Relative Validity and Reproducibility of a Semi-Quantitative Web-Based Food Frequency Questionnaire for Swiss Adults

Background/Objectives: Food frequency questionnaires (FFQs) are widely used in large epidemiological studies to assess diet and elucidate its impacts on health. However, they must be validated in the target population before use. Methods: We assessed the relative validity, reproducibility, and usability of the Swiss eFFQ, a web-based, 83-item food frequency questionnaire, using a convenience sample of 177 adults (53.1% females, aged 18-75 years) from German- and French-speaking regions of Switzerland. The participants completed the Swiss eFFQ twice and kept a 4-day estimated food record (4-d FR). The dietary data were compared for energy, nutrient, and food group intakes by calculating mean group-level bias, performing the Wilcoxon signed-rank test, quartile cross-classification, weighted Cohen's kappa (K_w), and correlation coefficients. Results: The Swiss eFFQ was highly rated by the participants, with a completion time under 35 min, although it tended to underestimate nutrient and food intake compared to the 4-d FR. For 31 of 36 nutrients, fewer than 10% of the participants were classified in opposite quartiles. The median proportion of subjects classified in the same or adjacent quartile was 74.7% (median K_w: 0.25). The median crude and de-attenuated Spearman correlation coefficients were 0.37 and 0.42 for nutrients and 0.45 and 0.52 for food groups, respectively. The median Spearman and intraclass correlation coefficients for the reproducibility of the Swiss eFFQ were 0.70 and 0.69 for nutrients and 0.70 and 0.61 for food groups, respectively. Conclusions: The Swiss eFFQ was shown to be reproducible and user-friendly, with acceptable accuracy in categorizing study participants based on food intake, and offers several advantages for dietary assessment of Swiss adult populations.