Research Research and Professional Briefs| Volume 114, ISSUE 7, P1046-1052, July 2014

Download started.


Validation of a Food Frequency Questionnaire to Assess Macronutrient and Micronutrient Intake among Jordanians

Published:November 12, 2013DOI:


      The aim of this study was to examine the validity and reliability of a food frequency questionnaire (FFQ) among a convenience sample of healthy adults in Jordan. A modified version of the questionnaire known as Diet History Questionnaire I, which measures dietary intakes over a 1-year period, was administrated to 101 apparently healthy men and women recruited from three large medical centers in Jordan. Fifty-five participants completed the modified FFQ and three 24-hour recalls. Participants (N=101) completed the FFQ two times separated by a 1-month period. Reliability of the FFQ was assessed using test–retest method. Mean age of participants was 33.4±18.5 years. Energy, carbohydrate, fiber, fat, saturated fat, calcium, and iron had deattenuated correlations of .732, .563, .544, .487, .484, .451, and .459, respectively. The FFQ and 24-hour recalls produced similar agreement percentages ranging between 25.5% and 43.6%. Mean energy-adjusted reliability coefficients ranged from .695 to .943. A Cronbach's α for the total FFQ items of .857 was found. The modified FFQ has reasonable relative validity and reliability for energy, carbohydrate, fiber, fat, saturated fat, calcium, and iron intakes in Jordanian adults over a 1-year period. However, its application may require additional modifications and validation efforts. Future research is warranted to further modify and test the FFQ in a larger and more diverse sample of Jordanians as well as to develop FFQ for the use among other age groups.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Cade J.E.
        • Burley V.J.
        • Warm D.L.
        • Thompson R.L.
        • Margetts B.M.
        Food-frequency questionnaires: A review of their design, validation and utilisation.
        Nutr Res Rev. 2004; 17: 5-22
        • Baer H.J.
        • Blum R.E.
        • Rockett H.R.
        • et al.
        Use of a food frequency questionnaire in American Indian and Caucasian pregnant women: A validation study.
        BMC Public Health. 2005; 5: 135
        • Fumagalli F.
        • Pontes Monteiro J.
        • Sartorelli D.S.
        • Vieira M.N.
        • de Lourdes Pires Bianchi M.
        Validation of a food frequency questionnaire for assessing dietary nutrients in Brazilian children 5 to 10 years of age.
        Nutrition. 2008; 24: 427-432
        • Bae Y.J.
        • Choi H.Y.
        • Sung M.K.
        • Kim M.K.
        • Choi M.K.
        Validity and reproducibility of a food frequency questionnaire to assess dietary nutrients for prevention and management of metabolic syndrome in Korea.
        Nutr Res Pract. 2010; 4: 121-127
        • Day N.
        • McKeown N.
        • Wong M.
        • Welch A.
        • Bingham S.
        Epidemiological assessment of diet: A comparison of a 7-day diary with a food frequency questionnaire using urinary markers of nitrogen, potassium and sodium.
        Int J Epidemiol. 2001; 30: 309-317
        • Torheim L.E.
        • Barikmo I.
        • Hatloy A.
        • et al.
        Validation of a quantitative food-frequency questionnaire for use in Western Mali.
        Public Health Nutr. 2001; 4: 1267-1277
        • Cade J.
        • Thompson R.
        • Burley V.
        • Warm D.
        Development, validation and utilisation of food-frequency questionnaires—a review.
        Public Health Nutr. 2002; 5: 567-587
        • Katsouyanni K.
        • Rimm E.B.
        • Gnardellis C.
        • Trichopoulos D.
        • Polychronopoulos E.
        • Trichopoulou A.
        Reproducibility and relative validity of an extensive semi-quantitative food frequency questionnaire using dietary records and biochemical markers among Greek schoolteachers.
        Int J Epidemiol. 1997; 26: S118-S127
        • Bohlscheid-Thomas S.
        • Hoting I.
        • Boeing H.
        • Wahrendorf J.
        Reproducibility and relative validity of energy and macronutrient intake of a food frequency questionnaire developed for the German part of the EPIC project. European Prospective Investigation into Cancer and Nutrition.
        Int J Epidemiol. 1997; 26: S71-S81
        • Sharma S.
        • Cao X.
        • Gittelsohn J.
        • et al.
        Dietary intake and development of a quantitative food-frequency questionnaire for a lifestyle intervention to reduce the risk of chronic diseases in Canadian First Nations in north-western Ontario.
        Public Health Nutr. 2008; 11: 831-840
        • Subar A.F.
        • Thompson F.E.
        • Kipnis V.
        • et al.
        Comparative validation of the Block, Willett, and National Cancer Institute food frequency questionnaires: The Eating at America's Table Study.
        Am J Epidemiol. 2001; 154: 1089-1099
        • Bawadi H.A.
        • Al-Shwayat N.
        Developing meal-planning exchange list for traditional dishes in Jordan.
        Am Diet Assoc. 2008; 108: 840-846
        • Bawadi H.A.
        • Al-Shwayat N.
        • Tayyem R.F.
