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Background Ultra-processed foods (UPF) are associated with poor diet quality and chronic diseases. UPF falls into one of the four groups classified according to the extent and purpose of processing: Group 1 includes unprocessed and minimally processed foods (MPF); group 2 refers to processed culinary ingredients (PCI); group 3, processed foods (PF); and group 4, UPF. Objective The aim of this study was to evaluate the relative validity of a semi-quantitative food frequency questionnaire (SFFQ) compared to two 24-hour dietary recalls to estimate dietary intake per NOVA food group in Mexican children and adolescents. Design This study is a secondary analysis of dietary data from a subsample of children and adolescents who participated in the 2012 Mexican National Health and Nutrition Survey Participants/setting The study participants were 217 children (5 to 11 years) and 165 adolescents (12 to 19 years) with complete information for the SFFQ and two 24 hour-dietary recalls (24DRs). Main outcome measures Daily averages of energy intake and % of energy intake for each NOVA category were calculated using the SFFQ and two 24DRs. Statistical analysis To assess relative validity, the SFFQ was compared with two 24DRs to estimate dietary intake per NOVA food group. Mean differences, Spearman correlations and intra-class correlations coefficients (ICC) and Bland–Altman plots for continuous variables and weighted kappa for ordinal variables were calculated. Results For percentage of energy intake, ICC in children and adolescents were moderate for MPF (ICC=0.47, ICC=0.56, respectively) and UPF (ICC=0.53, ICC=0.57, respectively). Bland–Altman plots indicated reasonably consistent agreement for UPF and MPF groups in children and adolescents. Classification by quintiles was acceptable in all groups. Conclusions Data from this study indicated reasonable relative validity of the SFFQ to rank the percentage of energy intake from MPF and UPF in Mexican children and adolescents.

Advances in technology enabled the development of a web-based, pictorial FFQ to collect parent-report dietary intakes of 7-year-old children in the Growing Up in Singapore Towards healthy Outcomes study. This study aimed to compare intakes estimated from a paper-FFQ and a web-FFQ and examine the relative validity of both FFQ against 3-d diet records (3DDR). Ninety-two mothers reported food intakes of their 7-year-old child on a paper-FFQ, a web-FFQ and a 3DDR. A usability questionnaire collected participants’ feedback on the web-FFQ. Correlations and agreement in energy, nutrients and food groups intakes between the dietary assessments were evaluated using Pearson’s correlation, Lin’s concordance, Bland–Altman plots, Cohen’s κ and tertile classification. The paper- and web-FFQ had good correlations (≥ 0·50) and acceptable-good agreement (Lin’s concordance ≥ 0·30; Cohen’s κ ≥ 0·41; ≥ 50 % correct and ≤ 10 % misclassification into same or extreme tertiles). Compared with 3DDR, both FFQ showed poor agreement (< 0·30) in assessing absolute intakes except micronutrients (web-FFQ had acceptable-good agreement), but showed acceptable-good ability to classify children into tertiles (κ ≥ 0·21; ≥ 40 % and ≤ 15 % correct or misclassification). Bland–Altman plots suggest good agreement between web-FFQ and 3DDR in assessing micronutrients and several food groups. The web-FFQ was well-received, and majority (81 %) preferred the web-FFQ over the paper-FFQ. The newly developed web-FFQ produced intake estimates comparable to the paper-FFQ, has acceptable-good agreement with 3DDR in assessing absolute micronutrients intakes and has acceptable-good ability to classify children according to categories of intakes. The positive acceptance of the web-FFQ makes it a feasible tool for future dietary data collection.

Background The suitability of driving simulators for the prediction of driving behaviour in road traffic has been able to be confirmed in respect of individual assessment parameters. However, there is a need for overarching approaches that take into account the interaction between various influencing factors in order to establish proof of validity. The aim of this study was to explore the validity of our driving simulator in respect of its ability to predict driving behaviour based on participants‘ observed driving errors and driver’s individual characteristics. Method 41 healthy participants were assessed both in a Smart-Realo-Simulator and on the road. By means of linear modelling, the correlation between observed driving errors was investigated. In addition, the influence of self-reported and externally assessed driving behaviour as well as individual parameters (education and training; driving history) were analysed. Results By including these factors, 58% of the variance could be explained. For observed driving errors, a relative validity was established. For self-reported and externally assessed driving behaviour, an absolute to relative validity emerged. The amount of time spent in education and training proved to have a significant influence on driving performance in the simulator, but not on the road. Discussion In general, our results confirmed the validity of our driving simulator with regard to observed and self-reported driving behaviour. It emerged that education and training as potential indicators of cognitive resources played a differential role regarding the study conditions. Since real road driving is considerably automated in experienced drivers, this result suggests that simulation-related behavioural regulation is challenged by additional cognitive demands as opposed to behavioural regulation extending to real road driving. However, the source of these additional cognitive demands remains currently elusive and may form the subject of future research.

Background The aim was to investigate the relative validity of the preference-based measure EORTC QLU-C10D in comparison with the EQ-5D-3L in myelodysplastic syndromes (MDS) patients. Methods We used data from an international multicentre, observational cohort study of MDS patients. Baseline EORTC QLU-C10D and EQ-5D-3L scores were used and index scores calculated for Italy, Australia, and the UK. Criterion validity was established by Spearman and intraclass correlations (ICC) and Bland-Altman plots. Construct validity was established by the instruments’ ability to discriminate known groups, i.e. groups whose health status is expected to differ. Results We analyzed data from 619 MDS patients (61.1% male; median age 73.8 years). Correlations between theoretically corresponding domains were largely higher than between unrelated domains. ICCs and Bland-Altman plots indicated moderate to good criterion validity. Ceiling effects were lower for the QLU-C10D (4.7%) than for the EQ-5D-3L (22.6%). The EQ-5D-3L failed to discriminate known-groups in two and the QLU-C10D in one of the comparisons; the QLU-C10D's efficiency in doing so was higher in clinical known-groups. Results were comparable between the countries. Conclusions The QLU-C10D may be suitable to generate health utilities for economic research in MDS. Responsiveness and minimal important differences need yet to be established.

Background The association between cocaine- and amphetamine-regulated transcript prepropeptide gene (CARTPT) and obesity-related outcomes has shown in the epidemiological studies. Nevertheless, there is lack of data regarding the CARTPT gene–diet interactions in terms of antioxidant potential of diet. So, this study aimed to test CARTPT gene–dietary non-enzymatic antioxidant capacity (NEAC) interactions on cardio-metabolic risk factors in obese individuals. Methods and material The present cross-sectional study was carried out among 288 apparently healthy obese adults within age range of 20–50 years. Antioxidant capacity of diet was estimated by calculating the oxygen radical absorbance capacity (ORAC), ferric reducing antioxidant power (FRAP), total radical-trapping antioxidant parameter (TRAP) and Trolox equivalent antioxidant capacity (TEAC) using a semiquantitative food frequency questionnaire (FFQ). Genotyping for CARTPT rs2239670 polymorphism was conducted by polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) method. Results A significant interaction was revealed between CARTPT rs2239670 and dietary ORAC on BMI (PInteraction = 0.048) and fat mass percent (FM%) (PInteraction = 0.008); in A allele carriers, higher adherence to the dietary ORAC was related to lower level of BMI and FM%. And, the significant interactions were observed between FRAP index and rs2239670 in relation to HOMA (PInteraction = 0.049) and QUICKI (PInteraction = 0.048). Moreover, there were significant interactions of rs2239670 with TRAP (PInteraction = 0.029) and TEAC (PInteraction = 0.034) on the serum glucose level; individuals with AG genotype were more respondent to higher intake of TRAP. Conclusion The present study indicated that the relationships between CARTPT rs2239670 and obesity and its-related metabolic parameters depend on adherence to the dietary NEAC. Large prospective studies are needed to confirm our findings.

OBJECTIVE The objective of this study was to evaluate the characteristics and performance of current prediction models in the fields of spine metastasis and degenerative spine disease to create a scoring system that allows direct comparison of the prediction models. METHODS A systematic search of PubMed and Embase was performed to identify relevant studies that included either the proposal of a prediction model or an external validation of a previously proposed prediction model with 1-year outcomes. Characteristics of the original study and discriminative performance of external validations were then assigned points based on thresholds from the overall cohort. RESULTS Nine prediction models were included in the spine metastasis category, while 6 prediction models were included in the degenerative spine category. After assigning the proposed utility of prediction model score to the spine metastasis prediction models, only 1 reached the grade of excellent, while 2 were graded as good, 3 as fair, and 3 as poor. Of the 6 included degenerative spine models, 1 reached the excellent grade, while 3 studies were graded as good, 1 as fair, and 1 as poor. CONCLUSIONS As interest in utilizing predictive analytics in spine surgery increases, there is a concomitant increase in the number of published prediction models that differ in methodology and performance. Prior to applying these models to patient care, these models must be evaluated. To begin addressing this issue, the authors proposed a grading system that compares these models based on various metrics related to their original design as well as internal and external validation. Ultimately, this may hopefully aid clinicians in determining the relative validity and usability of a given model.

