Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Nephrology
Published in: BMC Nephrology 1/2017

Open Access 01-12-2017 | Research article

Validity and reproducibility of a short food frequency questionnaire among patients with chronic kidney disease

Authors: Aurélie Affret, Sandra Wagner, Douae El Fatouhi, Courtney Dow, Emmanuelle Correia, Maryvonne Niravong, Françoise Clavel-Chapelon, Julie De Chefdebien, Denis Fouque, Bénédicte Stengel, Marie-Christine Boutron-Ruault, Guy Fagherazzi, on behalf of CKD-REIN study investigators

Published in: BMC Nephrology | Issue 1/2017

Login to get access

Abstract

Background

A balanced diet is essential to slowing the progression of chronic kidney disease (CKD) and managing the symptoms. Currently, no tool is available to easily and quickly assess energy and macronutrient intake in patients with non end-stage CKD.
We aimed to develop and evaluate the validity and reproducibility of a new short 49-item food frequency questionnaire (SFFQ) adapted to patients with CKD.

Methods

The CKD-REIN study is a prospective cohort that enrolled 3033 patients with moderate or advanced CKD from a national sample of nephrology clinics. A sub-sample of 201 patients completed the SFFQ twice, at a one-year interval and were included in the reproducibility study. During this interval, 127 patients also completed six 24-h recalls and were included in the validity study. Main nutrient and dietary intakes were computed. Validity was evaluated by calculating crude, energy-adjusted and de-attenuated correlation coefficients (CC) between FFQ and the mean of the 24-h recall results. Bland-Altman plots were performed and cross-classification into quintiles of consumption of each nutrient and food group was computed. Reproducibility between the two SFFQs was evaluated by intraclass CC (ICC).

Results

Regarding validity, CC ranged from 0.05 to 0.79 (unadjusted CC, median: 0.40) and 0.10 to 0.59 (de-attenuated CC, median: 0.35) for food group and nutrient intakes, respectively. Five of the most important nutrients of interest in CKD, i.e. protein, calcium, phosphorus, potassium, and sodium had de-attenuated CC of 0.46, 0.43, 0.39, 0.32, and 0.12, respectively. The median of classification into the same or adjacent quintiles was 68% and 65% for food and nutrient intakes, respectively, and ranged from 63% to 69% for the five nutrients mentioned before. Bland-Altman plots showed good agreement across the range of intakes. ICC ranged from 0.18 to 0.66 (median: 0.46).

