inflammation score (MIS). Multivariable linear regression and logistic regression were employed adjusting for covariables including age, gender, body mass index and dialysis vintage.

Results

A total of 161 Chinese MHD patients with an average age of 60.0 ± 13.6 years were enrolled. The median (IQR) DII score among participants was 0.60 (−0.80, 2.32), revealing a generally pro-inflammatory diet. DII was positively associated with MIS score (β= 0.61, 95% CI: 0.51, 0.69, p < 0.0001) and CRP (β = 0.54, 95% CI: 0.46, 0.63, p < 0.0001). A negative relationship between DII and NLR (β = −0.37, 95% CI: −0.61, −0.13, p = 0.008) was found in the most anti-inflammatory diet. Multivariable logistic regression showed that each unit increase in DII was linked with 3.06 (95% CI: 1.39, 6.69, p = 0.005) times increased odds of MIS.

Conclusion

Diet with a higher DII score may act as a potential trigger contributing to the development of malnutrition-inflammation status. Further studies for verification and for developing strategies to decrease the dietary inflammation burden are warranted.

The Relative Validity and Reproducibility of Food Frequency Questionnaires in the China Kadoorie Biobank Study

BACKGROUND

Short versions of qualitative and quantitative food frequency questionnaires (FFQs) are widely used to assess usual food intake. However, fewer studies evaluated their relative validity and reproducibility in the Chinese population.

METHODS

This study compared 12-day 24-h dietary recalls with qualitative and quantitative FFQs designed by the China Kadoorie Biobank (CKB) study to assess the relative validity. Two FFQs were administered in the second and third seasons and compared to evaluate the reproducibility. Statistical tests included Spearman correlation coefficients, weighted kappa, and cross-classification.

RESULTS

A total of 432 participants were eligible after stratifying by age, sex, and four regions. In the validation of qualitative FFQ, adjusted Spearman coefficients were between 0.23 and 0.59, and weighted kappa coefficients ranged from 0.61 to 0.88, except for fresh vegetables. The percentage of correct classification was highest in fresh vegetables and lowest in fresh fruit, but the percentages of extreme classification were below 3.0%. Corresponding Spearman and kappa coefficients for the reproducibility were 0.17-0.56 and 0.62-0.90. Furthermore, the correct classification constituted between 35.6 and 93.3% of all participants. Regarding the relative validity of the quantitative FFQ, Spearman coefficients ranged from 0.14 to 0.69 in addition to dried vegetables and carbonated soft drinks. For items with more than two-thirds of total participants consumed, weighted kappa coefficients were from 0.57 to 0.79; correct classification percentages were between 34.6% and 67.5%. Spearman and kappa coefficients for the reproducibility of the quantitative FFQ were 0.15-0.71 and 0.60-0.86, respectively; correct classification percentages varied from 47.8% to 71.6%.

CONCLUSION

Most food items from the qualitative FFQ showed acceptable or even good relative validity and reproducibility in the CKB study. Likewise, major food items in the quantitative FFQ were valid and reproducible, but poor performances of dried vegetables and carbonated soft drinks indicated the need for modification and validation in future research.

Prepregnancy adherence to plant-based diet indices and exploratory dietary patterns in relation to fecundability

BACKGROUND

Modest associations have been reported between specific food groups or nutrients and fecundability [measured by time to pregnancy (TTP)]. Examining overall diets provides a more holistic approach towards understanding their associations with fecundability. It is not known whether plant-based diets indices or exploratory dietary patterns are associated with fecundability.

OBJECTIVES

We examine the associations between adherence to 1) plant-based diet indices; and 2) exploratory dietary patterns and fecundability among women planning pregnancy.

METHODS

Data were analyzed from the Singapore Preconception Study of Long-Term Maternal and Child Outcomes (S-PRESTO) study. Prepregnancy diet was assessed using a semi-quantitative FFQ from which the overall, healthful, and unhealthful plant-based diet indices (oPDI, hPDI, and uPDI, respectively) were calculated. Exploratory dietary patterns were derived using factor analysis based on 44 predefined food groups. Participants were categorized into quintiles based on their dietary pattern scores. TTP (expressed in menstrual cycles) was ascertained within a year from the prepregnancy dietary assessment. Discrete-time proportional hazard models, adjusted for confounders, were used to estimate fecundability ratios (FRs) and 95% CIs, with FR > 1 indicating a shorter TTP.