International audience; Car manufacturers expect driving simulators to be reliable research and development tools. Questions arise, however, as to whether drivers’ behavior on simulators exactly matches that observed when they are driving real cars. Drivers’ performances and their subjective feelings about their driving were compared between two groups during a 40-min driving test on the same circuit in a real car (n = 20) and a high-fidelity dynamic simulator (n = 27). Their speed and its variability, the braking force and the engine revolutions per minute (rpm) were recorded five times on a straight line and three times on a curve. The differences observed in these measurements between circuit driving (CD) and simulator driving (SD) from the 6th to 40th minute showed no significant changes during the drive. The drivers also completed the NASA Raw Task Load Index (NASA RTLX) questionnaire and the Simulator Sickness Questionnaire (SSQ) and estimated the ease and standard of their own driving performances. These subjective feelings differed significantly between the two groups throughout the experiment. The SD group’s scores on the NASA RTLX and SSQ questionnaires increased with time and the CD group’s perceived driving quality and ease increased with time, reaching non-significantly different levels from their usual car driving standards by the end of the drive. These findings show the existence of a fairly good match between real-life and simulated driving, which stabilized six minutes after the start of the test, regardless of whether the road was straight or curved. These objective findings and subjective assessments suggest possible ways of improving the match between drivers’ performances on simulators and their real-life driving behavior.

AIM To validate a semi-quantitative food frequency questionnaire (SFFQ) and assess the dietary intake of Iranian adults. METHODS This study was conducted among 113 healthy adults in Iran. We administered twelve 24-hour dietary recalls (24DRs) during a year as a reference method. The 165-item SFFQ was administered twice, along with the first and last 24DRs. To examine validity and reproducibility of SFFQ, the correlation coefficients (r) and de-attenuated correlation coefficients and intra-class correlation coefficient (ICC) between 24DRs and SFFQ were calculated. The Bland-Altman method was used to assess agreement between the two methods. RESULTS De-attenuated correlations varied from 0.42 (polyunsaturated fatty acids) to 0.62 (energy) (all P

Research background. Food frequency questionnaire (FFQ) is an important method for estimation of dietary intake in epidemiologic studies. The aim of the study is to develop a FFQ and evaluate its relative validity for adolescents 12 to 18 years old. Experimental approach. FFQ was developed from previously validated youth/adolescent diet questionnaire (YAQ) by modifying it in order to include Croatian national foods. The final version of the FFQ (FFQ-m) comprised 87 food items. The reference method was a set of two 3-day food records (3DFR) administered twice during the 3 non-consecutive days, one month apart. The FFQ-m was administered approximately on the last day of the second applied dietary food record. Adolescents were recruited from randomly selected elementary and high schools in urban and rural areas of Croatia. FFQ-m was validated on a sample of 84 adolescents (70.2 % female). Nutritional intake from FFQ-m and 3DFR was analysed for each participant. Spearman correlation coefficients (r) and Bland-Altman method were used to assess the validity of the FFQ-m compared to 3DFR. Anthropometric parameters were assessed in 78 adolescents. Results and conclusions. The mean nutrient intake estimated by the FFQ-m were higher than that of the 3DFR. The average correlation coefficient for energy and nutrients in our validation study was 0.40. On average, 76.5 % of adolescents were classified in the same or adjacent quartile of the nutrient intake. Bland-Altman analysis showed good agreement with all macronutrients and some micronutrients (sodium, phosphorus, potassium, calcium, magnesium and iron). A simple self-administrated questionnaire completed by adolescents is a valid tool for measuring energy and nutrient intake among adolescent population. Novelty and scientific contribution. This is the first FFQ developed and validated for population of adolescents in Croatia. It will contribute to further research of nutritional intake in the population of adolescents, especially those from the region.

Background: In Saudi Arabia, few studies have addressed iron, selenium and copper intake and status. Most studies on iron have focused on iron deficiency anemia rather than the intake of iron. Objective: To assess the relative validity and repeatability of a Zinc-food Frequency Questionnaire (FFQ) for estimating the intakes of iron, copper and selenium in Saudi adults. Methods: Ninety-seven Saudi adults participated in this study. All participants completed the FFQ1 and a three-days (3d) Food Record (FR) to assess validity. After one month, the FFQ was administered again (FFQ2) to assess the repeatability. Results: Mean intakes of iron, copper and selenium estimated by FFQ1 were significantly higher than those from the 3d FR. Estimated intakes of iron and selenium by both methods were significantly correlated. The Bland-Altman analysis showed that the difference in iron intakes, as measured by the two methods, was similar across the range of intakes while the difference in copper and selenium intakes increased with an increase in the mean intake. No detectable differences were observed between FFQ1 and FFQ2 in estimating iron, copper and selenium intakes. For all nutrients, the intakes from both FFQs were highly correlated. Conclusion: The Zinc-FFQ showed reasonable relative validity and repeatability for estimating other micronutrients, such as iron, copper and selenium.

Estimations of individuals' polyphenol intake contributes to the understanding of the health benefits of dietary polyphenol. We developed a food frequency questionnaire for polyphenol intake (FFQ) and a short-form FFQ for polyphenol intake (SF-FFQ) for assessing the polyphenol intake of Japanese. The aim of this study was to compare the relative validity of polyphenol intake derived from the FFQ with that from the SF-FFQ, using a 4-consecutive-d dietary record (DR) as the reference. Sixty Japanese subjects aged 30-69 y completed the 4-d DR and the two FFQs regarding their polyphenol intake in November 2019. The polyphenol intake values estimated by the DR, FFQ, and SF-FFQ were 1,057±524 mg/d, 1,061±537 mg/d and 1,015±491 mg/d, respectively. No significant differences were present in the estimated polyphenol intake between the 4-d DR and both FFQs. The correlation coefficient with the DR was 0.779 for the FFQ and 0.814 for the SF-FFQ. These results indicate that the total polyphenol intake in a Japanese population were accurately estimated by the FFQ and SF-FFQ.

Diet quality indices are a practical, cost-effective method to evaluate dietary patterns, yet few have investigated diet quality in athletes. This study describes the relative validity and reliability of the recently developed Athlete Diet Index (ADI). Participants completed the electronic ADI on two occasions, 2 weeks apart, followed by a 4-d estimated food record (4-dFR). Relative validity was evaluated by directly comparing mean scores of the two administrations (mAdm) against scores derived from 4-dFR using Spearman’s rank correlation coefficient and Bland–Altman (B–A) plots. Construct validity was investigated by comparing mAdm scores and 4-dFR-derived nutrient intakes using Spearman’s coefficient and independent t test. Test–retest reliability was assessed using paired t test, intraclass correlation coefficients (ICC) and B–A plots. Sixty-eight elite athletes (18·8 (sd 4·2) years) from an Australian sporting institute completed the ADI on both occasions. Mean score was 84·1 (sd 15·2; range 42·5–114·0). The ADI had good reliability (ICC = 0·80, 95 % CI 0·69, 0·87; P < 0·001), and B–A plots (mean 1·9; level of agreement −17·8, 21·7) showed no indication of systematic bias (y = 4·57–0·03 × x) (95 % CI −0·2, 0·1; P = 0·70). Relative validity was evaluated in fifty athletes who completed all study phases. Comparison of mAdm scores with 4-dFR-derived scores was moderate (rs 0·69; P < 0·001) with no systematic bias between methods of measurement (y = 6·90–0·04 × x) (95 % CI −0·3, 0·2; P = 0·73). Higher scores were associated with higher absolute nutrient intake consistent with a healthy dietary pattern. The ADI is a reliable tool with moderate validity, demonstrating its potential for application to investigate the diet quality of athletes.

IntroductionAdherence to cardioprotective dietary patterns can reduce risk for developing cardiometabolic disease. Rates of diet assessment and counselling by physicians are low. Use of a diet screener that rapidly identifies individuals at higher risk due to suboptimal dietary choices could increase diet assessment and brief counselling in clinical care.MethodsWe evaluated the relative validity and reliability of a 9-item diet risk score (DRS) based on the Healthy Eating Index (HEI)-2015, a comprehensive measure of diet quality calculated from a 160-item, validated food frequency questionnaire (FFQ). We hypothesised that DRS (0 (low risk) to 27 (high risk)) would inversely correlate with HEI-2015 score. Adults aged 35 to 75 years were recruited from a national research volunteer registry (ResearchMatch.org) and completed the DRS and FFQ in random order on one occasion. To measure reliability, participants repeated the DRS within 3 months.ResultsIn total, 126 adults (87% female) completed the study. Mean HEI-2015 score was 63.3 (95% CI: 61.1 to 65.4); mean DRS was 11.8 (95% CI: 10.8 to 12.8). DRS and HEI-2015 scores were inversely correlated (r=−0.6, p2=0.36). The DRS ranked 37% (n=47) of subjects in the same quintile, 41% (n=52) within ±1 quintile of the HEI-2015 (weighted κ: 0.28). The DRS had high reliability (n=102, ICC: 0.83). DRS mean completion time was 2 min.ConclusionsThe DRS is a brief diet assessment tool, validated against a FFQ, that can reliably identify patients with reported suboptimal intake. Future studies should evaluate the effectiveness of DRS-guided diet assessment in clinical care.Trial registration detailsClinicalTrials.gov (NCT03805373).