Conclusions

The CKD-REIN SFFQ showed acceptable validity and reproducibility in a sample of patients with CKD, notably for CKD nutrients of importance. It can now be used in large-scale epidemiological studies to easily assess the relations between diet and CKD outcomes as well as in clinical routine. It may also serve as a basis for the development of FFQs in international CKD cohort networks.
Appendix
Available only for authorised users
Literature
1.
KDIGO 2012. Clinical practice guideline for the evaluation and Management of Chronic Kidney Disease. Kidney International Supplements (2013). 2013;3(1):73-90. Chapter 3.
2.
Ash S, Campbell KL, Bogard J, Millichamp A. Nutrition prescription to achieve positive outcomes in chronic kidney disease: a systematic review. Nutrients. 2014;6:416–51.CrossRefPubMedPubMedCentral
3.
4.
5.
Fouque D, Mitch WE. Low-protein diets in chronic kidney disease: are we finally reaching a consensus? Nephrol Dial Transplant. 2015;30:6–8.CrossRefPubMed
6.
Klahr S, Levey AS, Beck GJ, Caggiula AW, Hunsicker L, Kusek JW, et al. The effects of dietary protein restriction and blood-pressure control on the progression of chronic renal disease. Modification of diet in renal disease study group. N Engl J Med. 1994;330:877–84.CrossRefPubMed
7.
Menon V, Kopple JD, Wang X, Beck GJ, Collins AJ, Kusek JW, et al. Effect of a very low-protein diet on outcomes: long-term follow-up of the modification of diet in renal disease (MDRD) study. Am J Kidney Dis. 2009;53:208–17.CrossRefPubMed
8.
Fouque D, Pelletier S, Mafra D, Chauveau P. Nutrition and chronic kidney disease. Kidney International. 2011;80:348–57.
9.
Bross R, Noori N, Kovesdy CP, Murali SB, Benner D, Block G, et al. Dietary assessment of individuals with chronic kidney disease. Semin Dial. 2010;23:359–64.CrossRefPubMedPubMedCentral
10.
Gopinath B, Harris DC, Flood VM, Burlutsky G, Mitchell P. Associations between dairy food consumption and chronic kidney disease in older adults. Sci Rep. 2016;6:39532.CrossRefPubMedPubMedCentral
11.
Lew QJ, Jafar TH, Koh HW, Jin A, Chow KY, Yuan JM, et al. Red meat intake and risk of ESRD. J Am Soc Nephrol. 2017;28:304–12.CrossRefPubMed
12.
Mirmiran P, Yuzbashian E, Bahadoran Z, Asghari G, Azizi F. Dietary Acid-Base load and risk of chronic kidney disease in adults: Tehran lipid and glucose study. Iran J Kidney Dis. 2016;10:119–25.PubMed
13.
Diaz-Lopez A, Bullo M, Basora J, Martinez-Gonzalez MA, Guasch-Ferre M, Estruch R, et al. Cross-sectional associations between macronutrient intake and chronic kidney disease in a population at high cardiovascular risk. Clin Nutr. 2013;32:606–12.CrossRefPubMed
14.
Koning SH, Gansevoort RT, Mukamal KJ, Rimm EB, Bakker SJ, Joosten MM. Alcohol consumption is inversely associated with the risk of developing chronic kidney disease. Kidney Int. 2015;87:1009–16.CrossRefPubMed
15.
Nerbass FB, Pecoits-Filho R, McIntyre NJ, McIntyre CW, Willingham FC, Taal MW. Demographic associations of high estimated sodium intake and frequency of consumption of high-sodium foods in people with chronic kidney disease stage 3 in England. J Ren Nutr. 2014;24:236–42.CrossRefPubMed
16.
Domingos MAM, Goulart AC, Lotufo PA, Bensenor IJM, Titan SMO. Chronic kidney disease - determinants of progression and cardiovascular risk. PROGREDIR cohort study: design and methods. Sao Paulo Med J. 2017;135:133–9.CrossRefPubMed
17.
Clavel-Chapelon F, van Liere MJ, Giubout C, Niravong MY, Goulard H, Le CC, et al. E3N, a French cohort study on cancer risk factors. E3N Group. Etude Epidemiologique aupres de femmes de l'Education Nationale. Eur J Cancer Prev. 1997;6:473–8.CrossRefPubMed
18.
19.
Montagni I, Guichard E, Carpenet C, Tzourio C, Kurth T. Screen time exposure and reporting of headaches in young adults: a cross-sectional study. Cephalalgia. 2015;36(11):1020-7. doi:10.​1177/​0333102415620286​.
20.
Vandentorren S, Bois C, Pirus C, Sarter H, Salines G, Leridon H. Rationales, design and recruitment for the Elfe longitudinal study. BMC Pediatr. 2009;9:58.CrossRefPubMedPubMedCentral
21.
Vercambre MN, Boutron-Ruault MC, Niravong M, Berr C, Clavel-Chapelon F, Ragusa S. Performance of a short dietary questionnaire to assess nutrient intake using regression-based weights. Public Health Nutr. 2009;12:547–52.CrossRefPubMed
22.
Giovannelli J, Dallongeville J, Wagner A, Bongard V, Laillet B, Marecaux N, et al. Validation of a short, qualitative food frequency questionnaire in French adults participating in the MONA LISA-NUT study 2005-2007. J Acad Nutr Diet. 2014;114:552–61.CrossRefPubMed
