Development of a dish-based food frequency questionnaire for Iranian population.

Background: Food frequency questionnaires (FFQs) are widely used in large studies worldwide. They usually seek to rank people according to their usual food intake rather than a specific period of time. In the present study, we aimed to develop a dish-based, semi-quantitative FFQ to seek habitual diet of general population aged 9 to 65 years in Tehran. Methods: To develop the FFQ, four main steps were taken. At the beginning a list of commonly consumed Iranian foods and mixed dishes was prepared. To prevent excessive questionnaire length, some food items were grouped. Then, reference portion sizes were defined for each mixed dish in the list. The portion sizes were defined either based on the most common food portions reported in existing data or based on conventional portioning. In the third step the frequency response for consumption of food items and mixed dishes were determined. In the last step, recipes were developed for mixed dishes based on several data sources, including previous surveys. Finally, the content validity of the questionnaire was evaluated by the expert panel. Results: The final food list of the FFQ comprised 142 food items and mixed dishes in six major food groups, including dairy products, breads, mixed dishes, dried fruits, nuts and seeds, fruits and vegetables, and miscellaneous food items and beverages. Nine frequency response options for all food items varying from "never or less than once per month" to "more than 6 times a day" were considered. A portion size was included for each item, whether food items or mixed dishes. Conclusion: As Iranian food recipes are typically characterized by various ingredients it is very difficult for the respondent to recall the amount and type of the ingredients. Likewise, information about cooking methods beside ingredients of foods are important to estimate their nutritive values, which can be explored only through asking about consumption of mixed dishes. The current FFQ was developed to overcome the mentioned problems. It can be applied in nationwide studies in which foods and/or nutrients are predominant determinant of health and/or diseases.

Validity and reliability of a dish-based semi-quantitative food frequency questionnaire for assessment of energy and nutrient intake among Iranian adults.

OBJECTIVE: This study aimed to assess the validity and reliability of a dish-based, semi-quantitative food frequency questionnaire (DFFQ) for epidemiological studies in Iran. The DFFQ included 142 items (84 foods and 58 mixed dishes) which was filled in by 230 adults (110 men). All participants completed two separate DFFQs with a 6 months interval as well as six 24-h recalls, each month. Dietary biomarkers and anthropometric measurements were made. The validity was evaluated by comparing the DFFQ against 24-h dietary recalls and dietary biomarkers, including serum retinol and beta-carotene. Reliability was evaluated using intra-class correlation coefficient (ICC) and validity was determined by unadjusted and energy adjusted correlation coefficients (CC), de-attenuated CC, and cross-classification analyses. RESULTS: ICC for reliability ranged between 0.42 and 0.76. De-attenuated CC for the FFQ and the 24-h recalls ranged between 0.13 and 0.54 (Mean = 0.38). The de-attenuated CC between the DFFQ and plasma levels of retinol and beta-carotene were 0.58 (P = 0.0001) and 0.40 (P = 0.0001), respectively. Cross-classification analysis revealed that on average 73% were correctly classified into same or adjacent quartiles and 5% were classified in opposite quartiles.

Correction to: Validity and reliability of a dish-based semi-quantitative food frequency questionnaire for assessment of energy and nutrient intake among Iranian adults.

An amendment to this paper has been published and can be accessed via the original article.

Nutritional assessment for primary school children in tehran: an evaluation of dietary pattern with emphasis on snacks and meals consumption.

BACKGROUND: In order to provide better advice for prevention of obesity and eating disorders among children, there is a need to have more knowledge of their dietary patterns. This study examined meal and snacking patterns of primary school children in Tehran. METHODS: A total of 761 male and female primary school children from all educational areas in Tehran were recruited in a cross-sectional survey. The data was collected by interviewing the students and their mothers or caregivers. Information on food consumption patterns was collected by one 24-h-recall and one snack-oriented food frequency questionnaire which covered a period of 1 month. Means, standard deviations, frequencies, percentages, energy and nutrient analyzes and nutrient densities were reported. RESULTS: All of the students snacked at least once on the day of the survey. Snacks provided 38% of total energy intake by the students. Fruits and sweet snacks were consumed by almost all of the students during a week. Energy and most nutrient intakes from meals were greater than those consumed from snacks. Snacks had a higher density of fiber, carbohydrate, calcium, iron, vitamin C, riboflavin and thiamin and had a lower density of protein, fat and niacin, compared with main meals. Salty snacks such as extruded cheese curls (Cheetos) and chips were not consumed so often. CONCLUSIONS: Results provide detailed information about dietary patterns, which in turn enable development of targeted messages and/or interventions to improve nutritional status of school children.

Nutritional status of the Iranian children with physical disability: a cross-sectional study.

BACKGROUND: Malnutrition can potentially prone a disabled child to further morbidities thus imposing further suffering to the affected child and his/her family. This is the first report on the nutritional status of physically disabled children from Iran. METHODS: A total of 290 physically disabled children aged 6-12 years old, of both sexes, and from all specialized schools in Tehran, Meshed and Rasht were enrolled in a descriptive cross-sectional study. Dietary assessment was performed for disabled children using 24hr and food-frequency questionnaires. Weight and height were assessed and body mass index (BMI) was calculated for all subjects. RESULTS: In disabled children, while the mean energy intake was more than 90% of the amount required, mean calcium and iron intakes were 75.8% and 58.7% of the corresponding required amounts. Despite absence of significant difference in energy and fat intake, the intakes of protein, calcium and riboflavin were significantly lower in girls than in boys. Z score of weight showed that over 40% of disabled girls and boys were underweight. Comparison with anthropometric data from other studies showed that low weight was more prevalent in disabled than in non-disabled children (p<0.001). Moreover, both disabled boys and girls had significantly shorter statures than their non-disabled counterparts. CONCLUSIONS: Malnutrition (low weight and stunting) is quite prevalent among Iranian children with motor disabilities and it is more prevalent in girls than in boys. It seems that poor food composition is a more important contributing factor than total low calorie intake. These data warrant further studies.