Development and Validation of a Food Frequency Questionnaire for Assessment of Diet in Lower and Middle Income Countries; A study among People Living with HIV/AIDS in Nepal.

Authors

  • Dilip Upreti University of Aberdeen
  • Janet Kyle
  • Padam Simkhada
  • Janine Thoulass
  • Geraldine McNeil

Keywords:

HIV/AIDS, Food, Nutrition, Diet, FFQ, Validation, Nepal

Abstract

Assessing the validity of a Food FrequencyQuestionnaire (FFQ) by comparison with other established dietary assessmentmethods is essential prior to use of a new FFQ in different population groups.In this study a new FFQ for Nepal was developed with 73 food items andadministered by an interviewer who then carried out a 24-h recall.  73 adults living with HIV/HIDS (43M and 30F)were purposively recruited. A nutrient database to estimate the intake ofenergy and macronutrients (fat, protein, and carbohydrate) and selectedmicronutrients (iron, β-carotene and vitamin C) was compiled from Nepalese,Indian and UK based on food composition tables. Comparison of mean intakes bythe two methods showed good agreement between the FFQ and 24-h recall for themean intake of energy, protein, carbohydrate, iron, vitamin C and Vitamin A(all p>0.20) but fat intake was significantly lower by the FFQ than the 24-hrecall (p<0.001). Pearson correlation coefficients between the methodsranged from 0.50 to 0.60 for energy and macronutrients but were below 0.3 formicronutrients. Bland-Altman analyses showed reasonable agreement between thegroup means but wide individual differences between methods. The newly designedsemi-quantitative FFQ can estimate the group mean intake for selectednutrients.

Author Biography

Dilip Upreti, University of Aberdeen

Public Health NutritionGroupInstitute of AppliedHealth SciencesUniversity of AberdeenPolwarth Building, room1.040Foresterhill, Aberdeen,Scotland,UK

References

• Balarajan, Y., &Villamor, E. (2009). Nationally representative surveys show recent increases in the prevalence of overweight and obesity among women of reproductive age in Bangladesh, Nepal, and India. The Journal of nutrition, jn-109.

• Bautista, L. E., Herrán, O. F., &Pryer, J. A. (2005). Development and simulated validation of a food-frequency questionnaire for the Colombian population. Public health nutrition, 8(02), 181-188.

• Bharathi, A. V., Kurpad, A. V., Thomas, T., Yusuf, S., Saraswathi, G., &Vaz, M. (2008). Development of food frequency questionnaires and a nutrient database for the Prospective Urban and Rural Epidemiological (PURE) pilot study in South India: methodological issues. Asia Pacific journal of clinical nutrition, 17(1), 178-185.

• Bland, J., & Altman, D. (1986). Statistical methods for assessing agreement between two methods of clinical measurement. The lancet, 327(8476), 307-310.

• BROWN, M. L., WORTH, R. M., & SHAH, N. K. (1968). Health Survey of Nepal Diet and Nutritional Status of the Nepalese People. The American journal of clinical nutrition, 21(8), 875-881.

• Cade, J., Thompson, R., Burley, V., & Warm, D. (2002). Development, validation and utilisation of food-frequency questionnaires–a review. Public health nutrition, 5(04), 567-587.

• Campbell, V. A., &Dodds, M. L. (1967). Collecting dietary information from groups of older people. Journal of the American Dietetic Association, 51(1), 29.

• CBS (Central Bureau of Statistics) (2003). Population monograph Nepal, Kathmandu, Nepal

• CFTRI (Central Food Technological Research Institute) (1981). Balanced diet and nutritive value of common recipes. Mysore, India.

• Chen, Y., Ahsan, H., Parvez, F., & Howe, G. R. (2004). Validity of a food-frequency questionnaire for a large prospective cohort study in Bangladesh. British journal of nutrition, 92(05), 851-859.

• Chiplonkar, S. A., &Agte, V. V. (2007). Extent of error in estimating nutrient intakes from food tables versus laboratory estimates of cooked foods. Asia Pacific journal of clinical nutrition, 16(2), 227.

• Dahal, N. R., Karki, T. B., Swamylingappa, B., Li, Q., &Gu, G. (2005). Traditional foods and beverages of Nepal—a review. Food Reviews International, 21(1), 1-25.

