Nutr Res Pract.  2022 Dec;16(6):789-800. 10.4162/nrp.2022.16.6.789.

Validity and reproducibility of a food frequency questionnaire for breast cancer survivors in Korea

• Moon SE
• Shin Wk
• Song S
• Koh D
• Ahn JS
• Yoo Y
• Kang M
• Lee JE

• KMID: 2536512
• DOI: http://doi.org/10.4162/nrp.2022.16.6.789

Abstract

BACKGROUND/OBJECTIVES
The aim of this study was to examine the validity and reproducibility of a food frequency questionnaire (FFQ) developed in Korea for breast cancer survivors.
SUBJECTS/METHODS
Ninety-nine breast cancer survivors who completed an FFQ twice and three 3-day dietary records (DRs) between 2016–2017 were included. Energy and 14 nutrient intakes were calculated from FFQs and DRs. To determine the validity of the FFQ, energyadjusted de-attenuated Pearson correlations between two FFQ assessments and the average of the three 3-day DRs were calculated, and to determine reproducibility, energy-adjusted Pearson correlations and degrees of agreement were calculated between the first and second FFQ assessments.
RESULTS
Correlation coefficients of validity ranged from 0.29 (protein) to 0.47 (fat) (median value = 0.36) for the FFQ assessment and from 0.20 (riboflavin) to 0.53 (calcium) (median value = 0.37) for the second. Correlation coefficients of reproducibility ranged from 0.22 (sodium) to 0.62 (carbohydrate) (median value = 0.36). Regarding FFQ reproducibilities, percentage classifications of exact agreements for energy-adjusted nutrients ranged from 27.3% (sodium) and 45.5% (fat). A median 76.8% of participants were classified into the same or adjacent quartiles, while a median of 5.6% of participants were classified in extreme quartiles. Bland–Atman plots for the majority of data points of three macronutrients, calcium and vitamins A and C fell within limits of agreement.
CONCLUSIONS
These results indicated that the newly developed FFQ for Korean breast cancer survivors has acceptable validity and reproducibility as compared with three 3-day DRs collected over a one-year period.

Keyword

Validation study; reproducibility of results; nutrition assessment; breast neoplasms; cancer survivors

Figure

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  Fig. 1 Study design for testing the validity and reproducibility of the developed food frequency questionnaire.DR, dietary record; FFQ1, the first food frequency questionnaire assessment; FFQ2, the second food frequency questionnaire assessment.

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  Fig. 2 Bland-Altman plots showing relationships between differences in daily intakes of breast cancer survivors (n = 99) for (A) carbohydrate, (B) fat, (C) protein, (D) calcium, (E) vitamin A, and (F) vitamin C as determined by three 3-day dietary records and the first FFQ assessment. The solid lines represent mean differences between DRs and the FFQ, whereas the dashed lines represent two standard deviations about mean differences (limit of agreement).DR, dietary records; FFQ1, the first food frequency questionnaire assessment; FFQ, food frequency questionnaire.

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  Fig. 3 Bland-Altman plots showing relationships between differences in daily intakes of breast cancer survivors (n = 99) for (A) carbohydrate, (B) fat, (C) protein, (D) calcium, (E) vitamin A, and (F) vitamin C as determined by the three 3-day dietary records and the second FFQ assessment. The solid lines represent average differences between DRs and the FFQ, represent two standard deviations about mean differences (limit of agreement).DR, dietary records; FFQ2, the second food frequency questionnaire assessment; FFQ, food frequency questionnaire.

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