Development and Validation of Food Frequency Questionnaire (FFQ) for Brunei Adults

OBJECTIVES: To date, there is no specific validated food frequency questionnaire (FFQ) to assess the dietary intake among Brunei adults. This study aimed to develop and validate an FFQ specifically to determine the dietary intake of Bruneian adults. METHODS: Adults aged 18–59 years were approached through voluntary participation throughout Brunei. A total of 50 adults and 100 adults participated in the FFQ development and validation phase, respectively. A list of foods consumed was documented by a 3-day dietary recall (3DR). Consequently, two-day dietary record (2DR) was used as a reference method in the validation phase. Energy and macronutrients (carbohydrates, protein and fats) intake was included in the analysis. Spearman correlations, mean difference, cross-classification, Bland-Altman plot, and Cohen Kappa were used to assess validity. RESULTS: The FFQ consisted of 138 food items from 12 food groups. In the validation study, the FFQ was found to have over-estimated almost all nutrients compared to those in the dietary record. The percentage mean difference was more than 10%. The Spearman correlation coefficients for energy, carbohydrates, protein, and fat intake based on the FFQ and 2-day diet records were significantly correlated with 0.096,0.142, 0.911 and 0.172, respectively. The cross-classification into the same and adjacent quartiles was between 51–100% for macronutrients consumed. Bland-Altman plots showed relatively good agreement (between ±2 standard deviation) for both dietary methods used. Cohen's kappa ranges from 0.081 to 0.040, demonstrating weak agreement. CONCLUSIONS: The developed FFQ is a reasonably valid tool to appropriately estimate the dietary intake of Bruneian adults, as it showed a moderate agreement with dietary record for intake of energy and macronutrients. FUNDING SOURCES: No funding was provided for this research.