RESULTS

Among 805 women, 383 pregnancies were confirmed by ultrasound scans. Compared with women in the lowest quintile, those in the highest quintile of the uPDI had reduced fecundability (FR of Q5 compared with Q1, 0.65; 95% CI, 0.46-0.91; P trend, 0.009). Conversely, greater adherence to the hPDI was associated with increased fecundability (1.46; 95% CI, 1.02-2.07; P trend, 0.036). The oPDI was not associated with fecundability. Among the 3 exploratory dietary patterns, only greater adherence to the Fast Food and Sweetened Beverages (FFSB) pattern was associated with reduced fecundability (0.61; 95% CI, 0.40-0.91; P trend, 0.018).

CONCLUSIONS

Greater adherence to the uPDI or the FFSB dietary pattern was associated with reduced fecundability among Asian women. Greater adherence to the hPDI may be beneficial for fecundability, though this requires confirmation by future studies.

Relative Validity and Reproducibility of a Semi-Quantitative Food Frequency Questionnaire for Determining Nutrient Intake in Older Adults in New Zealand: The REACH Study

Dietary intake is an important predictor of health and disease outcomes. This cross-sectional study evaluated the relative validity and reproducibility of a semi-quantitative food frequency questionnaire (FFQ) for assessing energy and nutrient intake in older adults. Dietary data were collected 2018–2019 in Auckland, New Zealand from a convenience sample of community-dwelling adults (65–74 years, n = 294, 37% male) using a 109-item self-administered FFQ at baseline (FFQ1) and four weeks later to assess reproducibility. FFQ1 was compared to a four-day food record to determine relative validity. Agreement between dietary assessment tools was assessed for both raw and energy-adjusted nutrient intakes using paired t-tests, correlation coefficients, weighted kappa statistic, Bland–Altman plots, and linear regression analysis. Energy adjustments moderately improved the relative validity and reproducibility for most nutrients. For energy and energy-adjusted nutrient intakes, the mean correlation coefficients were 0.38 (validity) and 0.65 (reproducibility); the mean weighted kappa statistics were 0.27 (validity) and 0.51 (reproducibility). A significant slope of bias was present in 54% (validity) and 25% (reproducibility) of Bland–Altman plots. The Researching Eating, Activity, and Cognitive Health (REACH) FFQ has acceptable relative validity and good reproducibility for ranking nutrient intakes in older New Zealand adults, but is less suitable for assessing absolute nutrient intakes.

Dietary intake patterns, nutrient adequacy and associated factors in a multi-ethnic Caribbean population

Background: Diet is a significant contributor to health and wellbeing of individuals. Aim: In this study we investigated patterns of dietary intakes, levels of nutrient inadequacies and associated sociodemographic, anthropometric and lifestyle factors among adults in Trinidad and Tobago. Method: The study was cross-sectional in nature. A convenience sample of 11783 persons from districts throughout Trinidad and Tobago completed a self-administered questionnaire comprising socio-demographic and lifestyle items. Anthropometry was self-reported with 15% of participants having measurements done according to recommended procedures. Dietary patterns were determined by principal component analysis (PCA) while nutrient intakes and adequacy were assessed using the NutriGenie 7.0 software and nutrient adequacy ratio (MAR) respectively. Foods were categorised as unprocessed/minimally processed and processed/ultra-processed. The University of The West Indies Ethics Committee approved the study. Results: Approximately 72.5% of participants met the Goldberg criteria for plausible reporting. The three predominant dietary patterns 'Typical', 'Fruits and Vegetables', and 'High Fat' explained 45% of the total variance in foods consumed. Processed/ultra-processed foods accounted for most of the energy (80%) and nutrients consumed. Nutrient inadequacies were observed for potassium, vitamins B₁₂, D, E, K, fibre, magnesium; and iron among females. The mean adequacy ratio (MAR) for participants was 67%. MAR was positively associated with predominant dietary patterns independent of socioe demographic and lifestyle factors (p < 0.001). Conclusion: Irrespective of their nature, the predominant dietary pattern was associated with nutrient adequacy among participants. Reducing the risk of inadequate nutrient intakes may be addressed by increasing availability, access and consumption of appropriate sources of these micronutrients.