Introduction: Accurate measurement of physical behavior in adults with lower limb absence is essential to report true patterns of physical behavior and the effectiveness of interventions. The effect of placing accelerometers on prostheses may also affect the reliability and validity. Purpose: To assess reliability and criterion-related validity of the activPAL for measuring incidental and purposeful stepping, and reclining and stepping time in adults with unilateral lower limb absence. Methods: 15 adults with unilateral lower limb absence completed simulated lifestyle activities in a laboratory setting that were retrospectively scored via video analysis. Objective data were obtained simultaneously from two activPAL monitors placed on the sound and prosthetic side. Data were analyzed using one-way intraclass correlation coefficients (ICC), paired t-tests and Cohen’s d. Results: Reliability (prosthetic side vs. sound side) was poor for incidental steps (ICC = .05, d = 0.48) but acceptable for all other measures (ICC = .77–.88; d = .00–.18). Mean activPAL measures, although highly related to the criterion, underestimated, on average, stepping and time-related variables. Differences were large for all stepping variables (d = .38–.96). Conclusions: The activPAL is a reliable measurement tool in adults with lower limb absence when used in a laboratory setting. Placement of the monitor on the sound side limb is recommended for testing. The activPAL shows evidence of relative validity, but not absolute validity. Further evaluation is needed to assess whether similar evidence is found in free-living activity and sedentary contexts.

Driving simulation is an efficient, safe, and data-collection-friendly method to examine driving behavior in a controlled environment. However, the validity of a driving simulator is inconsistent when the type of the driving simulator or the driving scenario is different. The purpose of this research is to verify driving simulator validity in driving behavior research in work zones. A field experiment and a corresponding simulation experiment were conducted to collect behavioral data. Indicators such as speed, car-following distance, and reaction delay time were chosen to examine the absolute and relative validity of the driving simulator. In particular, a survival analysis method was proposed in this research to examine the validity of reaction delay time. The result indicates the following: (1) most indicators are valid in driving behavior research in the work zone. For example, spot speed, car-following distance, headway, and reaction delay time show absolute validity. (2) Standard deviation of the car-following distance shows relative validity. Consistent with previous researches, some driving behaviors appear to be more aggressive in the simulation environment.

Background FFQs are commonly used to assess dietary intake and it is important to evaluate their performance in the target population. Objective We evaluated the reproducibility and relative validity of the Cancer Prevention Study-3 (CPS-3) FFQ in estimating usual intake of 63 food groups and diet quality in accordance with the American Cancer Society dietary guidelines for cancer prevention. Methods A subset of participants from the CPS-3 (433 women, 244 men), 31-70 y of age, were included in a cross-sectional diet assessment substudy (2015-2016). Reproducibility was assessed by comparing estimates from repeat FFQs, approximately 1 y apart, using Spearman correlation coefficient (rs) and Pearson correlation coefficient (rp) correlations for food groups and diet quality, respectively. Validity was assessed similarly by comparing FFQ estimates with estimates from ≤6 interviewer-administered 24-h dietary recall (24HR). Analyses were stratified by sex and race/ethnicity. Results Reproducibility correlations for repeated FFQs were > 0.50 for 83-97% of food groups analyzed across strata of sex and race. Although participants tended to overreport plant foods (e.g., fruits and legumes) and underreport refined grains and sugar-sweetened beverages, the median energy-adjusted, deattenuated Spearman correlations comparing the second FFQ to the 24HR were 0.50 and 0.52 among men and women (range: 0.05-0.82), respectively, suggesting that ranking was preserved for most food groups. Validity was highest for coffee, alcohol, and total dairy, and lowest for pasta and regular-fat yogurt. Median validity across food groups varied by race/ethnicity and was highest among whites (rs = 0.54) followed by Hispanics (rs = 0.49) and African Americans (rs = 0.45). The diet quality score had good validity in all subgroups examined, but was higher among men (rp = 0.69) than women (rp = 0.61), and lower among whites (rp = 0.62) than Hispanics (rp = 0.64) or African Americans (rp = 0.73). Conclusions This study indicates good reproducibility and validity of the CPS-3 FFQ for most major food groups and the diet quality score in all sex and race/ethnicity groups examined.

AIM: Nutrition-based applications ("apps") offer enormous research potential, however evidence of their use and acceptability among older adults is limited. We compared self-reported and dietitian-adjusted dietary intake records among adults aged 55 to 75 years using the Research Food Diary (RFD) app. METHODS: Participants were recruited from the 45 and Up Study and completed a 3-day food record using the RFD. A follow-up dietetic telephone interview was performed to confirm the electronic dietary data. Independent of these interviews, a set of adjustments based on dietetic skills, nutritional database knowledge, food composition and dietary assessment was established to resolve probable reporting errors. The "adjusted" and "dietitian-assisted" records were compared to self-reported records for nutrient intakes and serves of The Five Food Groups using one-way repeated measures analysis of variance. RESULTS: Sixty-two participants were recruited, with 48 using the RFD app which included eight records without any identified errors. Reporting errors contained in the raw self-reported records included: food items with missing/implausible quantities or insufficient descriptions to allow automatic coding. After removal of unusable records, 44 records were analysed. Differences were found between the self-reported and adjusted records for protein, calcium, vitamin B12 , zinc and dairy food serves (all P

Background: To assess the validity of the single question to determine sedentary behavior (SB) by using the Global Physical Activity Questionnaire (GPAQ) in older adults. Methods: The sample included 163 participants (96 women) aged 65–92 years. Self-reported SB was obtained from the GPAQ. Objectively measured SB was assessed using the Intelligent Device for Energy Expenditure and Activity. Participants wore the Intelligent Device for Energy Expenditure and Activity continuously during 2 consecutive days while following their daily routine. The relative validity was assessed using the Spearman rank correlation coefficient (ρ), and the agreement was examined using mean bias and 95% limit of agreement with the Intelligent Device for Energy Expenditure and Activity as reference. Results: The results showed small correlations (ρ = .291, P ρ = .217 to ρ = .491 depending on the potential moderator. Similarly, the GPAQ underestimates the SB for approximately 2 hours per day in older adults (limit of agreement = −7.3 to 3.4 h/d). Conclusion: The GPAQ may not be the most suitable questionnaire for measuring SB in this population and should be used with caution because those studies that use this questionnaire in older adults may have an inaccurate measurement of SB levels.

The validity of grocery purchase data as an indicator of food consumption is uncertain. This paper investigated (1) the associations between food consumption and grocery purchases using automatically accumulated purchase data and (2) whether the strength of the associations differed in certain sub-populations. The participants filled in a FFQ, and a major Finnish retailer issued us with their loyalty-card holders’ grocery purchase data covering the 1- and 12-month periods preceding the FFQ. We used gamma statistics to study the association between thirds/quarters of FFQ and grocery purchase data (frequency/amount) separately for eighteen food groups among the 11 983 participants. Stratified analyses were conducted for subgroups based on sex, family structure, educational level, household income and self-estimated share of purchases from the retailer. We also examined the proportion of participants classified into the same, adjacent, subsequent and opposite categories using the FFQ and purchase data. The gammas ranged from 0·12 (cooked vegetables) to 0·75 (margarines). Single households had stronger gammas than two-adult families, and participants with > 60 % of purchases from the retailer had stronger gammas. For most food groups, the proportion of participants classified into the same or adjacent category was > 70 %. Most discrepancies were observed for fresh/cooked vegetables, berries and vegetable oils. Even though the two methods did not categorise all food groups similarly, we conclude that grocery purchase data are able to describe food consumption in an adult population, and future studies should consider purchase data as a resource-saving and moderately valid measure in large samples.

Background Valid and reproducible dietary patterns (DP) are necessary to assess relationships between diet and disease. This study, Researching Eating, Activity, and Cognitive Health (REACH), assessed the reproducibility and relative validity of DPs derived from a food frequency questionnaire (FFQ) in older New Zealand adults. Methods Participants (n = 294, 70±3yrs, 37% male), completed two identical 109-item FFQs to assess reproducibility. A 4-day food record (4DFR) was used to assess relative validity. After collapsing data into 57 food groups, DPs were derived using principal component analysis. Agreement of DP loadings were assessed using Tucker’s congruence coefficient. Agreement between derived DP scores from the FFQs and 4-DFR were assessed using Spearman correlation coefficients, weighted kappa statistic, and Bland-Altman analysis. Results Three similar DPs (‘Mediterranean style’, ‘Western’ and ‘prudent’) were identified from each dietary assessment tool. Congruence coefficients between DP loadings ranged from 0.66-0.80 (reproducibility) and 0.54-0.75 (validity). Correlations of DP scores ranged from 0.47-0.59 (reproducibility) and 0.33-0.43 (validity) (all P Conclusions The FFQ derived DPs demonstrated acceptable reproducibility and relative validity and can be used to examine associations between DPs and health outcomes in older New Zealand adults. Key Message Valid DPs improve evidence for assessing DP and health outcome associations.

