Validation of a food consumer frequency questionnaire for pregnant women in primary Health Care Units
DOI:
https://doi.org/10.7322/jhgd.v30.9972Keywords:
Questionnaires, Pregnant woman, Validation studies, Food consumptionAbstract
Introduction: The Food Consumption Frequency Questionnaire (FCFQ) is a tool for assessing food consumption. However, to be used in pregnant women, it must be submitted to validation. The food consumption of pregnant women can impact on maternal and child health, becoming a public health issue. The questionnaire applied during pregnancy can create parameters for better prenatal care.
Objective: To validate a FCFQ for pregnant women attended at primary health care units.
Methods: The Food Consumption Frequency Questionnaire and two 24-hour recall were applied to 155 pregnant women from the municipality of Montes Claros, Minas Gerais, Brazil. The questionnaire results were contrasted with the average of the two 24- hour recall using the chi-square test. The mean of the differences were estimated by limits of agreement. Pearson's correlation test and Intraclass Correlation Coefficient as well were used. Food consumption medians and quartiles were calculated.
Results: The value of estimate energy consumption and most nutrients was higher by the questionnaire. The concordance between the methods in the classification in quartiles of consumption was variable, being similar for 26.11% and opposite for 12.1%. After adjusting for energy, the correlation coefficient ranged from -0.144 (carbohydrate) to 0.337 (potassium). The questionnaire estimated values were approximately 1.94 higher than the 24 hour recall, corresponding to 20% higher for almost all nutrients.
Conclusion: The FCFQ showed to be a good instrument to be considered clinically as well as for research purposes in Brazilian pregnant women, this tool measures appropriately food intake which is fundamental for establishing health conditions during pregnancy, helping to assess the association between diet, nutrition and health..
Downloads
Download data is not yet available.
References
1. Christian P, Mullany LC, Hurley KM, Katz J, Black RE. Nutrition and maternal, neonatal, and child health. Semin Perinatol. 2015;39(5):361-72. DOI: https://doi.org/10.1053/j.semperi.2015.06.009
2. Gomes CB, Vasconcelos LG, Cintra RMGC, Dias LCGD, Carvalhaes MABL. Hábitos alimentares das gestantes brasileiras: revisão integrativa da literatura. Cienc Saúde Coletiva. 2019;24(6):2293-2306. DOI: http://dx.doi.org/10.1590/1413-81232018246.14702017
3. Oliveira T, Marquitti FD, Carvalhaes MABL, Sartorelli DS. Desenvolvimento de um Questionário Quantitativo de Frequência Alimentar (QQFA) para gestantes usuárias de unidades básicas de saúde de Ribeirão Preto, São Paulo, Brasil. Cad Saude Publica. 2010;26(12):2296-306. DOI: http://dx.doi.org/10.1590/S0102-311X2010001200008
4. Willett WC. Future directions in the development of food-frequency questionnaires. Am J Clin Nutr. 1994;59(Suppl1):171S-4. DOI: https://doi.org/10.1093/ajcn/59.1.171S