• Davies, J., & Dickerson, J. (1991). Nutrient content of food portions. Royal Society of Chemistry, Information Services.

• Decarli, A., Franceschi, S., Ferraroni, M., Gnagnarella, P., Parpinel, M. T., Vecchia, C. L., ...&Giacosa, A. (1996). Validation of a food-frequency questionnaire to assess dietary intakes in cancer studies in Italy results for specific nutrients. Annals of epidemiology, 6(2), 110-118.

• DFTQC (Department of Food Technology and Quality Control) (2004). Nutrition in Nepalese food. Ministry of Agriculture and Cooperatives; Babarnahal, Kathmandu, Nepal.

• DFTQC (Department of Food Technology and Quality Control) (2007). Food composition table. Ministry of Agriculture and Cooperatives, Babarnahal, Kathmandu, Nepal.

• Erkkola, M., Karppinen, M., Javanainen, J., Räsänen, L., Knip, M., & Virtanen, S. M. (2001). Validity and reproducibility of a food frequency questionnaire for pregnant Finnish women. American journal of epidemiology, 154(5), 466-476.

• FAO (Food and Agriculture Organization) (2004). The state of agriculture commodity markets. Available on ftp://ftp.fao.org/docrep/fao/007/y5419e/y5419e00.pdf; access on 09072012.

• FAO (Food and Agriculture Organization) (2007). Food balance sheet Nepal. Available on http://faostat.fao.org/site/368/DesktopDefault.aspx?PageID=368#ancor access on 09072012.

• Friis, H. (2006). Micronutrient interventions and HIV infection: a review of current evidence. Tropical medicine & international health, 11(12), 1849-1857.

• FSA (Food Standard Agency) (2002). Food portion size; 3rd edition, London, UK.

• Gibson, R. S. (1990). Principles of nutritional assessment: food consumption of individual. Oxford university press.

• Gopalan, C., Sastri, B. R., Balasubramanian, S. C., & National Institute of Nutrition (2007). Nutritive value of Indian foods. National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India.

• Hirai, K., Nakayama, J., Sonoda, M., Ohno, Y., Okuno, Y., Nagata, K., Tamura, T., Sakya, H.N., & Shrestha, M.P. (1993). Food-Consumption and Nutrient Intake and Their Relationship among Nepalese. Nutrition Research, 13 (9), 987-994.

• McCance, R. A., &Widdowson, E. M. (2006). The composition of foods. Med. Res, Council Spec. Rep. Ser. 297; 6th revised edition of Spec. Rep. No. 235.

• NCASC (National Centre for AIDS and STI Control) (2014). Country Progress Report on HIV/AIDS Response, Kathmandu, Nepal.

• Ohno, Y., Hirai, K., Sakata, S., Shimizu, S., Akai, Y., Ogoshi, K., ... & Shrestha, M. P. (2005). Food consumption and serum nutritional status of people living in the Kathmandu valley in Nepal. Environmental health and preventive medicine, 10(2), 78-85.

• Ohno, Y., Hirai, K., Sakata, S., Shimizu, S., Akai, Y., Ogoshi, K., ... & Shrestha, M. P. (2006). Nutritional status of people living in Dzong village, in the northern mountainous area of Nepal. Asia-Pacific journal of public health/Asia-Pacific Academic Consortium for Public Health, 18(3), 20-29.

• Ohno, Y., Hirai, K., Sato, N., Ito, M., Yamamoto, T., Tamura, T., & Shrestha, M. P. (1997). Food consumption patterns and nutrient intake among Nepalese living in the southern rural Terai region. Asia Pacific journal of clinical nutrition, 6, 251-255.

• Opsomer, J. D., Jensen, H. H., & Pan, S. (2003). An evaluation of the US Department of Agriculture food security measure with generalized linear mixed models. The Journal of nutrition, 133(2), 421-427.

• Pandey, D., Bhatia, V., Boddula, R., Singh, H. K., & Bhatia, E. (2005). Validation and reproducibility of a food frequency questionnaire to assess energy and fat intake in affluent north Indians. National Medical Journal of India, 18(5), 230.