BackgroundUltra-processed foods are recognized as indicators of an unhealthy diet in epidemiological studies. In addition to ultra-processed foods, the NOVA food classification system identifies three other groups with less processing. Unprocessed foods that, together with minimally processed foods (MPF), make NOVA group 1, NOVA group 2 is processed culinary ingredients, and NOVA group 3 is processed foods.ObjectiveTo assess the relative validity of the semi-quantitative food frequency questionnaire (SFFQ) to estimate the energy intake for each group NOVA classification system by comparing it with two 24 h-dietary-recall (24DRs) Mexican adults.MethodsWe analyzed dietary information from 226 adults included ResultsThe percentage energy intake from unprocessed and minimally processed foods group, Spearman correlation coefficients was 0.54 in adults ConclusionThe SFFQ had acceptable validity to rank the percentage of energy intake from unprocessed and minimally processed foods group and ultra-processed foods group in Mexican adults, both in adults under 60 years and who were 60 years old or older.

Introduction: Morphometric differences of several bones form the basis of sexual differentiation. The mastoid triangle has been widely used as a predictor of sexual differentiation. However, the radiographic measurements of the mastoid triangle, which form the clinical alternative of this parameter, have not been studied in the North Indian population. Therefore, we analyzed skull radiographs of live subjects to investigate the effectiveness of the radiographic mastoid triangle in sex determination. Methods: One hundred skull lateral radiographs (55 male and 45 female) from the digital archives of a tertiary care teaching institute in Northern India were retrospectively analyzed. The following parameters: porion-mastoidale length, mastoidale-asterion length, asterion-porion length, and area of the mastoid triangle were measured. Gender-based differences for these parameters were then calculated for any statistical significance. Further, the low value of Wilks’ lambda, high values of Eigenvalues, and percentage of correct prediction accuracy denoted higher predictive value. Finally, discriminant function analysis was used to predict the relative validity of each measured parameter. Result: All measured parameters were significantly higher in the male group. The porion-mastoidale length was 32.21±2.15 mm in males and 31.66±3.21 mm in females. The mastoidale-asterion length was 50.00±9.75 mm in males and 49.84±6.97 in females. The asterion-porion length was 44.11±6.82 mm in males and 39.72±5.77 mm in females. The area of the mastoid triangle was 690.74±123.35 mm2 in males and 570.57±130.0 mm2 in females. The area of the mastoid triangle has the highest relative validity (78%). Conclusion: Considerable ethnic and racial differences have been observed in the radiographic morphology of the mastoid. The radiographic dimensions of the mastoid are potential predictors of sexual dimorphism. With the use of discriminant function analysis, the current study predicts the effectiveness of the area of the mastoid triangle as a reliable parameter for sexual differentiation in the Northern Indian population.

As an important part of antenatal care for pregnant women in China, dietary assessment plays a positive role in maternal and fetal health. Shortcomings in the associated methodologies require improvement. Our purpose was to develop a novel WeChat Applet for image-based dietary assessment (WAIDA) and evaluate its relative validity among pregnant women in China. Data on 251 lunch meals of pregnant women in their second trimester were analyzed. The differences in food weight, energy, and nutrient estimates by the dietary recall or WAIDA method with the weighing method were compared using paired t-tests. Pearson correlation coefficients were used to analyze the correlation between food weight, energy, and nutrient intake obtained from the recall or WAIDA method and those obtained from the weighing method. The Bland–Altman analysis was used to examine the agreement between the recall or WAIDA method and the weighing method for energy and nutrients. Compared with the weighing method, the variation range of food weight, energy and nutrients estimated by the WAIDA method was smaller and more stable than that estimated by the recall method. Compared with the recall method, the correlations suggested a better relationship between the energy and nutrient intakes from the weighing method and those estimated by the WAIDA method (0.752–0.970 vs. 0.480–0.887), which were similar to those of food weight (0.332–0.973 vs. −0.019–0.794). The Bland-Altman analysis showed that the mean differences of the energy and nutrients estimated from the recall method were further away from zero relative to the weighing method compared to the WAIDA method and with numerically wider 95% confidence intervals. The spans between the upper and lower 95% limit of agreement (LOAs) of the energy and nutrients obtained by the WAIDA method were narrower than those obtained by the recall method, and the majority of the data points obtained by the WAIDA method lay between the LOAs, closer to the middle horizontal line. Compared with the recall method, the WAIDA method is consistent with the weighing method, close to the real value of dietary data, and expected to be suitable for dietary assessment in antenatal care.

Objectives The aim of this study was to examine the reproducibility and relative validity of a semiquantitative food frequency questionnaire (FFQ) in assessing food group estimates. Methods Food group estimates were assessed via a 37-item FFQ and a 3-d food record (FR). Pearson's correlation coefficients for log-transformed values were calculated to assess the reproducibility and Spearman's rank correlation coefficients for log-transformed values were calculated to assess the validity. Kindergartens from six European countries participated in the preparatory substudies of the ToyBox intervention study; data from preschool children 4 to 6 y of age (n = 196, reproducibility study; n = 324, validation study) were obtained. Results In the reproducibility study, positive Pearson's correlation coefficients for single and aggregated food groups ranged from 0.14 for pasta and rice to 0.90 for cooked vegetables. In the validation study, the FR gave higher estimates of 40 of the 50 food items (single and aggregated) examined compared with those obtained from the FFQ. Positive crude Spearman rank correlation coefficients ranged from 0.01 for total beverages (added sugar) and rice to 0.62 for tea. Corrections for the deattenuation effect did not improve observed correlations. Quartiles and tertiles were calculated for a small number of food groups (N = 14) owing to zero consumption in the rest of the groups. Conclusions Moderately good reproducibility and low-moderate relative validity of the FFQ used in preschool children was observed. Relative validity, however, varied by food and beverage group; for some of the “key” foods/drinks targeted in the ToyBox intervention (e.g., biscuits), the validity was good. The findings should be considered in future epidemiologic and intervention studies in preschool children.

Background Research on the relationship between maternal diet and pregnancy outcomes requires valid dietary assessment tools in pregnancy. Objective This study aimed to develop and examine the relative validity and reproducibility of a quantitative food frequency questionnaire (FFQ) to estimate food group intake in a sample of pregnant Jordanian women. Design In this validation study, food group intake from a culturally sensitive quantitative FFQ was compared with food group intake from three 24-hour dietary recalls. Participants and setting The validation study was conducted from 2015 to 2017 at the maternity clinics in Jordan University Hospital among 131 healthy singleton pregnant Jordanian women. Of these women, 30 also took part in the reproducibility phase, which involved repeated completion of the FFQ in a time frame of 1 month. Pregnant women who had gestational diabetes, preeclampsia, and chronic diseases were excluded. Main outcome measures Relative validity and reproducibility of a 117-item quantitative FFQ used to estimate usual food intake over a period of 1 month. Statistical analyses performed Intraclass correlation coefficients and weighted κ statistics were calculated to test the reproducibility between the two administrations of the FFQ. Pearson correlations were estimated to validate the FFQ against 24-hour dietary recalls. Cross-classification and Bland-Altman plots were used to examine the agreement between the two dietary assessment methods. Results The intraclass correlation coefficients between the two FFQs ranged from 0.24 for legumes to 0.93 for processed meats. A moderate level of agreement was observed between two FFQs. De-attenuated and energy-adjusted correlations ranged from 0.08 for sweets and sugar to 0.93 for sugary drinks. On average, 50.9% and 45.2% of participants were classified by the FFQ and the 24-hour dietary recalls into the same quartile based on their crude and energy-adjusted food group intake, respectively. Bland-Altman plots showed satisfactory agreement between two methods for most food groups. Conclusions The FFQ showed moderate reproducibility and good relative validity for most food groups.

