Repeatability and validation of a short, semi-quantitative food frequency questionnaire designed for older adults living in Mediterranean areas: the MEDIS-FFQ

Department of Dietetics-Nutrition Science, Harokopio University, Athens, Greece.
Journal of Nutrition for the Elderly 07/2010; 29(3):311-24.
Source: PubMed


The aim of the present work was to evaluate the repeatability and the validity of a short food frequency questionnaire (FFQ) that could be used for older people living in Mediterranean areas. The semi-quantitative FFQ included questions regarding the frequency of consumption of the main food groups and beverages typically consumed in the Mediterranean areas as well as some questions regarding eating habits of older persons. During 2006-2007, for the repeatability assessment (within 10-30 days), 150 individuals (51 +/- 17 yrs, 40% males) were studied, while another 190 individuals (74 +/- 9 yrs, 52% males) were enrolled for the validation purposes. Agreement of the FFQ with the 3-day food records was evaluated using the Bland-Altman method and the Kendall's tau-b coefficient. Repeatability was tested using the Cohen's kappa coefficient. Between 3-day food records and the FFQ, good agreement for alcohol (tau-b = 0.64, p < 0.001) was found, while moderate agreement for food and beverage groups of greens (tau-b = 0.32, p < 0.001), fruits (tau-b = 0.35, p < 0.001), cereals (tau-b = 0.61, p < 0.001), sweets (tau-b = 0.51, p < 0.001), and coffee (tau-b = 0.58, p < 0.001) was observed. Low, but still significant, agreement for fish (tau-b = 0.21, p = 0.001), legumes (tau-b = 0.23, p < 0.001), vegetables (tau-b = 0.23, p < 0.001), pasta (tau-b = 0.25, p < 0.001), potatoes (tau-b = 0.17, p = 0.006) and meat consumption (tau-b = 0.14, p < 0.001) were also found. The FFQ was also valid regarding the estimation of macronutrients and energy intake. Sensitivity analyses by sex, age category (<or= or > 75 yrs), and education status showed similar validity of the FFQ in each subgroup, except for elders older than 75 years. The repeatability of the FFQ was fair in all foods tested (Cohen's kappa coefficients varied between 0.15-0.39, p-values < 0.05). The suggested FFQ seems to be a reasonably valid and repeatable measure of dietary intake and can be used in older persons living in the Mediterranean areas.

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    • "Dietary habits were assessed through a semi-quantitative, validated and reproducible food-frequency questionnaire (Tyrovolas et al., 2010). To evaluate the level of adherence to the Mediterranean diet, the MedDietScore (theoretical range 0- 55) was used (Panagiotakos et al., 2006). "
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    ABSTRACT: The definition and determinants of successful ageing is still controversial. Although dietary habits have long been associated with ageing, eating habits and behaviours have rarely been included in various proposed indices of successful ageing. The aim of this work was to evaluate determinants of successful ageing together with assessment of dietary habits in relation to healthcare facility use among elders living in the Mediterranean basin. During 2005-2011, 2663 elderly (aged 65-100 years) individuals from 21 Mediterranean islands and rural Mani region (Peloponnesus) were voluntarily enrolled in the study. A successful ageing index ranging from a score of 0 to a score of 10 was constructed using 10 attributes, i.e., education, financial status, physical activity, body mass index, depression, participation in social activities with friends and family, number of yearly excursions, number of cardiovascular disease risk factors and adherence to the Mediterranean diet. The applied factor analysis on the components of the index extracted three main components for successful ageing: phychosocial-economic, bioclinical and lifestyle; confirming the multiple dimensions of ageing. After adjusting for confounders, a 1/10-unit increase in the successful ageing index was associated with 0.8 less annual visits to healthcare centers (95%CI -1.2 to -0.4). Stratified analysis by gender revealed heterogeneity of factors predicting successful ageing. These findings suggest that successful ageing is a multidimensional and complex concept that exhibits gender heterogeneity. Annual use of health care services by the elders was found to be related to level of successful ageing.
    Full-text · Article · Sep 2014 · Experimental Gerontology
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    • "As already has been presented in previous reports from the MEDIS study [12,23] the dietary habits were assessed through a semi-quantitative, validated and reproducible food-frequency questionnaire [27]. To evaluate the level of adherence to the Mediterranean diet, the MedDietScore (possible range 0–55) was used [28]. "
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    ABSTRACT: Climate variation has long been studied in relation to human health. The aim of the present work was to evaluate the relationship between environmental humidity, and air temperature with the prevalence of diabetes, among elderly islanders. During 2005-2011, 1959 elderly (aged 65 to 100 years) individuals from 13 Mediterranean islands were enrolled. Socio-demographic, clinical and lifestyle factors were assessed using standard procedures. Diabetes was defined as fasting blood glucose levels > 125 mg/dl. Relative environmental humidity was measured as a percentage of air moisture and mean daily temperature in degrees Celsius. For the present analysis 713 men (74 +/- 7 years) and 596 women (73 +/- 7 years) with complete data were studied; 27% of both men and women had diabetes. The prevalence of diabetes was 42% in the elders living in high relative humidity areas (i.e., >70%) as compared with 24% among those living at low relative humidity residential areas (p < 0.001). After adjusting for age, sex and mean temperature, an increase in the area's relative humidity by 1 degree, increased the likelihood of having diabetes by 12% (OR = 1.12, 95%CI 1.05 to 1.20). No significant association was observed between mean temperature and diabetes (OR = 0.97, 95%CI 0.74, 1.26). A considerable proportion of elderly, especially those living in high relative humidity areas, had diabetes. Further research is needed to confirm this observation and to understand the underlying mechanisms.
    Full-text · Article · Feb 2014 · Journal of Diabetes and Metabolic Disorders
    • "Dietary habits were assessed through a semi-quantitative, validated, and reproducible food-frequency questionnaire (Tyrovolas et al. 2010). The frequency of consumption of various food groups and beverages (i.e., meat and meat products, fish and seafood, milk and milk products, fruits, vegetables , greens and salads, legumes, cereals, coffee, tea, and soft drinks) was assessed on a daily, weekly, or monthly basis. "
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    ABSTRACT: In the 1960s, the recorded dietary pattern of Southern European populations was typical of the traditional Mediterranean diet. However, diets have been rapidly changing. The aim of the current work was to examine the extent by which present food habits of inhabitants residing in various Mediterranean islands uphold past dietary traditions of the Mediterranean diet. A population-based, multi-stage sampling method was used to voluntarily enroll 876 men and 936 women (aged > 65 years) from 12 Mediterranean islands. Demographic, behavioral, clinical, and dietary data were collected. Principal component analysis derived fruits, vegetables, and greens as part of the main dietary pattern across most Mediterranean regions. Surprisingly, Crete had the highest frequency of fast-food and sweets consumption. Malta had the lowest frequency of fish and vegetable consumption and the lowest MedDietScore. As Mediterranean populations gradually move away from traditional dietary patterns, public-health efforts to preserve these diets are needed.
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