Development, reproducibility and validity of a food frequency questionnaire among pregnant women adherent to the Mediterranean dietary pattern

Background & aims: Accurate dietary assessment tools are required to ensure that maternal diet supplies all the nutrients needed for fetal development. However, no dietary method could accurately estimate food intake during gestation. Food Frequency Questionnaires (FM), frequently used in epidemiological studies, estimate long term nutritional status of the target population. However, it is recommended to create and validate a FFQ compatible with the dietary habits of the studied population, to avoid cultural and social discrepancies. This study aimed to develop and test the reproducibility and the validity of a semi-quantitative FFQ compatible with the diet of Mediterranean and Middle-Eastern population, in a sample of Lebanese pregnant women. Methods: 128 women participated in the validation study, while 38 took part in the reproducibility phase, which was repeated in a time frame of 21 days. The FFQ was validated against a 24 h dietary recall (DR). Results: The intra class correlation coefficient (ICC) ranged from 0.935 for calcium to 0.984 for vitamin D (p value < 0.001), indicating an excellent reproducibility. A satisfactory agreement between the two dietary tools was demonstrated using Bland-Altman plot and Spearman's and Pearson's correlations coefficients which varied between 0.294 for iron to 0.762 for caloric intake (p value < 0.01). Conclusions: The newly developed FFQ englobing Mediterranean food items was culture specific and assessed the nutrient intake of our population. Administering this tool in future researches will help monitor the nutritional status of pregnant women, aiming at improving maternal and newborn health. (C) 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.