• Pasricha, S., Rebello L., M., & National Institute of Nutrition (1982). Some common Indian recipes and their nutritive values. National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India.

• Roumelioti, M., &Leotsinidis, M. (2009). Relative validity of a semiquantitative food frequency questionnaire designed for schoolchildren in western Greece. Nutr J, 8(8), 1-5.

• Saleheen, D., Zaidi, M., Rasheed, A., Ahmad, U., Hakeem, A., Murtaza, M., ...&Danesh, J. (2009). The Pakistan Risk of Myocardial Infarction Study: a resource for the study of genetic, lifestyle and other determinants of myocardial infarction in South Asia. European journal of epidemiology, 24(6), 329-338.

• Shahar, D., Fraser, D., Shai, I., &Vardi, H. (2003). Development of a food frequency questionnaire (FFQ) for an elderly population based on a population survey. The Journal of nutrition, 133(11), 3625-3629.

• Sudo, N., Sekiyama, M., Maharjan, M., &Ohtsuka, R. (2005). Gender differences in dietary intake among adults of Hindu communities in lowland Nepal: assessment of portion sizes and food consumption frequencies. European journal of clinical nutrition, 60(4), 469-477.

• Teufel, N. I. (1997). Development of culturally competent food-frequency questionnaires. The American journal of clinical nutrition, 65(4), 1173S-1178S.

• Thompson, F. E., & Byers, T. (1994). Dietary assessment resource manual. The Journal of Nutrition, 124(11 Suppl), 2245s-2317s.

• UNAIDS (United Nations General Assembly Special Sessions on HIV/AIDS) (2008). Report on the global AIDS epidemic.

• Wei, E. K., Gardner, J., Field, A. E., Rosner, B. A., Colditz, G. A., & Suitor, C. W. (1999). Validity of a food frequency questionnaire in assessing nutrient intakes of low-income pregnant women. Maternal and child health journal, 3(4), 241-246.

• WFP (World Food Programme) (2009). A sub regional hunger index for Nepal. Nepal food security monitoring system.

• WHO (World Health Organization) (2005). Consultation on nutrition and HIV/AIDS in Africa. Evidence, lessons and recommendations for action.

• Willett, W. A. L. T. E. R., &Lenart, E. L. I. Z. A. B. E. T. H. (1998). Reproducibility and validity of food-frequency questionnaires. Nutritional epidemiology, 2.

• Wrieden, W., Peace, H., Armstrong, J., & Barton, K. (2003). A short review of dietary assessment methods used in National and Scottish Research Studies. In Briefing Paper Prepared for: Working Group on Monitoring Scottish Dietary Targets Workshop. Edinburgh.

• Xu, J., Eilat-Adar, S., Loria, C., Goldbourt, U., Howard, B. V., Fabsitz, R. R., ... & Lee, E. T. (2006). Dietary fat intake and risk of coronary heart disease: the Strong Heart Study. The American journal of clinical nutrition, 84(4), 894-902.

Downloads

Additional Files

Published

2015-12-11

How to Cite

Upreti, D., Kyle, J., Simkhada, P., Thoulass, J., & McNeil, G. (2015). Development and Validation of a Food Frequency Questionnaire for Assessment of Diet in Lower and Middle Income Countries; A study among People Living with HIV/AIDS in Nepal. Asian Journal of Agriculture and Food Sciences, 3(6). Retrieved from https://ajouronline.com/index.php/AJAFS/article/view/3282

Issue

Vol. 3 No. 6 (2015): December 2015

Section

Articles

License

  • Papers must be submitted on the understanding that they have not been published elsewhere (except in the form of an abstract or as part of a published lecture, review, or thesis) and are not currently under consideration by another journal published by any other publisher.
  • It is also the authors responsibility to ensure that the articles emanating from a particular source are submitted with the necessary approval.
  • The authors warrant that the paper is original and that he/she is the author of the paper, except for material that is clearly identified as to its original source, with permission notices from the copyright owners where required.
  • The authors ensure that all the references carefully and they are accurate in the text as well as in the list of references (and vice versa).
  • Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Attribution-NonCommercial 4.0 International that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  • Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  • Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
  • The journal/publisher is not responsible for subsequent uses of the work. It is the author's responsibility to bring an infringement action if so desired by the author.