23.
Barrat E, Aubineau N, Maillot M, Derbord E, Barthes P, Lescuyer JF, et al. Repeatability and relative validity of a quantitative food-frequency questionnaire among French adults. Food Nutr Res. 2012;56:1,18472, doi: 10.​3402/​fnr.​v56i0.​18472.
24.
Kipnis V, Midthune D, Freedman L, Bingham S, Day NE, Riboli E, et al. Bias in dietary-report instruments and its implications for nutritional epidemiology. Public Health Nutr. 2002;5:915–23.CrossRefPubMed
25.
Stengel B, Combe C, Jacquelinet C, Briancon S, Fouque D, Laville M, et al. The French chronic kidney disease-renal epidemiology and information network (CKD-REIN) cohort study: to better understand chronic kidney disease. Nephrol Ther. 2016;12(Suppl 1):S49–56.CrossRefPubMed
26.
Cottet V, Touvier M, Fournier A, Touillaud MS, Lafay L, Clavel-Chapelon F, et al. Postmenopausal breast cancer risk and dietary patterns in the E3N-EPIC prospective cohort study. Am J Epidemiol. 2009;170:1257–67.CrossRefPubMed
27.
FAO/WHO/ONU. Report of a join expert consultation. Energy and protein requirements. Geneva: WHO Technical Report; 1985.
28.
Schofield WN. Predicting basal metabolic rate, new standards and review of previous work. Hum Nutr Clin Nutr. 1985;39(Suppl 1):5–41.PubMed
29.
Bonifacj C, Gerber M, Scali J, Daures JP. Comparison of dietary assessment methods in a southern French population: use of weighed records, estimated-diet records and a food-frequency questionnaire. Eur J Clin Nutr. 1997;51:217–31.CrossRefPubMed
30.
Deschamps V, de Lauzon-Guillain B, Lafay L, Borys JM, Charles MA, Romon M. Reproducibility and relative validity of a food-frequency questionnaire among French adults and adolescents. Eur J Clin Nutr. 2009;63:282–91.CrossRefPubMed
31.
Kesse-Guyot E, Castetbon K, Touvier M, Hercberg S, Galan P. Relative validity and reproducibility of a food frequency questionnaire designed for French adults. Ann Nutr Metab. 2010;57:153–62.CrossRefPubMed
32.
van Liere MJ, Lucas F, Clavel F, Slimani N, Villeminot S. Relative validity and reproducibility of a French dietary history questionnaire. Int J Epidemiol. 1997;26(Suppl 1):S128–36.CrossRefPubMed
33.
34.
Lucas F, Niravong M, Villeminot S, Kaaks R, Clavel-Chapelon F. Estimation of food portion size using photographs: relative validity, strengths, weaknesses and recommendations. J Hum Nutr Diet. 1995;8:65–74.CrossRef
35.
36.
Rosner B, Willett WC. Interval estimates for correlation coefficients corrected for within-person variation: implications for study design and hypothesis testing. Am J Epidemiol. 1988;127:377–86.CrossRefPubMed
37.
Willett WC. Nutritional epidemiology. New York: Oxford University Press edn; 1998.CrossRef
38.
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–10.CrossRefPubMed
39.
Bland JM, Altman DG. Agreed statistics: measurement method comparison. Anesthesiology. 2012;116:182–5.CrossRefPubMed
40.
Douglas G. Altman: practical statistics for medical research. Chap 14; 1990. p. 396–403.
41.
Hebert JR, Hurley TG, Steck SE, Miller DR, Tabung FK, Peterson KE, et al. Considering the value of dietary assessment data in informing nutrition-related health policy. Adv Nutr. 2014;5:447–55.CrossRefPubMedPubMedCentral
42.
Cade J, Thompson R, Burley V, Warm D. Development, validation and utilisation of food-frequency questionnaires - a review. Public Health Nutr. 2002;5:567–87.CrossRefPubMed
43.
Molag ML, de Vries JH, Ocke MC, Dagnelie PC, van den Brandt PA, Jansen MC, et al. Design characteristics of food frequency questionnaires in relation to their validity. Am J Epidemiol. 2007;166:1468–78.CrossRefPubMed
44.
45.
Potosky AL, Block G, Hartman AM. The apparent validity of diet questionnaires is influenced by number of diet-record days used for comparison. J Am Diet Assoc. 1990;90:810–3.PubMed
46.
Mennen LI, Bertrais S, Galan P, Arnault N. Potier de CG, Hercberg S. The use of computerised 24 h dietary recalls in the French SU.VI.MAX study: number of recalls required. Eur J Clin Nutr. 2002;56:659–65.CrossRefPubMed
47.
Stram DO, Longnecker MP, Shames L, Kolonel LN, Wilkens LR, Pike MC, et al. Cost-efficient design of a diet validation study. Am J Epidemiol. 1995;142:353–62.CrossRefPubMed
48.
Hebert JR, Ma Y, Clemow L, Ockene IS, Saperia G, Stanek EJ III, et al. Gender differences in social desirability and social approval bias in dietary self-report. Am J Epidemiol. 1997;146:1046–55.CrossRefPubMed