5. Willett WC. Nutritional epidemiology. 2 ed. New York: Oxford University Press, 1998.
6. Zhang H, Qiu X, Zhang C, Zhang K, Xiao M, Yi N, et al. Reproducibility and relative validity of a semi-quantitative food frequency questionnaire for Chinese pregnant women. Nutr J. 2015;14:56. DOI: https://doi.org/10.1186/s12937-015-0044-x
7. Dwarkanath P, Soares MJ, Thomas T, Vaz M, Swaminathan S, Kurpad AV. Food Frequency Questionnaire is a valid tool for the assessment of dietary habits of South Indian pregnant women. Asia Pac J Public Health. 2014;26(5): 494-506. DOI: https://doi.org/10.1177/1010539512459945
8. Isobe MT, Bertola MR, Zuccolotto DCC, Sartorelli DS. Influência da escolaridade na reprodutibilidade de um questionário quantitativo de frequência alimentar para gestantes. Rev Bras Saúde Mater Infant. 2013;13(1):23-8. DOI: http://doi.org/10.1590/S1519-38292013000100003
9. Vian I, Zielinsky P, Zilio AM, Mello A, Lazzeri B, Oliveira A, et al. Development and validation of a food frequency questionnaire for consumption of polyphenol-rich foods in pregnant women. Matern Child Nutr. 2015;11(4):511-24. DOI: http://doi.org/10.1111/mcn.12025
10. Barbieri P, Nishimura RY, Crivellenti LC, Sartorelli DS. Relative validation of a quantitative FFQ for use in Brazilian pregnant women. Public Health Nutr. 2013;16(8): 1419-26. DOI: http://doi.org/10.1017/S1368980012003783
11. Barbieri P, Crivellenti LC, Nishimura RY, Sartorelli DS. Validation of a food frequency questionnaire to assess food group intake by pregnant women. J Hum Nutr Diet. 2015;28(Suppl 1):38-44. DOI: http://doi.org/10.1111/jhn.12224
12. Zangirolami-Raimundo J, Echeimberg JO, Leone C. Research methodology topics: Cross-sectional studies. J Hum Growth Dev. 2018;28(3):356-360. DOI: http://dx.doi.org/10.7322/jhgd.152198
13. Willett W, Lenart E. Reproducibility and validity of food-frequency questionnaires. In: Willett W. Nutritional epidemiology. New York: Oxford University Press, 1998. p. 101-47.
14. Cade J, Thompson R, Burley V, Warm D. Development, validation and utilization of food-frequency questionnaires – a review. Public Health Nutr. 2002;5(4):567-87. DOI: https://dx.doi.org/10.1079/PHN2001318
15. Ribeiro AC, Sávio KEO, Rodrigues MLCF, Costa THM, Schmitz BAS. Validação de um questionário de frequência de consumo alimentar para população adulta. Rev Nutr. 2006;19(5):553-62. DOI: http://dx.doi.org/10.1590/S1415-52732006000500003
16. Monteiro JP, Pfrimer K, Tremeschin MH, Molina MC, Chiarello PC. Nutrição e metabolismo. Consumo alimentar: visualizando porções. Rio de Janeiro: Guanabara Koogan, 2007.
17. Núcleo de Estudos e Pesquisas em Alimentação (NEPA). Universidade Estadual de Campinas (UNICAMP). Tabela brasileira de composição de alimentos (TACO). 4 ed. Campinas: UNICAMP, 2011.
18. Universidade Federal de São Paulo (UNIFESP). Tabela de composição química dos alimentos. São Paulo: Departamento de Informática em Saúde. [cited 2015 Jul 02] Available from: http://www.unifesp.br/dis/servicos/nutri/
19. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307-10.
20. Giacomello A, Schmidt MI, Nunes MAA, Duncan BB, Soares RM, Manzolli P, et al. Validação relativa de questionário de frequência alimentar em gestantes usuárias de serviços do sistema único de saúde em dois municípios no Rio Grande do Sul, Brasil. Rev Bras Saúde Matern Infant. 2008;8(4):445-54. DOI: http://dx.doi.org/10.1590/S1519-38292008000400010
21. Molina MCB, Benseñor IM, Cardoso LO, Velasquez-Meléndez G, Drehmer M, Pereira TSS, et al. Reprodutibilidade e validade relativa do questionário de frequência alimentar do ELSA-Brasil. Cad Saude Publica. 2013;29(2):379-89. DOI: http://dx.doi.org/10.1590/S0102-311X2013000200024