Development and validation of a food frequency questionnaire for children aged 7 to 10 years

ABSTRACT Objective Food and nutritional evaluation of children can support public policies to combat early overweight and obesity. This study developed and validated a quantitative food frequency questionnaire for assessing the dietary intake of children. Methods This is a cross-sectional study of the development of a food frequency questionnaire for 130 children of both genders aged 7 to 10 years old. For the food frequency questionnaire list, 81 food items were selected. The validity of the food frequency questionnaire was evaluated by comparison with 24-hour recalls and reproducibility was performed by comparing two food frequency questionnaires. Results Most of the foods with 95% relative contribution were ultra-processed, such as packaged snacks and powdered juice. In validation, correlation coefficients were found between 0.45 (p<0.000) for lipids and 0.37 (p<0.000) for carbohydrates. An adjustment for energy reduced the correlations, but there was an increase in the correlation in calcium (r=0.75) and retinol (r=0.20). In terms of reproducibility, all macronutrients and calcium showed a satisfactory intraclass correlation coefficient (>0.400) and moderate correlations [proteins (0.54; p<0.000) and lipids (0.41; p<0.000)]. Conclusion The food frequency questionnaire developed was valid and able to assess the local food consumption by children from northeastern Brazil.

Distinct Nutrient Intake Style in Inhabitants of Ultra-High-Altitude Areas in North of Tibet, China: A Cross-Sectional Study Based on Newly Developed Tibetan Food Frequency Questionnaires

Dietary pattern is quite distinct among the inhabitants of high-altitude areas because of environmental and geographical uniqueness; hence, it is important to investigate this data as accurately as possible. However, very few data are related to these populations up to now. Based on the food frequency questionnaire (FFQ) used in the Chinese population, a revised Tibetan edition was developed with respect to the lifestyle in high-altitude areas. After assessment of validity and reproducibility, a nutrition intake survey was conducted among 1,071 randomly sampled Tibetan people. In addition, the Bland-Altman approach was used to compare the agreement between the two dietary tools. For the reproducibility analysis, intraclass correlation coefficients (ICC) were calculated to examine the agreement of food groups and nutrients from the two FFQs (FFQ1 and FFQ2). Nutrient intake was calculated using food composition tables. For the validity analysis, Pearson's correlation of food groups intakes varied from 0.22 to 0.91 (unadjusted). The correlations of nutrients ranged from 0.24 to 0.76 (unadjusted). In the analysis of reliability, the ICC of food groups varied from 0.27 to 0.70 (unadjusted). The ICC of nutrient intakes ranged from 0.22 to 0.87 (unadjusted). The results of nutritional analysis showed that ~25% of foods consumed frequently were traditional Tibetan foods. However, traditional Han foods were frequently consumed. In addition, the energy, iron, and protein intakes for male or female subjects were close to the Chinese Dietary Nutrient Reference Intake (Chinese DRIs); however, fat and sodium intakes were significantly higher than the Chinese DRIs. Interestingly, lower intakes of other types of nutrition, such as vitamin C were detected in people living in high-altitude areas. Our data indicated that excess consumption of fat and sodium and insufficient intake of vitamin C were common among Tibetan people, as compared with the most Chinese people living in the plateau areas. More investigations are needed to reveal the association between the food intake style and high-altitude endemic diseases.