49.
Hebert JR, Ebbeling CB, Matthews CE, Hurley TG, Ma Y, Druker S, et al. Systematic errors in middle-aged women's estimates of energy intake: comparing three self-report measures to total energy expenditure from doubly labeled water. Ann Epidemiol. 2002;12:577–86.CrossRefPubMed
50.
Haute Autorité de santé.. Guide du parcours de soins. Maladie rénale Chronique de l'adulte. Saint-Denis, HAS, avril 2012, 29 pages.
51.
Pietinen P, Hartman AM, Haapa E, Rasanen L, Haapakoski J, Palmgren J, et al. Reproducibility and validity of dietary assessment instruments. II. A qualitative food frequency questionnaire. Am J Epidemiol. 1988;128:667–76.CrossRefPubMed
52.
Kaaks R, Slimani N, Riboli E. Pilot phase studies on the accuracy of dietary intake measurements in the EPIC project: overall evaluation of results. European prospective investigation into cancer and nutrition. Int J Epidemiol. 1997;26(Suppl 1):S26–36.CrossRefPubMed
53.
Tsubono Y, Nishino Y, Fukao A, Hisamichi S, Tsugane S. Temporal change in the reproducibility of a self-administered food frequency questionnaire. Am J Epidemiol. 1995;142:1231–5.CrossRefPubMed
54.
Cade JE, Burley VJ, Warm DL, Thompson RL, Margetts BM. Food-frequency questionnaires: a review of their design, validation and utilisation. Nutr Res Rev. 2004;17:5–22.CrossRefPubMed
55.
Asghari G, Rezazadeh A, Hosseini-Esfahani F, Mehrabi Y, Mirmiran P, Azizi F. Reliability, comparative validity and stability of dietary patterns derived from an FFQ in the Tehran lipid and glucose study. Br J Nutr. 2012;108:1109–17.CrossRefPubMed
56.
Barclay AW, Flood VM, Brand-Miller JC, Mitchell P. Validity of carbohydrate, glycaemic index and glycaemic load data obtained using a semi-quantitative food-frequency questionnaire. Public Health Nutr. 2008;11:573–80.CrossRefPubMed
57.
Fernandez-Ballart JD, Pinol JL, Zazpe I, Corella D, Carrasco P, Toledo E, et al. Relative validity of a semi-quantitative food-frequency questionnaire in an elderly Mediterranean population of Spain. Br J Nutr. 2010;103:1808–16.CrossRefPubMed
58.
Hankin JH, Stram DO, Arakawa K, Park S, Low SH, Lee HP, et al. Singapore Chinese health study: development, validation, and calibration of the quantitative food frequency questionnaire. Nutr Cancer. 2001;39:187–95.CrossRefPubMed
59.
Mannato LW, Pereira TS, Velasquez-Melendez G, Cardoso LO, Bensenor 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;133:414–20.CrossRefPubMed
60.
Beaton GH. Approaches to analysis of dietary data: relationship between planned analyses and choice of methodology. Am J Clin Nutr. 1994;59:253S–61S.PubMed
61.
Dienemann T, Fujii N, Orlandi P, Nessel L, Furth SL, Hoy WE, et al. International network of chronic kidney disease cohort studies (iNET-CKD): a global network of chronic kidney disease cohorts. BMC Nephrol. 2016;17:121.CrossRefPubMedPubMedCentral
Metadata
Title
Validity and reproducibility of a short food frequency questionnaire among patients with chronic kidney disease
Authors
Aurélie Affret
Sandra Wagner
Douae El Fatouhi
Courtney Dow
Emmanuelle Correia
Maryvonne Niravong
Françoise Clavel-Chapelon
Julie De Chefdebien
Denis Fouque
Bénédicte Stengel
Marie-Christine Boutron-Ruault
Guy Fagherazzi
on behalf of CKD-REIN study investigators
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2017
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-017-0695-2

Other articles of this Issue 1/2017

BMC Nephrology 1/2017 Go to the issue

Research article

A retrospective study to assess the evaluation of living related kidney donors and their outcomes following nephrectomy at Kenyatta National Hospital

Case report

Steroid-resistant nephrotic syndrome as the initial presentation of nail-patella syndrome: a case of a de novo LMX1B mutation

Research article

Effect of large weight reductions on measured and estimated kidney function

Research article

VDJ gene usage among B-cell receptors in ABO-incompatible kidney transplantation determined by RNA-seq Transcriptomic analysis

Research article

Identification of compound heterozygous patients with primary hyperoxaluria type 1: clinical evaluations and in silico investigations

Research article

Effect of tolvaptan on renal water and sodium excretion and blood pressure during nitric oxide inhibition: a dose-response study in healthy subjects
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits