Abstract
Background
Fermentable, short chain carbohydrates (FODMAPs) have been identified as triggers
for functional gastrointestinal symptoms. In addition, excess FODMAP consumption has
been implicated in the onset of Crohn's disease, and animal studies suggest that a
low glycemic index diet can impair absorption of fructose, a major dietary FODMAP.
Such hypotheses cannot be tested without the ability to quantify FODMAP ingestion
with a validated dietary assessment tool.
Objective
To assess the validity and reproducibility of a 297-item comprehensive, semi-quantitative
food frequency questionnaire (FFQ) in estimating intake of macro- and micronutrients,
FODMAPs, and glycemic index/load.
Subjects/setting
One hundred healthy participants were recruited to complete the FFQ on two occasions,
plus four 1-week food diaries kept during a 12-month period. Participants exhibiting
major dietary change during the study period or low energy reporting on the FFQ were
excluded.
Main outcome measures
Validation and reproducibility of the semi-quantitative FFQ by comparison with the
mean of four 1-week food diaries.
Statistical analyses performed
Validation was assessed using Wilcoxon signed rank test, Spearman's correlation, Bland-Altman,
and weighted κ statistics. Reproducibility was examined using Shrout-Fleiss intraclass
correlation coefficient.
Results
Seventy-two participants fulfilled inclusion and exclusion criteria. Demographics
of the participants were comparable with 2006 Australian Census data. Consistent with
other reported FFQs, the FFQ overestimated nutrient intake by a mean 140% (range=95%
to 249%). However, based on the other analyses performed, it demonstrated validity
for intake of sugars, fiber, alcohol, glycemic index, glucose, FODMAPs, calcium, folate,
phosphate, potassium, iron, and magnesium; moderate validation for energy, total fat,
saturated fat, carbohydrates, sodium, thiamin, sucrose, and retinol; poor validation
for protein, mono/polyunsaturated fat, starch, glycemic load, niacin, and zinc. Riboflavin
intake was not validated. Intraclass correlation coefficients for reproducibility
ranged from 0.352 to 0.928.
Conclusions
The FFQ was validated for assessment of a wide range of nutrients, including the new
class of carbohydrates, FODMAPs, and glycemic index. This provides a useful tool for
dietary research, particularly in the area of gastroenterological disorders.
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Biography
J. S. Barrett is an accredited practicing dietitian and lecturer, Monash University, Eastern Health Clinical School, Victoria, Australia.
Biography
P. R. Gibson is a gastroenterologist and head of school, Monash University, Eastern Health Clinical School, Victoria, Australia.
Article info
Publication history
Accepted:
May 7,
2010
Identification
Copyright
© 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.