A Food Frequency Questionnaire for Hemodialysis Patients in Bangladesh (BDHD-FFQ): Development and Validation

Diet is a recognized risk factor and cornerstone for chronic kidney disease (CKD) management; however, a tool to assess dietary intake among Bangladeshi dialysis patients is scarce. This study aims to validate a prototype Bangladeshi Hemodialysis Food Frequency Questionnaire (BDHD-FFQ) against 3-day dietary recall (3DDR) and corresponding serum biomarkers. Nutrients of interest were energy, macronutrients, potassium, phosphate, iron, sodium and calcium. The BDHD-FFQ, comprising 132 food items, was developed from 606 24-h recalls and had undergone face and content validation. Comprehensive facets of relative validity were ascertained using six statistical tests (correlation coefficient, percent difference, paired t-test, cross-quartiles classification, weighted kappa, and Bland-Altman analysis). Overall, the BDHD-FFQ showed acceptable to good correlations (p < 0.05) with 3DDR for the concerned nutrients in unadjusted and energy-adjusted models, but this correlation was diminished when adjusted for other covariates (age, gender, and BMI). Phosphate and potassium intake, estimated by the BDHD-FFQ, also correlated well with the corresponding serum biomarkers (p < 0.01) when compared to 3DDR (p > 0.05). Cross-quartile classification indicated that <10% of patients were incorrectly classified. Weighted kappa statistics showed agreement with all but iron. Bland-Altman analysis showed positive mean differences were observed for all nutrients when compared to 3DDR, whilst energy, carbohydrates, fat, iron, sodium, and potassium had percentage data points within the limit of agreement (mean ± 1.96 SD), above 95%. In summary, the BDHD-FFQ demonstrated an acceptable relative validity for most of the nutrients as four out of the six statistical tests fulfilled the cut-off standard in assessing dietary intake of CKD patients in Bangladesh.

Reproducibility and Validity of a Food Frequency Questionnaire (FFQ) Developed for Middle-Aged and Older Adults in Semarang, Indonesia

We assessed the reproducibility and validity of a food frequency questionnaire (FFQ) among middle-aged and older adults in Semarang, Indonesia. A total of 259 subjects aged 40-80 years completed two FFQs (nine-month apart) and nine 24 h dietary recalls (24HDRs, as a reference method). The reproducibility of the FFQ was analyzed using correlation coefficient, intra-class correlation coefficient (ICC), weighted kappa statistics and misclassification analysis. The validity was estimated by comparing the data acquired from FFQ1 and 24HDRs. The crude Pearson's correlation coefficients and ICC for total energy and nutrients between FFQ1 and FFQ2 ranged from 0.50 to 0.81 and 0.44 to 0.78, respectively. Energy adjustment decreased the correlation coefficients for most nutrients. The crude, energy-adjusted and de-attenuated correlation coefficients for FFQ1 and 24HDRs ranged from 0.41 to 0.70, 0.31 to 0.89 and 0.54 to 0.82, respectively. The agreement rates for the same or adjacent quartile classifications were 81.1-94.6% for two FFQs and 80.7-89.6% for FFQ1 and 24HDRs. The weighted kappa values were 0.21 to 0.42 for two FFQs and 0.20 to 0.34 for FFQ1 and 24HDRs. A positive mean difference was found in the Bland-Altman analyses for energy and macronutrients. The FFQ could be acceptable for nutritional epidemiology study among Indonesians.

Antioxidant Vitamins and Carotenoids Intake and the Association With Poor Semen Quality: A Cross-Sectional Analysis of Men Referring to an Italian Fertility Clinic

Several studies suggested that male's diet affects fertility. This cross-sectional analysis from a prospective cohort study aims to explore the relation between antioxidants intake and sperm parameters in sub-fertile couples referring to a Fertility center. Socio-demographic characteristics, health history, lifestyle habits, and diet information were obtained. A semen sample was analyzed to proceed with assisted reproduction. Three hundred and twenty-three men were enrolled: 19.1% had semen volume (SV) < 1.5 mL, 31.4% sperm concentration (SC) < 15.0 mil/mL, 26.8% sperm motility < 32%, and 33.0% had total sperm count (TSC) < 39.0 mil. Higher levels of α-carotene were associated to lower risk of low SC [4th vs. 1st quartile, adjusted OR (aOR) 0.43, 95% CI 0.20–0.91) and low TSC (aOR 0.46, 95% CI 0.22–0.95). Higher intake of β-carotene was inversely associated with risk of low TSC. Lycopene intake was associated with higher risk for these conditions (aOR 2.46, 95%CI 1.01–5.98, SC), and (aOR 3.11, 95%CI 1.29–7.50, TSC). Risk of low semen volume was lower in men with higher level of vitamin D intake (aOR 0.25, 95%CI 0.09–0.66)]. Further research, especially, well-designed randomized clinical trials (RCT), is needed to understand how diet modifications may have a role in modulating male fertility and fecundability.

Validity of the food frequency questionnaire for adults in nutritional epidemiological studies: A systematic review and meta-analysis

As the most widely used tool for assessing dietary intake, the validity of food frequency questionnaires (FFQs) should be evaluated before application. A comprehensive search of the PubMed and Web of Science databases was conducted for publications from January 2000 to April 1, 2020. Pooled estimates were calculated for correlation coefficients and mean differences for energy and 61 nutrients between FFQs and standard methods. The literature search identified 130 articles that included 21,494 participants. Subgroup analyses according to the number of administrations of the reference method, sample size, administration methods, FFQ items, reference periods, quality of the studies, gender, and regions were also performed. We conducted a meta-analysis by summarizing the available evidence to comprehensively assess the validity of FFQs stratified by the reference method type (24-hour recall (24HRs) and food records (FRs). We also performed subgroup analyses to examine the impact on the final summary estimates. After a meta-analysis of the FFQs' validity correlation coefficients of the included studies, this study showed that the range (median) of the validity coefficients of the 24HRs as reference methods was 0.220-0.770 (0.416), and for the FRs, it was 0.173-0.735 (0.373), which indicated that FFQs were suitable to assess the overall dietary intake in nutritional epidemiological studies. The results of the subgroup analysis showed that the number of administrations of the reference method, administration mode, number of items, reference periods, sample size, and gender mainly affected the validity correlation of FFQs.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.1966737 .

Validity and Reproducibility of a Food Frequency Questionnaire to Assess Macro and Micro-Nutrient Intake among a Convenience Cohort of Healthy Adult Qataris

This study aimed at developing a valid culture-sensitive quantitative food frequency questionnaire (FFQ) for Qatari adults. A convenient sample of healthy Qataris (n = 107) were recruited from family members of Qatar University students. The Diet History Questionnaire II of the US National Cancer Institute was translated to Arabic language, back-translated to English, pilot tested, and then modified accordingly to be used in Qatari setting. Participants were asked to complete the translated version of the FFQ. This FFQ was then validated against three 24 h diet recall (24 hDR) including a weekend day. Participants were asked to complete the FFQ again after one-month period to measure its repeatability. Dietary data were analyzed using the dietary analysis software ESHA. The validity and reliability of FFQ were assessed by comparing the median intake of nutrients and foods and by calculating the Pearson correlation coefficients. The median nutrient intakes assessed by the second FFQ were higher than that reported in the baseline FFQ1 except for fat. The percentage of increase varies between 1.5% and 96%. Results of the second FFQ indicated an overestimation of intake for most nutrients (macro and micro). Macronutrient intakes assessed by the two FFQ and 24 hDR were strongly correlated. The correlation coefficients for micronutrient intakes between FFQ2 and 24hDR were lower than that of the two FFQs except for calcium (r = 0.55) and sodium (r = 0.643). They ranged from (-0.17) for fluorine to (0.643) for sodium. The agreement rates for classifying macronutrient intakes into same or adjacent quartile were between 79.4% and 100% for the two FFQs and between 71% and 100% for the second FFQ and 24hDR. The reported consumption of food groups estimated by FFQ2 was significantly higher than that reported by FFQ1. In conclusion, the developed FFQ was sufficiently valid to assess energy and macronutrients but not micronutrients. The reliability was adequate for most nutrients.