22. Zanolla AF, Olinto MTA, Henn RL, Wahrlich V, Anjos LA. Avaliação de reprodutibilidade e validade de um questionário de frequência alimentar em adultos residentes em Porto Alegre, Rio Grande do Sul, Brasil. Cad Saude Publica. 2009;25(4): 840-8. DOI: http://dx.doi.org/10.1590/S0102-311X2009000400015
23. Machado FCS, Henn RL, Olinto MTA, Anjos LA, Wahrlich V, Waissmann W. Reprodutibilidade e validade de um questionário de frequência alimentar por grupos de alimentos, em adultos da Região Metropolitana de Porto Alegre, Brasil. Rev Nutr 2012; 25(1):65-77. DOI: http://dx.doi.org/10.1590/S1415-52732012000100007
24. Voci SM, Enes CC, Slater B. Validação do questionário de frequência alimentar para adolescentes (QFAA) por grupo de alimentos em uma população de escolares. Rev Bras Epidemiol 2008;11(4):561-72. DOI: http://dx.doi.org/10.1590/S1415-790X2008000400005
25. Mannato LW, Pereira TSS, Velasquez-Melendez G, Cardoso LO, Benseñor IM, Molina MC. Comparison of a short version of the Food Frequency Questionnaire with its long version - a cross-sectional analysis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Sao Paulo Med J. 2015;133(5):414-20. DOI: http://dx.doi.org/10.1590/1516-3180.2014.00533004
26. Baer HJ, Blun RE, Rockett HRH, Leppert J, Gardner JD, Suitor CW, et al. Use of a food frequency questionnaire in American Indian and Caucasian pregnant women: a validation study. BMC Public Health. 2005;5:135. DOI: https://doi.org/10.1186/1471-2458-5-135
27. Mouratidou T, Ford F, Fraser RB. Validation of a food-frequency questionnaire for use in pregnancy. Public Health Nutr. 2006;9(4):515-22. DOI: https://doi.org/10.1079/phn2005876
28. Yuan MY, He JR, Chen NN, Lu JH, Shen SY, Xiao WQ, et al. Validity and reproducibility of a dietary questionnaire for consumption frequencies of foods during pregnancy in the Born in Guangzhou Cohort Study (BIGCS). Nutrients. 2016;8(8): E454. DOI: https://doi.org/10.3390/nu8080454
29. Chen X, Zhao D, Mao X, Xia Y, Baker PN, Zhang H. Maternal dietary patterns and pregnancy outcome. Nutrients. 2016; 8(6):E351. DOI: https://doi.org/10.3390/nu8060351
30. Martins MA, Neves AN, Moss T, Martins WH, Pereira GV, Pessôa KVO, et al. Cross Cultural adaptation into Brazilian Portuguese language of Derriford Appearance Scale 24 (DAS-24) for people living with HIV/AIDS. J Hum Growth Dev. J Hum Growth Dev. 2019;29(2):200-15. http://dx.doi.org/10.7322/jhgd.000000
31. Almeida RC, Zachêu PRZ, Diniz MT, Dias MCCPO, Guiguer IC, Almeida RC, et al. Portuguese translation and Brazilian cultural adaptation of the Assessment of Burden in Chronic Venous Disease questionnaire (ABC-V). J Hum Growth Dev. 2018; 28(1):89-94. DOI: http://dx.doi.org/10.7322/jhgd.143885
32. Montoro APPN, Capistrano R, Ferrari EP, Reis MS, Cardoso FL, Beltrame TS. Concurrent validation of the MABC-2 and Developmental Coordination Disorder Questionnaire-BR. J Hum Growth Dev. 26(1): 74-80. DOI: http://dx.doi.org/10.7322/jhgd.110421
33. Badaró FAR, Araújo RC, Behlau M. The Copenhagen neck functional disability scale – CNFDS: translation and culturaladaptation to Brazilian portuguese. J Hum Growth Dev. 2014; 24(3):304-12. https://doi.org/10.7322/jhgd.88965
2. Gomes CB, Vasconcelos LG, Cintra RMGC, Dias LCGD, Carvalhaes MABL. Hábitos alimentares das gestantes brasileiras: revisão integrativa da literatura. Cienc Saúde Coletiva. 2019;24(6):2293-2306. DOI: http://dx.doi.org/10.1590/1413-81232018246.14702017
3. Oliveira T, Marquitti FD, Carvalhaes MABL, Sartorelli DS. Desenvolvimento de um Questionário Quantitativo de Frequência Alimentar (QQFA) para gestantes usuárias de unidades básicas de saúde de Ribeirão Preto, São Paulo, Brasil. Cad Saude Publica. 2010;26(12):2296-306. DOI: http://dx.doi.org/10.1590/S0102-311X2010001200008
4. Willett WC. Future directions in the development of food-frequency questionnaires. Am J Clin Nutr. 1994;59(Suppl1):171S-4. DOI: https://doi.org/10.1093/ajcn/59.1.171S