Background: Driving simulators have become an effective research tool in traffic safety, but the validity of results obtained in simulated environments remains a debated issue of high importance. Objective: The objective of this study is to validate a fixed-base driving simulator for speed perception and actual speed and to support its application in traffic safety studies. Method: The study consisted of two experiments to test the external and subjective validity of the driving simulator in absolute and relative terms. External validity was framed into two parts i.e. for speed perception and actual speed. In the first part, the external validity was assessed based on the speed perception observations from forty volunteers that participated in the study. Speed estimations for four different requested speeds (50, 70, 80 and 100 kph) were recorded under two conditions: speedometer hidden and speedometer revealed. In the second part, the external validity was assessed based on the comparison of actual speed observations from field and simulator. The subjective validity of the simulator setting was assessed through a questionnaire. Results: Results from both experiments showed correspondence of the driving behavior between the simulator and real-world settings. In general, the profiles for estimated speed and actual speed followed a significantly similar tendency and indicated relative validity in both experiments. Moreover, external absolute validity for speed perception was established on all the requested speeds with speedometer hidden while only for the requested speed of 80 kph with speedometer revealed. Participants' evaluation of the quality and performance of the driving simulator supported the subjective validity of the simulator setting. Conclusion: The fixed-base driving simulator used in this study can be considered as a useful tool for research on actual speed and speed perception. Qatar National Research Fund, Qatar Foundation Scopus

Risk analysis and hazard management can prompt varied intra-scientific disputes, some which have or will become public, and thus potentially available for lay judgments of the relative validity of the positions taken. As attentive laypeople may include elites as well as the general public, understanding whether and how cues to credibility of disputing groups of scientists might shape those lay judgments can be important. Relevant literatures from philosophy, social studies of science, risk analysis, and elsewhere have identified potential cues, but not tested their absolute or relative effects. Two experiments with U.S. online panel members tested multiple cues (e.g., credentials, experience, majority opinions, research quality) across topics varying in familiarity subject to actual intra-science disputes (dark matter, marijuana, sea-level rise). If cues supported a position, laypeople were more likely to choose it as relatively more valid, with information quality, majority "vote," experience, and degree source as the strongest, and interest, demographic, and values similarity as the weakest, cues. These results were similar in overall rankings to those from implicit rankings of cue reliability ratings from an earlier U.S. online survey. Proposed moderators were generally nonsignificant, but topic familiarity and subjective topic knowledge tended to reduce cue effects. Further research to confirm and extend these findings can inform both theory about citizen engagement with scientific and risk disputes, and practice in communication about science and risk.

Background Patient-reported outcome measures that are more practical and clinically useful are needed for patients with CKD. We compared a new CKD-specific quality-of-life impact scale (CKD-QOL) with currently used measures. Methods Patients ( n =485) in different treatment groups (nondialysis stages 3–5, on dialysis, or post-transplant) completed the kidney-specific CKD-QOL and Kidney Disease Quality of Life-36 (KDQOL-36) forms and the generic SF-12 Health Survey at baseline and 3 months. New items summarizing quality of life (QOL) impact attributed to CKD across six QOL domains yielded single impact scores from a six-item static (fixed-length) form and from computerized adaptive tests (CATs) with three to six items. Validity tests compared the CKD-QOL, KDQOL-36 (Burden, Effects, and Symptoms/Problems subscales), and generic SF-12 measures across groups in four tests of clinical status and clinician assessment of change (CKD-specific tests), and number of comorbidities. ANOVA was used to test for group mean differences, variances in each measure explained by groups, and relative validity (RV) in comparison with the referent KDQOL-36 Burden subscale. Results KDQOL-36 and CKD-QOL measures generally discriminated better than generic SF-12v2 measures. The pattern of variances across CKD-specific tests comparing validity favored CKD-QOL two-fold over KDQOL-36. Two RV test results confirmed CKD-QOL improvements over the referent KDQOL scale. Results for static and CAT CKD-QOL forms were similar. SF-12 Physical and KDQOL-36 Symptoms scores worsened with increasing comorbid condition counts. Conclusions Overall, compared with the KDQOL-36, the new approach to summarizing CKD-specific QOL impact performed better across multiple tests of validity. CAT surveys were more efficient than static surveys.

Summary Background The contribution of dietary factors in the development and progression of pre-diabetes has been increasingly recognized. However, due to high variability in dietary habits measurement of dietary intake remains one of the most challenging tasks in this population. Food frequency questionnaire (FFQ) which investigates usual dietary intake can be used to identify frequent consumption of foods such as dietary fat, fiber, grains that are linked to the risk of pre-diabetes. Method This systematic review was conducted to identify and describe FFQs that measure dietary intake of pre-diabetic patients and to examine their relative validity and reliability. The systematic search was done through electronic databases such as PubMed, CINAHL, PsycINFO, ProQuest and Scopus. Methodological quality of included studies and results of study outcome was also summarized in this review. Result The search identified 445 papers, of which 18 studies reported 15 FFQs, met inclusion criteria. Most of the FFQs (n = 12) were semi-quantitative while three were frequency measures with portion size estimation of selected food items. Test-retest reliability of FFQ was reported in 7 (38.3%) studies with the correlation coefficient of 0.33–0.92. Relative validity of FFQ was reported in 16 (88.8%) studies with the range of correlation coefficient of 0.08–0.83. Dietary patterns rich in carbohydrate, fat, animal protein and n-3 fatty acids were associated with increased risk of pre-diabetes. Conclusion No well-established disease-specific FFQ identified in the literature. Development of a valid, practical and reliable tool is needed for better understanding of the impact of diet in pre-diabetic population.

A new, web-based, 24-h recall (R24 W) was developed and programmed to assess adherence to Canadian dietary guidelines by automatically generating the Canadian Healthy Eating Index 2007 (C-HEI 2007). The aim of the present study was to determine the relative validity of the R24 W in terms of its ability to generate C-HEI 2007 scores that match those derived from a food record (FR).A total of 57 women and 50 men filled a 3-d FR and three 24-h food recalls with the R24 W. C-HEI 2007 was calculated with both dietary assessment tools and compared using de-attenuated correlations and kappa scores. Internal validity (correlations between total score and components) and external validity (comparison of the C-HEI 2007 by sex and age groups) were compared between the two dietary assessment methods.The average C-HEI 2007 score obtained with the R24 W (59.4 ± 11.8) was significantly lower than the one obtained with the FR (62.6 ± 11.1). However, the de-attenuated correlation coefficient between C-HEI 2007 obtained either with R24 W or FR was 0.80 (P0.01) and 91.6% of participants were classified in the same or adjacent quartile of C-HEI 2007 with both tools. Women obtained a higher C-HEI 2007 mean score (P0.01) with both methods and older adults (age:51 y) received a higher score than younger adults (age: 18-30 y; P0.01) with the R24 W but not with the FR (P = 0.22).Although the R24 W yields lower C-HEI 2007 scores compared with data from FR, the classification of individuals was highly consistent between the two measurements.

espanolIntroduccion: los estudios sobre el impacto de la dieta en la prevencion y aparicion de enfermedades en todas las etapas de la vida requieren una herramienta de evaluacion dietetica confiable y valida para evaluar la ingesta dietetica. Objetivos: este estudio tuvo como objetivo desarrollar y evaluar la validez relativa y la reproducibilidad de un cuestionario cuantitativo de frecuencia alimentaria (CFC) culturalmente sensible para evaluar la ingesta de grupos de alimentos entre ninos y adolescentes jordanos. Metodos: el estudio de validacion se realizo en 136 ninos y adolescentes de entre 6 y 18 anos matriculados en escuelas publicas y privadas seleccionadas. Cincuenta de estos ninos y adolescentes participaron en la fase de reproducibilidad. La ingesta del grupo de alimentos de un CFC cuantitativo se comparo con la ingesta del grupo de alimentos de los recordatorios dieteticos de 24 horas. Se recogieron cuatro recordatorios de 024 horas semanales durante un mes. Resultados: los coeficientes de correlacion intraclase entre los dos CFC variaron de 0,18 para las nueces a 0,98 para el te. Las correlaciones atenuadas y ajustadas por energia variaron de 0,08 para las nueces a 0,95 para los aceites vegetales. En promedio, el 46,6 % y el 43,6 % de los participantes fueron clasificados por el CFC-1 y el 24h-DR en el mismo cuartil en funcion de la ingesta de grupo de alimentos crudos y ajustados por energia, respectivamente. Los graficos de Bland-Altman mostraron una concordancia satisfactoria entre los dos metodos para la leche y los productos lacteos y las hortalizas. Conclusiones: los hallazgos de este estudio sugirieron que el CFC desarrollado tiene una excelente reproducibilidad y una buena validez relativa para la mayoria de los grupos de alimentos. EnglishIntroduction: studies of the impact of diet on the prevention and occurrence of diseases in all life stages require a reliable and valid dietary assessment tool for assessing dietary intake. Objectives: this study aimed to develop and evaluate the relative validity and reproducibility of a culturally sensitive quantitative food frequency questionnaire (FFQ) to assess food group intake among Jordanian children and adolescents. Methods: the validation study was carried out on 136 children and adolescents aged between 6 and 18 years who enrolled from selected public and private schools. Fifty of these children and adolescents participated in the reproducibility phase. Food group intake from a quantitative FFQ was compared with food group intake from 24-hour dietary recalls (24h-DRs). Four 24-HRs were collected weekly for one month. Results: intraclass correlation coefficients between the two FFQs ranged from 0.18 for nuts to 0.98 for tea. De-attenuated and energy-adjusted correlations ranged from 0.08 for nuts to 0.95 for vegetable oils. On average, 46.6 % and 43.6 % of participants were ranked by the FFQ-1 and the 24h-DRs into the same quartile based on their crude and energy-adjusted food group intake, respectively. Bland-Altman plots showed a satisfactory agreement between the two methods for milk and milk products and vegetables. Conclusions: the findings of this study suggested that the developed FFQ has excellent reproducibility and good relative validity for most food groups.

