Korean J Nutr.  2013 Apr;46(2):186-196. 10.4163/kjn.2013.46.2.186.

Development of a Food Frequency Questionnaire for the Korea National Health and Nutrition Examination Survey: Data from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV)

• Yun SH
• Shim JS
• Kweon S
• Oh K

• KMID: 2269396
• DOI: http://doi.org/10.4163/kjn.2013.46.2.186

Abstract

The objective of this study was to develop a semi-quantitative food frequency questionnaire (FFQ) for an adult population for use in the Korea National Health and Nutrition Examination Survey (KNHANES). The 24-hour recall data for 2,939 subjects aged 19 years and over from the fourth KNHANES first year (2007) were used to extract the items included in the questionnaire. The FFQ items were developed by selection of major dishes based on the cumulative contribution rate, between-person variability based on the cumulative R2 of energy and 14 nutrients (carbohydrate, protein, fat, crude fiber, calcium, phosphorous, iron, sodium, potassium, vitamin A, thiamin, riboflavin, niacin, and vitamin C) and the number of consumers of each dish. In addition, the FFQ items were revised with analysis of 24-hour recall data of the fourth KNHANES second and third year (2008, 2009). Finally, 112 items were included in the FFQ and grouped as follows: rice (5 items), noodles and dumplings (6), breads and rice cakes (8), soups and stews (12), soybeans, eggs, meat and fish (23), vegetables, seaweed and potatoes (27), milk and dairy products (4), fruits (13), beverages (5), snacks (6) and alcoholic beverages (3). The food items of FFQ accounted for an average of 87.0% of energy and 14 nutrient intakes and also accounted for 81.7% of the between-person variability. The frequency range of the FFQ items was classified into nine categories (never or seldom, once per month, 2-3 times per month, once per week, 2-4 times per week, 5-6 times per week, once per day, twice per day and three times per day) and the portion size was divided into three categories (small, medium and large). We expect that this developed dish-based FFQ could be used in assessment of long-term dietary intakes of Korean adults.

Keyword

food frequency questionnaire; development; Korea National Health and Nutrition Examination Survey

MeSH Terms

Adult
Aged
Alcoholic Beverages
Beverages
Bread
Calcium
Dairy Products
Eggs
Fruit
Humans
Iron
Korea
Meat
Milk
Niacin
Nutrition Surveys
Ovum
Potassium
Surveys and Questionnaires
Riboflavin
Seaweed
Snacks
Sodium
Solanum tuberosum
Soybeans
Vegetables
Vitamin A
Vitamins
Calcium
Iron
Niacin
Potassium
Riboflavin
Sodium
Vitamin A
Vitamins

Figure

• 

  Fig. 1. Diagram to develop food frequency questionnaire (FFQ) items.

Reference

1). Getz GS, Reardon CA. Nutrition and cardiovascular disease. Arterioscler Thromb Vasc Biol. 2007; 27(12):2499–2506.

2). Chen CM, Zhao W, Yang Z, Zhai Y, Wu Y, Kong L. The role of dietary factors in chronic disease control in China. Obes Rev. 2008; 9(Suppl 1):100-103.

3). Kim K, Yun SH, Choi BY, Kim MK. Cross-sectional relationship between dietary carbohydrate, glycaemic index, glycaemic load and risk of the metabolic syndrome in a Korean population. Br J Nutr. 2008; 100(3):576–584.

4). Willett W. Nutritional epidemiology. 2nd edition.New York: Oxford University Press;1998. p. 74–100.

5). Willett WC, Hu FB. The food frequency questionnaire. Cancer Epidemiol Biomarkers Prev. 2007; 16(1):182–183.

6). Willett WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, Hennekens CH, Speizer FE. Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol. 1985; 122(1):51–65.

7). Ocké MC, Bueno-de-Mesquita HB, Goddijn HE, Jansen A, Pols MA, van Staveren WA, Kromhout D. The Dutch EPIC food frequency questionnaire. I. Description of the questionnaire, and relative validity and reproducibility for food groups. Int J Epidemiol. 1997; 26(Suppl 1):S37-S48.

8). Esfahani FH, Asghari G, Mirmiran P, Azizi F. Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran Lipid and Glucose Study. J Epidemiol. 2010; 20(2):150–158.

9). Tokudome S, Ikeda M, Tokudome Y, Imaeda N, Kitagawa I, Fujiwara N. Development of data-based semiquantitative food frequency questionnaire for dietary studies in middle-aged Japanese. Jpn J Clin Oncol. 1998; 28(11):679–687.