5. Willett WC. Nutritional epidemiology. 2 ed. New York: Oxford University Press, 1998.
6. Zhang H, Qiu X, Zhang C, Zhang K, Xiao M, Yi N, et al. Reproducibility and relative validity of a semi-quantitative food frequency questionnaire for Chinese pregnant women. Nutr J. 2015;14:56. DOI: https://doi.org/10.1186/s12937-015-0044-x
7. Dwarkanath P, Soares MJ, Thomas T, Vaz M, Swaminathan S, Kurpad AV. Food Frequency Questionnaire is a valid tool for the assessment of dietary habits of South Indian pregnant women. Asia Pac J Public Health. 2014;26(5): 494-506. DOI: https://doi.org/10.1177/1010539512459945
8. Isobe MT, Bertola MR, Zuccolotto DCC, Sartorelli DS. Influência da escolaridade na reprodutibilidade de um questionário quantitativo de frequência alimentar para gestantes. Rev Bras Saúde Mater Infant. 2013;13(1):23-8. DOI: http://doi.org/10.1590/S1519-38292013000100003
9. Vian I, Zielinsky P, Zilio AM, Mello A, Lazzeri B, Oliveira A, et al. Development and validation of a food frequency questionnaire for consumption of polyphenol-rich foods in pregnant women. Matern Child Nutr. 2015;11(4):511-24. DOI: http://doi.org/10.1111/mcn.12025
10. Barbieri P, Nishimura RY, Crivellenti LC, Sartorelli DS. Relative validation of a quantitative FFQ for use in Brazilian pregnant women. Public Health Nutr. 2013;16(8): 1419-26. DOI: http://doi.org/10.1017/S1368980012003783
11. Barbieri P, Crivellenti LC, Nishimura RY, Sartorelli DS. Validation of a food frequency questionnaire to assess food group intake by pregnant women. J Hum Nutr Diet. 2015;28(Suppl 1):38-44. DOI: http://doi.org/10.1111/jhn.12224
12. Zangirolami-Raimundo J, Echeimberg JO, Leone C. Research methodology topics: Cross-sectional studies. J Hum Growth Dev. 2018;28(3):356-360. DOI: http://dx.doi.org/10.7322/jhgd.152198
13. Willett W, Lenart E. Reproducibility and validity of food-frequency questionnaires. In: Willett W. Nutritional epidemiology. New York: Oxford University Press, 1998. p. 101-47.
14. Cade J, Thompson R, Burley V, Warm D. Development, validation and utilization of food-frequency questionnaires – a review. Public Health Nutr. 2002;5(4):567-87. DOI: https://dx.doi.org/10.1079/PHN2001318
15. Ribeiro AC, Sávio KEO, Rodrigues MLCF, Costa THM, Schmitz BAS. Validação de um questionário de frequência de consumo alimentar para população adulta. Rev Nutr. 2006;19(5):553-62. DOI: http://dx.doi.org/10.1590/S1415-52732006000500003
16. Monteiro JP, Pfrimer K, Tremeschin MH, Molina MC, Chiarello PC. Nutrição e metabolismo. Consumo alimentar: visualizando porções. Rio de Janeiro: Guanabara Koogan, 2007.
17. Núcleo de Estudos e Pesquisas em Alimentação (NEPA). Universidade Estadual de Campinas (UNICAMP). Tabela brasileira de composição de alimentos (TACO). 4 ed. Campinas: UNICAMP, 2011.
18. Universidade Federal de São Paulo (UNIFESP). Tabela de composição química dos alimentos. São Paulo: Departamento de Informática em Saúde. [cited 2015 Jul 02] Available from: http://www.unifesp.br/dis/servicos/nutri/
19. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307-10.