The present study aimed to assess the relative validity and reliability of a modified Food and Nutrition Literacy (M-FNLIT) questionnaire in primary school children in the city of Mashhad. The study was conducted in four phases. In the first step, the content and face validity of the questionnaire were evaluated by Delphi consensus as well as interviewing the students. Then, construct validity was examined using Confirmatory Factor Analysis (CFA). The internal consistency and reliability of the questionnaire were also assessed using Cronbach α and Intraclass Correlation Coefficient (ICC), respectively. Finally, a receiver operating characteristic analysis was performed to detect the cut-off scores of the M-FNLIT scale. Findings of two rounds of Delphi showed satisfactory levels of Content Validity Ratio: 0·72 and 0·92, Content Validity Index (CVI): 0·92 and 0·98, respectively. The results of CFA for domains and subscales of the M-FNLIT questionnaire including cognitive domain (understanding food and nutrition information and nutritional health knowledge) and skill domain (functional, food choice, interactive, and critical skills) indicated acceptable fit indices. M-FNLIT subscale-specific Cronbach α values ranged between 0·68 and 0·8 and ICC was 0·95 (95 % CI 0·93, 96). The final questionnaire included forty items (thirty-six Likert-type and four true-false items). FNLIT scores were categorized as low (≤ 58), medium (> 58–< 81), and high (≥ 81). The M-FNLIT questionnaire has a good level of validity and reliability to measure food and nutrition literacy in primary school children. The questionnaire can be applied in the evaluation of nutritional interventions in this age group.

Objective:Individuals with HIV are at increased risk for osteoporosis. A healthy diet with adequate Ca is recommended to promote bone health. However, lengthy nutritional assessments pose barriers to routine screenings in clinical practice. This study aimed to examine the validity and reproducibility of a six-item dietary Ca screening tool among Chinese individuals with HIV.Design:We conducted a two time-point study in an outpatient setting. Volunteers self-administered the six-item tool upon enrolment and again at 1-month follow-up. At baseline, participants also completed a validated FFQ and surveys regarding demographic and clinical risk factors.Setting:Beijing, China; Shenzhen, Guangdong, China.Participants:Upon enrolment, 127 individuals with HIV participated in the study, of whom 83 completed the follow-up screening.Results:Mean age of participants was 35·2 (sd 9·3) years, average BMI was 22·8 (sd 3·8) kg/m2 and 89 % were men. Among the participants, 54·7 % reported Ca intake less than 800 mg/d. The six-item tool demonstrated fair-to-moderate relative validity with a correlation of 0·39 and 75·7 % of subjects classified in same/adjacent quartiles as the reference, and moderate-to-good reproducibility with a correlation of 0·60 and 83·1 % of subjects classified in same/adjacent quartiles. Finally, receiver operating characteristic analyses yielded a sensitivity of 87·0 % and a specificity of 39·4 % with optimised cut-off level.Conclusions:The six-item tool presented adequate validity and reproducibility to identify individuals with low Ca intake among the target population, providing a convenient instrument for categorising Ca intake in clinical practice, prompting referrals for further assessment, and raising awareness of dietary Ca in bone disease prevention.

Objective Food frequency questionnaires are widely used as a dietary assessment tool in nutritional epidemiology to determine the relationship between diet and diseases. In Tanzania, there are several cultural variations in food intake which makes it necessary to design and validate a culture-specific food frequency questionnaire (CFFQ). Therefore, we designed a 27-items CFFQ and examine its validity in pastoral communities. Validity of CFFQ was assessed by comparing nutrient intake estimated from the CFFQ against the average from two 24-h diet recall (2R24). Spearman’s correlation coefficients, cross classification and Bland–Altman’s methods were used to assess the validity of CFFQ. Results A total of 130 adults aged 18 years and above completed both CFFQ and 2R24. Correlation coefficients between CFFQ and 2R24 ranged from low (r = − 0.07) to moderate (r = 0.37). The correlation coefficients were moderately significant for kilocalories (r = 0.31, p p p p

Measuring dietary intakes in a multi-ethnic and multicultural setting, such as Malaysia, remains a challenge due to its diversity. This study aims to develop and evaluate the relative validity of an interviewer-administered food frequency questionnaire (FFQ) in assessing the habitual dietary exposure of The Malaysian Cohort (TMC) participants. We developed a nutrient database (with 203 items) based on various food consumption tables, and 803 participants were involved in this study. The output of the FFQ was then validated against three-day 24-h dietary recalls (n = 64). We assessed the relative validity and its agreement using various methods, such as Spearman’s correlation, weighed Kappa, intraclass correlation coefficient (ICC), and Bland–Altman analysis. Spearman’s correlation coefficient ranged from 0.24 (vitamin C) to 0.46 (carbohydrate), and almost all nutrients had correlation coefficients above 0.3, except for vitamin C and sodium. Intraclass correlation coefficients ranged from −0.01 (calcium) to 0.59 (carbohydrates), and weighted Kappa exceeded 0.4 for 50% of nutrients. In short, TMC’s FFQ appears to have good relative validity for the assessment of nutrient intake among its participants, as compared to the three-day 24-h dietary recalls. However, estimates for iron, vitamin A, and vitamin C should be interpreted with caution.

Background: To investigate the association between diet and health effects in population surveys, it is necessary to have precise tools that allow estimating the habitual consumption of the population. Introduction: To investigate the association between diet and health effects in population surveys, it is necessary to have precise tools that allow estimating the habitual consumption of the population. Aim: To evaluate the reproducibility and validity of the ELSA-Brasil food frequency questionnaire (FFQ) to assess macro and micronutrients intake. Material and methods: We collected dietary information of 281 participants which completed two ELSA-Brasil food frequency questionnaires (FFQ) over a year period and three records. To assess the reproducibility of the FFQ, we compared the macro and micronutrients intake from the two FFQ while to assess the validity, we compared the intakes of FFQ with the mean of three records. The intraclass correlation test (ICC) and agreement percentages of nutrient intake were calculated after categorization by tertiles. Results: ICC coefficients for reproducibility ranged from 0.51 (polyunsaturated fat) to 0.70 (magnesium) while the ICC coefficients for validity ranged from 0.14 to 0.61 for omega 3 and magnesium, respectively. The exact concordances between methods ranged from 37% for omega 3 to 50.2% for magnesium (mean = 44.6%). An average disagreement of 13.4% was found. Conclusions: This study suggests that the ELSA-Brasil FFQ is suitable tool to assess dietary intake with a satisfactory reproducibility and relative validity.

Self-rated health has been extensively studied, but the utility of a similarly structured question to rate diet quality is not well characterized. This study aims to assess the relative validity of self-rated diet quality, compared with that of a validated diet quality measure (Healthy Eating Index-2015) and to examine the associations with cardiometabolic risk factors.Analyses were conducted in 2020-2021 using cross-sectional data from the National Health and Nutrition Examination Survey, 2011-2018. Nonpregnant adults who responded to the question: How healthy is your overall diet? and provided 2 dietary recalls were eligible (n=16,913). Associations between self-rated diet quality (modeled as a 5-point continuous variable, poor=1 to excellent=5) and Healthy Eating Index-2015 scores and cardiometabolic risk factors were assessed by linear regression, accounting for the complex survey design and adjusting for demographic and lifestyle characteristics.Self-rated diet quality was positively associated with total Healthy Eating Index-2015 scores (p0.001) and with all components except with Dairy (p=0.94) and Sodium (p=0.66). Higher self-rated diet quality was associated with lower BMI, waist circumference, glucose, insulin, triglycerides, and HbA1c and with higher high-density lipoprotein cholesterol (all p0.01). Positive associations with total diet quality persisted across all racial/ethnic groups, although the associations with individual dietary components varied. Higher self-ratings were most consistently associated with better-scored diet quality among individuals with BMI30 kg/mSelf-rated diet quality was associated with Healthy Eating Index-2015 scores and cardiometabolic disease risk factors. This single-item assessment may be useful in time-limited settings to quickly and easily identify patients in need of dietary counseling to improve cardiometabolic health.

Background In China, many people are regarded suitable for participating in regular physical examination for diagnosis and prevention of diseases. Some simplified food frequency questionnaires have been designed and used; however, the accuracy of the questionnaire is absent. This study aimed to examine the reliability and validity of simplified food frequency questionnaire (SFFQ) used among adults undergoing physical examination in southwest region of China. Methods This was a cross-sectional study conducted among physical health examination adults in the Southwest region of China. A total of 239 participants aged 20–65 were included from February 2019 to June 2019. The performance of SFFQ was evaluated by means of a three-day 24-h dietary record (3R24). The relative validity and agreement was assessed by Pearson’s correlation and intra-class correlation coefficients (ICC), respectively. Results The median energy-adjusted ICC of food groups between SFFQ2 and SFFQ1 was 0.59 (range: 0.49–0.73) and the ICC of nutrients was 0.47(range: 0.39–0.76). The Pearson correlation showed a valid comparisons between SFFQ1 and 3R24, ranging from -0.086 to 0.93 for food and 0.21 to 0.71 for nutrition, respectively. The energy-adjustment slightly increased the correlation coefficients. Conclusions The reliability and validity of SFFQ was acceptable, and it could be an appropriate dietary assessment tool for the future epidemiological studies conducted among physical health examination adults of southwest China. Trial registration CHiCTR, ChiCTR1900020934, Registered 22 January 2019, https://www.chictr.org.cn/edit.aspx?pid=35414&htm=4.