        Developing exchange system for desserts and appetizers common in the Jordanian cuisine.
        Nutr Diet. 2009; 66: 20-26
        • Browner W.S.
        • Newman T.B.
        • Hulley S.B.
        Estimating sample size and power: Applications and examples.
        in: Hulley S.B. Cummings S.R. Browner W.S. Grady D.G. Newman T.B. Designing Clinical Research: An Epidemiologic Approach. 3rd ed. Lippincott Williams and Wilkins, Philadelphia, PA2007: 65-96
        • Willett W.
        • Stampfer M.J.
        Total energy intake: Implications for epidemiologic analyses.
        Am J Epidemiol. 1986; 124: 17-27
        • Masson L.F.
        • McNeill G.
        • Tomany J.O.
        • et al.
        Statistical approaches for assessing the relative validity of a food-frequency questionnaire: Use of correlation coefficients and the kappa statistic.
        Public Health Nutr. 2003; 6: 313-321
        • Willett W.C.
        • Sampson L.
        • Stampfer M.J.
        • et al.
        Reproducibility and validity of a semiquantitative food frequency questionnaire.
        Am J Epidemiol. 1985; 122: 51-65
        • Bountziouka V.
        • Bathrellou E.
        • Giotopoulou A.
        • et al.
        Development, repeatability and validity regarding energy and macronutrient intake of a semi-quantitative food frequency questionnaire: Methodological considerations.
        Nutr Metab Cardiovasc Dis. 2012; 22: 659-667
        • Carroll R.J.
        • Pee D.
        • Freedman L.S.
        • Brown C.C.
        Statistical design of calibration studies.
        Am J Clin Nutr. 1997; 65: 1187S-1189S
        • Stram D.O.
        • Longnecker M.P.
        • Shames L.
        • et al.
        Cost-efficient design of a diet validation study.
        Am J Epidemiol. 1995; 142: 353-362
        • Thompson F.E.
        • Kipnis V.
        • Midthune D.
        • et al.
        Performance of a food-frequency questionnaire in the US NIH-AARP (National Institutes of Health-American Association of Retired Persons) Diet and Health Study.
        Public Health Nutr. 2008; 11: 183-195
        • Osowski J.M.
        • Beare T.
        • Specker B.
        Validation of a food frequency questionnaire for assessment of calcium and bone-related nutrient intake in rural populations.
        J Am Diet Assoc. 2007; 107: 1349-1355
        • Sevak L.
        • Mangtani P.
        • McCormack V.
        • Bhakta D.
        • Kassam-Khamis T.
        • dos Santos Silva I.
        Validation of a food frequency questionnaire to assess macro- and micro-nutrient intake among South Asians in the United Kingdom.
        Eur J Nutr. 2004; 43: 160-168
        • Flagg E.W.
        • Coates R.J.
        • Calle E.E.
        • Potischman N.
        • Thun M.J.
        Validation of the American Cancer Society Cancer Prevention Study II Nutrition Survey Cohort Food Frequency Questionnaire.
        Epidemiology. 2000; 11: 462-468
        • Iqbal R.
        • Ajayan K.
        • Bharathi A.V.
        • et al.
        Refinement and validation of an FFQ developed to estimate macro- and micronutrient intakes in a south Indian population.
        Public Health Nutr. 2009; 12: 12-18
        • Willett W.
        Nutritional Epidemiology.
        2nd ed. Oxford University Press, New York, NY1998
        • Hernandez-Avila M.
        • Romieu I.
        • Parra S.
        • Hernandez-Avila J.
        • Madrigal H.
        • Willett W.
        Validity and reproducibility of a food frequency questionnaire to assess dietary intake of women living in Mexico City.
        Salud Publica Mex. 1998; 40: 133-140
        • Carithers T.C.
        • Talegawkar S.A.
        • Rowser M.L.
        • et al.
        Validity and calibration of food frequency questionnaires used with African-American adults in the Jackson Heart Study.
        J Am Diet Assoc. 2009; 109: 1184-1193
        • de la Fuente-Arrillaga C.
        • Ruiz Z.V.
        • Bes-Rastrollo M.
        • Sampson L.
        • Martinez-Gonzalez M.A.
        Reproducibility of an FFQ validated in Spain.
        Public Health Nutr. 2010; 13: 1364-1372
      1. Gliem JA, Gliem RR. Calculating, interpreting, and reporting Cronbach's alpha reliability coefficient for Likert-type Scale. Accessed March 3, 2013.

        • Al-Nsour M.
        • Zindah M.
        • Belbeisi A.
        • Hadaddin R.
        • Brown D.W.
        • Walke H.
        Prevalence of selected chronic, noncommunicable disease risk factors in Jordan: Results of the 2007 Jordan Behavioral Risk Factor Surveillance Survey.
        Prev Chronic Dis. 2012; 9: E25


      R. F. Tayyem is an associate professor, Department of Clinical Nutrition and Dietetics, The Hashemite University, Zarqa, Jordan.


      S. S. Abu-Mweis is an assistant professor, Department of Clinical Nutrition and Dietetics, The Hashemite University, Zarqa, Jordan.


      L. Agraib is a research assistant, Department of Clinical Nutrition and Dietetics, The Hashemite University, Zarqa, Jordan.


      K. Bani-Hani is a professor, Faculty of Medicine, The Hashemite University, Zarqa, Jordan.


      H. A. Bawadi is an associate professor, Department of Nutrition and Food Technology, Jordan University of Science and Technology, Al Ramtha, Irbid, Jordan.