20. Giacomello A, Schmidt MI, Nunes MAA, Duncan BB, Soares RM, Manzolli P, et al. Validação relativa de questionário de frequência alimentar em gestantes usuárias de serviços do sistema único de saúde em dois municípios no Rio Grande do Sul, Brasil. Rev Bras Saúde Matern Infant. 2008;8(4):445-54. DOI: http://dx.doi.org/10.1590/S1519-38292008000400010
21. Molina MCB, Benseñor IM, Cardoso LO, Velasquez-Meléndez G, Drehmer M, Pereira TSS, et al. Reprodutibilidade e validade relativa do questionário de frequência alimentar do ELSA-Brasil. Cad Saude Publica. 2013;29(2):379-89. DOI: http://dx.doi.org/10.1590/S0102-311X2013000200024
22. Zanolla AF, Olinto MTA, Henn RL, Wahrlich V, Anjos LA. Avaliação de reprodutibilidade e validade de um questionário de frequência alimentar em adultos residentes em Porto Alegre, Rio Grande do Sul, Brasil. Cad Saude Publica. 2009;25(4): 840-8. DOI: http://dx.doi.org/10.1590/S0102-311X2009000400015
23. Machado FCS, Henn RL, Olinto MTA, Anjos LA, Wahrlich V, Waissmann W. Reprodutibilidade e validade de um questionário de frequência alimentar por grupos de alimentos, em adultos da Região Metropolitana de Porto Alegre, Brasil. Rev Nutr 2012; 25(1):65-77. DOI: http://dx.doi.org/10.1590/S1415-52732012000100007
24. Voci SM, Enes CC, Slater B. Validação do questionário de frequência alimentar para adolescentes (QFAA) por grupo de alimentos em uma população de escolares. Rev Bras Epidemiol 2008;11(4):561-72. DOI: http://dx.doi.org/10.1590/S1415-790X2008000400005
25. Mannato LW, Pereira TSS, Velasquez-Melendez G, Cardoso LO, Benseñor IM, Molina MC. Comparison of a short version of the Food Frequency Questionnaire with its long version - a cross-sectional analysis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Sao Paulo Med J. 2015;133(5):414-20. DOI: http://dx.doi.org/10.1590/1516-3180.2014.00533004
26. Baer HJ, Blun RE, Rockett HRH, Leppert J, Gardner JD, Suitor CW, et al. Use of a food frequency questionnaire in American Indian and Caucasian pregnant women: a validation study. BMC Public Health. 2005;5:135. DOI: https://doi.org/10.1186/1471-2458-5-135
27. Mouratidou T, Ford F, Fraser RB. Validation of a food-frequency questionnaire for use in pregnancy. Public Health Nutr. 2006;9(4):515-22. DOI: https://doi.org/10.1079/phn2005876
28. Yuan MY, He JR, Chen NN, Lu JH, Shen SY, Xiao WQ, et al. Validity and reproducibility of a dietary questionnaire for consumption frequencies of foods during pregnancy in the Born in Guangzhou Cohort Study (BIGCS). Nutrients. 2016;8(8): E454. DOI: https://doi.org/10.3390/nu8080454
29. Chen X, Zhao D, Mao X, Xia Y, Baker PN, Zhang H. Maternal dietary patterns and pregnancy outcome. Nutrients. 2016; 8(6):E351. DOI: https://doi.org/10.3390/nu8060351
30. Martins MA, Neves AN, Moss T, Martins WH, Pereira GV, Pessôa KVO, et al. Cross Cultural adaptation into Brazilian Portuguese language of Derriford Appearance Scale 24 (DAS-24) for people living with HIV/AIDS. J Hum Growth Dev. J Hum Growth Dev. 2019;29(2):200-15. http://dx.doi.org/10.7322/jhgd.000000
31. Almeida RC, Zachêu PRZ, Diniz MT, Dias MCCPO, Guiguer IC, Almeida RC, et al. Portuguese translation and Brazilian cultural adaptation of the Assessment of Burden in Chronic Venous Disease questionnaire (ABC-V). J Hum Growth Dev. 2018; 28(1):89-94. DOI: http://dx.doi.org/10.7322/jhgd.143885
32. Montoro APPN, Capistrano R, Ferrari EP, Reis MS, Cardoso FL, Beltrame TS. Concurrent validation of the MABC-2 and Developmental Coordination Disorder Questionnaire-BR. J Hum Growth Dev. 26(1): 74-80. DOI: http://dx.doi.org/10.7322/jhgd.110421
33. Badaró FAR, Araújo RC, Behlau M. The Copenhagen neck functional disability scale – CNFDS: translation and culturaladaptation to Brazilian portuguese. J Hum Growth Dev. 2014; 24(3):304-12. https://doi.org/10.7322/jhgd.88965
Downloads
Published
2020-03-27
Issue
Section
ORIGINAL ARTICLES