The aim of this study was to assess the ability of the FFQ to describe reliable and valid dietary pattern (DP) scores. In a total of 134 participants of the European Prospective Investigation into Cancer and Nutrition-Potsdam study aged 35–67 years, the FFQ was applied twice (baseline and after 1 year) to assess its reliability. Between November 1995 and March 1997, twelve 24-h dietary recalls (24HDR) as reference instrument were applied to assess the validity of the FFQ. Exploratory DP were derived by principal component analyses. Investigated predefined DP were the Alternative Healthy Eating Index (AHEI) and two Mediterranean diet indices. From dietary data of each FFQ, two exploratory DP were retained, but differed in highly loading food groups, resulting in moderate correlations (r 0·45–0·58). The predefined indices showed higher correlations between the FFQ (r(AHEI) 0·62, r(Mediterranean Diet Pyramid Index (MedPyr)) 0·62 and r(traditional Mediterranean Diet Score (tMDS)) 0·51). From 24HDR dietary data, one exploratory DP retained differed in composition to the first FFQ-based DP, but showed similarities to the second DP, reflected by a good correlation (r 0·70). The predefined DP correlated moderately (r 0·40–0·60). To conclude, long-term analyses on exploratory DP should be interpreted with caution, due to only moderate reliability. The validity differed extensively for the two exploratory DP. The investigated predefined DP showed a better reliability and a moderate validity, comparable to other studies. Within the two Mediterranean diet indices, the MedPyr performed better than the tMDs in this middle-aged, semi-urban German study population.

FFQ are one of the most widely used tools of research into nutritional epidemiology, and many studies have been conducted in several countries using this dietary assessment method. The present study aimed to evaluate the relative validity of FFQ, in comparison with other methods, in assessing dietary intake of children and adolescents, through a systematic review. Four electronic databases (Embase, PubMed, Scopus and Web of Science) found sixty-seven articles, which met the inclusion criteria (healthy children and adolescents from 3 to 18 years of age; journal articles written in English, Spanish and Portuguese between 1988 and March 2019; results showing the comparison between the FFQ with other methods of assessment of dietary intake). The articles were analysed by two independent reviewers. A meta-analysis was conducted using correlation coefficients as estimate effects between the FFQ and the reference standard method. Subgroup analysis and meta-regression were performed to identify the probable source of heterogeneity. In fifty-five of the sixty-seven studies, a single dietary assessment method was used to evaluate the FFQ; nine combined the two methods and three used three reference methods. The most widely used reference method was the 24-h recall, followed by the food record. The overall relative validity of the FFQ to estimate energy, macronutrient, certain micronutrient and certain food item intakes in children and adolescents may be considered weak. The study protocol was registered in PROSPERO under number CRD42016038706.

Objective:To adapt a short FFQ (SFFQ) and evaluate its relative validity and reproducibility to assess food group intake in a population resident in the Basque Country. Moreover, the possible influence of associated variables (such as education level) on its validity and reproducibility was determined.Design:Nine-day 24-h recalls (24HR) were used as a reference to explore validity over the course of 1 year. The degree of misclassification in the SFFQ was evaluated by a contingency table of quartiles and by Bland–Altman plots comparing SFFQ2 and 24HR. SFFQ was administered twice to explore reproducibility at 1 year.Setting:Basque Autonomous Community.Participants:Adults aged ≥21 years (n 99). The sample was randomly selected and representative of the target population.Results:For validity, statistically significant correlations were observed for more than half of the food groups, with the lowest correlations (r or ρ) for fat (–0·008) and the highest for other foods (0·963). The mean percentage of the subjects’ food intake that was classified into the same or adjacent quartile in both methods was 75·2 %. Reproducibility was explored by the correlation coefficient and ranged from 0·201 to 0·809, and 82·6 % of participants were in the same or adjacent quartile in both SFFQ. The associated variables did not seem to influence the validity and reproducibility of the SFFQ.Conclusions:An adapted SFFQ presented good reproducibility and validity for measuring most food groups in the target population, and these results did not seem to be influenced by the associated variables.

Summary Background & aims Cancer treatment requires attentiveness to its broader effect on the body. Cancer's effect on appetite, strength, and body composition is contained in the summary term malnutrition. The tools used to detect malnutrition are a critical part of effective cancer care. In clinical care, selection of any specific tool is random. The relative validity of these tools have not been systematically compared. Using hierarchical Bayesian latent-class meta-analysis methods, this report compares three tools used for adult cancer patients – the Mini Nutritional Assessment (MNA), the Nutritional Risk Screening 2002 (NRS-2002) and the Patient Generated Subjective Global Assessment (PG-SGA). Method Drawing from English and Chinese language databases, a broad pool of eligible studies were identified for further selection and assessment. Using the hierarchical summary receiver operating characteristic (HSROC) model, pooled sensitivity, specificity, and other measurements the accuracy of the three tools were compared. Result A total of 37 eligible studies involving the MNA, NRS-2002 and PG-SGA were included in this meta-analysis. The pooled sensitivity was 0.910 (95% CI: 0.763 to 0.970) for MNA, 0.747 (95% CI: 0.680 to 0.804) for NRS-2002, and 0.964 (95% CI: 0.913 to 0.986) for PG-SGA. The pooled specificity was 0.720 (95% CI: 0.623 to 0.800) for MNA, 0.854 (95% CI: 0.808 to 0.891) for NRS-2002, 0.905 (95% CI: 0.807 to 0.956) for PG-SGA, respectively. The back-calculated likelihood ratio (LR) showed that MNA had a low negative likelihood ratio (LR−), NRS-2002 corresponded to a high positive likelihood ratio (LR+) and PG-SGA represented the best LR+ and LR−. Conclusions While there is no standard approach to assessment of malnutrition, the PG-SGA has the best diagnostic performance with cancer patients. Further work is needed to refine the utility of these tools in larger clinical samples.

Objective:To assess the relative validity of a FFQ developed for the Pelotas Birth Cohort Studies.Design:Participants completed a ninety-two-food-item FFQ and then answered two 24-h recalls (24HR), one in-person interview and a second one by telephone, administered 14–28 d apart. Median and relative differences of energy, fifteen nutrients and eleven food groups were estimated based on the FFQ and the average of two 24HR. Nutrients were log-transformed and energy-adjusted using residual method. Validity was assessed by crude, energy-adjusted and de-attenuated Pearson and Lin’s concordance correlation coefficients. Agreement of quartiles and weighted κ were performed. Differences in energy and nutrient estimations between methods were plotted in Bland–Altman graphs.Setting:Pelotas, southern Brazil.Participants:Two hundred fifty-four participants randomly selected from the 1993 Pelotas Birth Cohort during the 22-year follow-up (2015).Results:The FFQ overestimated energy and most nutrients and food groups compared with the two 24HR. Energy-adjusted and de-attenuated Pearson correlation coefficients ranged from 0·21 to 0·66. The highest energy-adjusted and de-attenuated concordance correlation coefficients were observed for Ca (0·48), niacin (0·32), Na (0·29), vitamin C (0·28) and riboflavin (0·25). The percentage of nutrients classified into the same and opposite quartiles ranged from 36·5 to 60·3 %, and from 4·8 to 19·1 %, respectively. Weighted κ was moderate for Ca (0·51), beans and legumes (0·50) and milk and dairies (0·49).Conclusions:The FFQ provides a reasonable dietary intake assessment for habitual food consumption. However, the relative validity was weak for specific nutrients and food groups.

Background Dietary supplement use is common, particularly among cancer survivors and those at increased risk for cancer. Objective The objectives of this study were to assess 1-year test–retest reproducibility of dietary supplement use reported via food frequency questionnaire (FFQ-1 vs FFQ-2) and relative validity in comparison to repeated 24-hour dietary recalls (FFQ-2 vs DRs). Design This ancillary study was conducted within a large prospective cohort, the American Cancer Society’s Cancer Prevention Study-3. Participants/setting Between 2015 and 2016, 684 participants in the United States (64% women; 62% non-Hispanic White, 23% non-Hispanic Black, and 15% Hispanic) completed two FFQs and up to six unannounced telephone interviewer-administered DRs over 1 year as part of the Cancer Prevention Study-3 Diet Assessment Substudy. Primary outcome measures FFQs queried current multivitamin-mineral supplement (≥10 components) use, frequency and dose (range) for seven supplements taken individually or as part of a complex (individual/complex) including calcium, vitamins D, C, and E, folic acid, fish oil, and glucosamine. DRs allowed exact reporting of supplement frequency and dose. Statistical analyses Weighted κ statistics were used to evaluate reproducibility between FFQ-1 and FFQ-2 and Spearman correlation coefficients assessed agreement between supplemental nutrient amounts assessed by FFQ-2 and the average of DRs. Results Just more than half of the participants reported taking multivitamin-mineral supplements on the baseline FFQ. Kappa statistics for the comparison of categorical responses between FFQ-1 and FFQ-2 were 0.67 for multivitamin-mineral supplements. Kappas for individual/complex supplements ranged from 0.47 for folic acid to 0.74 for vitamin D, with a mean of 0.64. Results were similar between men and women. Spearman correlation coefficients comparing FFQ-2 with the average of DRs (validity) for nutrient intakes from all sources ranged from 0.65 (fish oil for women) to 0.77 (vitamin D for men and calcium for women); results were similar among men and women. Conclusions These findings suggest the FFQ used in Cancer Prevention Study-3 has good reproducibility over 1 year and yields estimates comparable to a more detailed assessment for commonly consumed dietary supplements.