10). Ahn Y, Lee JE, Paik HY, Lee HK, Jo I, Kim K. Development of a semiquantitative food frequency questionnaire based on dietary data from the Korea National Health and Nutrition Examination Survey. Nutr Sci. 2003; 6(3):173–184.

11). Shim JS, Oh KW, Suh I, Kim MY, Sohn CY, Lee EJ, Nam CM. A study on validity of a semiquantitative food frequency questionnaire for Korean adults. Korean J Community Nutr. 2002; 7(4):484–494.

12). Kim MK, Yun YM, Kim Y. Developing dish-based food frequency questionnaire for the epidemiology study of hypertension among Korean. Korean J Community Nutr. 2008; 13(5):701–712.

13). Kim YO, Kim MK, Lee SA, Yoon YM, Sasaki S. A study testing the usefulness of a dish-based food-frequency questionnaire developed for epidemiological studies in Korea. Br J Nutr. 2009; 101(8):1218–1227.

14). Park MK, Kim DW, Kim J, Park S, Joung H, Song WO, Paik HY. Development of a dish-based, semiquantitative FFQ for the Korean diet and cancer research using a database approach. Br J Nutr. 2011; 105(7):1065–1072.

15). Korea Centers for Disease Control and Prevention. Final report of revision of the nutrition survey method for KNHANES. Cheongwon: Korea Centers for Disease Control and Prevention;2008. Available from. http://www.cdc.go.kr.

16). Korea Health Industry Development Institute. Report on 2005 National Nutrition Survey by season. Cheongwon: Korea Health Industry Development Institute;2006.

17). Korea Centers for Disease Control and Prevention. Final report of validation of food frequency questionnaire for Korea National Health and Nutrition Examination Survey. Cheongwon: Korea Centers for Disease Control and Prevention;2010. Available from. http://www.cdc.go.kr.

18). Cassidy CM. Walk a mile in my shoes: culturally sensitive food-habit research. Am J Clin Nutr. 1994; 59(1 Suppl):190S–197S.

19). Lee GS, Paik HY, Yi MS, Joung HJ. Response experiences with a semiquantitative food frequency questionnaire: a qualitative study using cognitive interview. Korean J Nutr. 2007; 40(6):566–575.

20). Yun SH, Choi BY, Kim MK. The effect of seasoning on the distribution of nutrient intakes by a food-frequency questionnaire in a rural area. Korean J Nutr. 2009; 42(3):246–255.

21). Shim JE, Ryu JY, PaiK HY. Contribution of seasonings to nutrient intake assessed by food frequency questionnaire in adults in rural area of Korea. Korean J Nutr. 1997; 30(10):1211–1218.

22). Subar AF, Thompson FE, Smith AF, Jobe JB, Ziegler RG, Po-tischman N, Schatzkin A, Hartman A, Swanson C, Kruse L, Hayes RB, Lewis DR, Harlan LC. Improving food frequency questionnaires: a qualitative approach using cognitive interviewing. J Am Diet Assoc. 1995; 95(7):781–788.

23). National Institutes of Health. Diet history questionnaire II. Bethesda, MD: National Institutes of Health;2010. Available from. http://riskfactor.cancer.gov/dhq2/forms/dhq2_pastyear.pdf.

24). Han MH, Kim MK, Lee SS, Choi BY. Study on the agreement of food frequency questionnaires according to the methods of collecting portion size. Korean J Nutr. 1995; 28(8):791–799.

25). Tylavsky FA, Sharp GB. Misclassification of nutrient and energy intake from use of closed-ended questions in epidemiologic research. Am J Epidemiol. 1995; 142(3):342–352.

26). Cummings SR, Block G, McHenry K, Baron RB. Evaluation of two food frequency methods of measuring dietary calcium intake. Am J Epidemiol. 1987; 126(5):796–802.

27). Kim M, Kim Y, Kim S. Validity of self-administered semiquantitative food frequency questionnaire by conditions of one portion size. Korean J Community Nutr. 1998; 3(2):273–280.

28). Song NY, Park MK, Paik HY, Joung H, Kim JS, Park SH. Comparison of frequency and amount of dishes reported in semiquantitative dish-based frequency questionnaire vs. 12-day dietary records. Korean J Nutr. 2010; 43(6):638–652.