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Development and external validation of the 'Flower-FFQ': a FFQ designed for the Lifelines Cohort Study
Elske M Brouwer-Brolsma1, Corine Perenboom1, Diewertje Sluik1
1Division of Human Nutrition and Health, Wageningen University, PO Box 17, 6700 AAWageningen, The Netherlands.
Objective:
FFQ assess habitual dietary intake and are relatively inexpensive to process, but may take up to 60 min to complete. This article describes the validation of the Flower-FFQ, which consists of four short FFQ measuring the intake of energy and macronutrients or specific (micro)nutrients/foods that can be merged into one complete daily assessment using predefined algorithms.
Design:
Participants completed the Flower-FFQ and validated regular-FFQ (n 401). Urinary N (n 242) and K excretions (n 361) were measured. We evaluated: (1) group-level bias, (2) correlations and (3) cross-classification.
Setting:
Observational study.
Participants:
Dutch adults, 54 ± 11 (mean ± SD) years.
Results:
Flower-FFQ1, Flower-FFQ2, Flower-FFQ3 and Flower-FFQ4 were completed in ±24, 9, 8 and 9 min (±50 min total), respectively. The regular-FFQ was completed in ±43 min. Mean energy (flower v. regular: 7953 v. 8718 kJ/d) and macronutrient intakes (carbohydrates: 204 v. 222 g/d; protein: 75 v. 76 g/d; fat: 74 v. 83 g/d; ethanol: 8 v. 12 g/d) were comparatively similar. Spearman correlations between Flower-FFQ and regular-FFQ ranged from 0·60 to 0·80 for macronutrients and from 0·40 to 0·80 for micronutrients and foods. For all micronutrients and foods, ≥ 78 % of the participants classified in the same/adjacent quartile. The Flower-FFQ underestimated urinary N and K excretions by 24 and 18 %; 75 and 73 % of the participants ranked in the same/adjacent quartile.
Conclusion:
Completing the Flower-FFQ required 50 min with a maximum of 25 min per short FFQ. The Flower-FFQ has a moderate to good ranking ability for most nutrients and foods and performs sufficiently to study diet-disease associations.