Background UK Biobank is a large prospective cohort study containing accelerometer-based physical activity data with strong validity collected from 100,000 participants approximately 5 years after baseline. In contrast, the main cohort has multiple self-reported physical behaviours from > 500,000 participants with longer follow-up time, offering several epidemiological advantages. However, questionnaire methods typically suffer from greater measurement error, and at present there is no tested method for combining these diverse self-reported data to more comprehensively assess the overall dose of physical activity. This study aimed to use the accelerometry sub-cohort to calibrate the self-reported behavioural variables to produce a harmonised estimate of physical activity energy expenditure, and subsequently examine its reliability, validity, and associations with disease outcomes. Methods We calibrated 14 self-reported behavioural variables from the UK Biobank main cohort using the wrist accelerometry sub-cohort (n = 93,425), and used published equations to estimate physical activity energy expenditure (PAEESR). For comparison, we estimated physical activity based on the scoring criteria of the International Physical Activity Questionnaire, and by summing variables for occupational and leisure-time physical activity with no calibration. Test-retest reliability was assessed using data from the UK Biobank repeat assessment (n = 18,905) collected a mean of 4.3 years after baseline. Validity was assessed in an independent validation study (n = 98) with estimates based on doubly labelled water (PAEEDLW). In the main UK Biobank cohort (n = 374,352), Cox regression was used to estimate associations between PAEESR and fatal and non-fatal outcomes including all-cause, cardiovascular diseases, respiratory diseases, and cancers. Results PAEESR explained 27% variance in gold-standard PAEEDLW estimates, with no mean bias. However, error was strongly correlated with PAEEDLW (r = −.98; p SR had narrower range than the criterion. Test-retest reliability (Λ = .67) and relative validity (Spearman = .52) of PAEESR outperformed two common approaches for processing self-report data with no calibration. Predictive validity was demonstrated by associations with morbidity and mortality, e.g. 14% (95%CI: 11–17%) lower mortality for individuals meeting lower physical activity guidelines. Conclusions The PAEESR variable has good reliability and validity for ranking individuals, with no mean bias but correlated error at individual-level. PAEESR outperformed uncalibrated estimates and showed stronger inverse associations with disease outcomes.

Poor diet quality contributes significantly to cardiometabolic mortality in the US. Diet assessment methodology is burdensome and non-standardized. Screeners for clinical use that rapidly assess dietary choices associated with cardiometabolic risk could enhance prevention. This study evaluated the relative validity and reliability of the Diet Risk Screener (DRS) in a sample of US adults with the hypothesis that the DRS would correlate with a validated measure of diet quality. The DRS includes nine questions related to foods/food groups strongly associated with cardiometabolic mortality based on previous evidence. Adults ages 35-75 were recruited through a national health volunteer registry (ResearchMatch.org). Participants completed the DRS and a validated food frequency questionnaire (FFQ) (Vioscreen.com) in random order on one occasion. To assess reliability, participants who completed the DRS were asked to repeat it within three months. The DRS was scored 0 (low risk) to 27 (high risk) and compared with the Healthy Eating Index (HEI)-2015 calculated from the FFQ (max. score 100). The DRS was moderately correlated with HEI-2015 [(n=126, 87% female; mean HEI-2015: 63.3 (95% CI: 61.1, 65.4); mean DRS: 11.8 (95% CI: 10.8, 12.8); r=-0.6, p2 =0.36]. Furthermore, the DRS ranked 37% (n=47) of subjects in the same quintile and 41% (n=52) within ± 1 quintile of the HEI-2015 (weighted kappa=0.27). The DRS had high reliability (n=102, ICC: 0.83). Mean completion time was two minutes. The DRS may be useful in clinical or other time-limited settings to quickly identify individuals at high risk of diet-related preventable cardiometabolic mortality.

Background and Aims: Food frequency questionnaires (FFQ) have been widely used in epidemiologic studies since 1990s, but instruments need to be validated. The aim of this work was to create and assess the validity and reproducibility of an interview administered FFQ to be used in a Mexican women’s bone health cohort study, located in Monterrey city, Mexico. Methods: Validation of FFQ formed by 11 food groups and 136 food and beverage items was performed on 40–65-year-old Mexican women (n = 200) by applying 2 FFQ (test method) and six 24-h dietary recalls (24hR, reference method; 1 per season on weekdays and 2 on weekends). Pearson correlation coefficient was calculated of both logs, transformed intakes and energy-adjusted nutrient intakes based on the residual method, and intraclass correlation coefficients were calculated. Results: The relative validity of FFQ against the average of six 24hR for intakes of energy, macronutrients, cholesterol, water, vitamins and minerals required for bone metabolism such as vitamin D, calcium, magnesium, phosphorus were obtained. Pearson coefficients of correlation show significance (p < 0.05) for the validity, 0.244–0.820 and 0.258–0.794, for energy-unadjusted and adjusted data, respectively. Reproducibility coefficients range 0.186–0.810 for energy-unadjusted data and 0.174–0.597 for energy-adjusted data. Most nutrients showed lower than 5% of misclassification. Conclusion: The designed 136-item FFQ shows acceptable validity and reproducibility, and it is useful to be applied on 40–65-year-old Mexican women for the estimation of nutrient intakes in epidemiological studies.

International audience; BACKGROUND: The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group (QLG) has developed computerised adaptive tests (CATs) for the 14 functional and symptom domains of the EORTC QLQ-C30 quality of life questionnaire. This is expected to optimise measurement precision, relevance to patients and flexibility. Here, we present the first international validation of the EORTC CAT Core.METHODS: A heterogeneous sample of 699 cancer patients scheduled for chemotherapy and/or radiotherapy was recruited across seven European countries. The EORTC CAT Core and all QLQ-C30 items were administered to participants before and after initiating treatment. Correlations between CAT and QLQ-C30 scores and floor/ceiling effects were calculated. Using several grouping variables, relative validity (cross-sectional known groups difference), responsiveness (changes over time) and relative sample size requirements of the CAT compared to the QLQ-C30 were estimated.RESULTS: Correlations of the CAT and QLQ-C30 ranged from 0.81 to 0.93 across domains. The mean relative reduction in floor and ceiling effects using the CAT was 42% (range 3-99%). Analyses of known groups validity and responsiveness indicated that, across domains, mean sample size requirements for the CAT were 72% and 70%, respectively, of those using the QLQ-C30.CONCLUSIONS: The EORTC CAT Core measures the same domains as the QLQ-C30 with reduced floor/ceiling effects. The CAT generally facilitated the use of smaller samples (about 30% smaller on average) without loss of power compared to the QLQ-C30. Based on this study, the EORTC QLG will release the EORTC CAT Core for general use.

IntroductionValidation studies are indispensable to test the appropriateness of dietary assessment methods used within epidemiological surveys to accurately assess food intake in young populations. The aim of this study was to examine the relative validity of the food group frequency questionnaire (FGFQ) used to assess dietary intake in the Childhood Obesity Surveillance Initiative.Materials and MethodsThis study was undertaken in a convenience sample of 33 Irish children aged 7–9 years old from urban Dublin-based primary schools. Food group intake estimates were collected with the FGFQand compared with those obtained with a 7-day semi-weighed food diary. Agreement between frequencies of intake between the two instruments were examined using Spearman's correlation coefficient, cross-classification analyses and weighted kappa.ResultsThe FGFQ over-estimated the number of portions for most of the food groups as compared with the reference method. Spearman correlation coefficients ranged from 0.75 (cheese) to 0.03 (flavoured milk). Level of agreement was moderate with an average correlation coefficient of 0.45. The proportion of children classified in the same category ranged from 96.9% (sweet treats) to 60.6% (vegetables). Misclassification was less than 15% for fruit, soft drinks, low fat milk, fish, savoury snacks and sweet treats and above 30% for vegetables, dairy products and pastries & biscuits. Weighted kappa statistic values ranged from 0.84 (sweet treats) to 0.10 (vegetables). Mean level of agreement was moderate (0.39). No agreement (< 0.0) was found for soft drinks.DiscussionAlthough the strength of association estimates varied by food group, strong to moderate levels of relative validity were observed. Our results show that the FGFQ gives acceptable estimates of food group intakes among Irish school-aged children and that the tool can be used for ranking subjects according to food group intakes.