The Validation of the Persian Version of Sugar Addiction Questionnaire: Factor Structure, Item Analysis and Model Fit

Objective: Excessive sugar consumption is a growing public health concern, with research suggesting it may function as an addictive substance. However, the lack of standardized tools to assess sugar addiction, particularly across cultures, remains a challenge. This study aims to validate the Persian version of the Sugar Addiction Questionnaire (SAQ) for use in Iran. Method : In this cross-sectional psychometric validation study, 504 Persian-speaking adults (59.1% female, mean age = 29.8 ± 19.5 years) were recruited using convenience sampling from Tehran health centers. Participants completed the SAQ and Yale Food Addiction Scale (YFAS 2.0), and participated in DSM-5-based semi-structured interviews for sugar addiction. Factor analysis and reliability measures (Cronbach's alpha, test-retest, split-half) were used to assess the SAQ's validity and reliability. Results: The Persian SAQ demonstrated strong psychometric properties. Factor analysis revealed a five-factor structure explaining 45.08% of the variance. Concurrent validity was confirmed by significant correlations with the YFAS 2.0 (r = 0.51, P < 0.001) and BMI (r = 0.55, P < 0.001). The scale showed a good model fit (CFI = 0.91, RMSEA = 0.08), with acceptable reliability (Cronbach's alpha = 0.79) and a test-retest correlation of 0.54. The optimal cutoff for diagnosing sugar addiction was 9, with the Area-Under-the-Curve (AUC) of 98%. Conclusion: The Persian version of the SAQ is a reliable and valid tool for assessing sugar addiction in Iran. This validated instrument can improve the diagnosis and understanding of sugar-related behavioral issues, supporting better public health strategies for managing excessive sugar consumption.