Korean Journal of Community Nutrition

Research Articles

[Korean]
Development and Validation of a Questionnaire on the Feasibility of a Mobile Dietary Self-Monitoring Application: Heejin Lee, Jeong Sun Ahn, Jung Eun Lee; Korean J Community Nutr 2022;27(2):146-157. Published online April 30, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.2.146

Abstract PDF: Objectives
This study aimed to develop and assess the content validity and internal consistency of a questionnaire on the feasibility of mobile dietary self-monitoring applications.
Methods
We developed a feasibility questionnaire to assess the overall usage, convenience, usefulness, and satisfaction of mobile dietary applications. The initial draft of the questionnaire contained 17 items with yes/no, multiple-choice, and open-ended questions and 52 items on 5-point Likert scales. To validate the content, ten experts evaluated the relevance of the items for each subscale using a 5-point scale. We calculated the item-level content validity index (I-CVI) and scale-level content validity index (S-CVI). A total of 102 adults answered the questionnaires which reflected the experts' reviews. We conducted an exploratory factor analysis to determine the underlying structure of responses and categorized convenience, usefulness, and satisfaction. We also calculated Cronbach's alpha coefficient to examine the internal consistency of items in each subscale.
Results
The S-CVI score of the items was 0.86, and we removed items with an I-CVI score of < 0.80. We combined, revised, or separated some remaining items and added one item as per the experts' comments. As a result, we included 16 items about overall usage and 42 sub-questions. Based on the responses of the 102 adults, we performed exploratory factor analysis using the principal axis method. We retained items with a factor loading of > 0.40, resulting in a final set of 35 questions (convenience: 15, usefulness: 12, satisfaction: 8 items). The Cronbach's alpha values of the three scales were 0.93, 0.91, and 0.91 for 1) usefulness, 2) convenience, and 3) satisfaction, respectively.
Conclusions
We developed a feasibility questionnaire for mobile dietary self-monitoring applications and examined its content validity and internal consistency. Our questionnaire has the potential to measure the feasibility of mobile dietary self-monitoring applications.

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[English]
Validity of Estimating Sodium Intake using a Mobile Phone Application of 24-hour Dietary Recall with Meal Photos: Seo-Yoon Kim, Sang-Jin Chung; Korean J Community Nutr 2020;25(4):317-328. Published online August 31, 2020; DOI: https://doi.org/10.5720/kjcn.2020.25.4.317

Objective
The objective of this study was to verify the validity of a mobile phone application (app) that applies a 24-hour dietary recall with meal photos, as a means of being a more accurate method of estimating dietary sodium intake.
Methods
Of the 203 subjects enrolled, 172 subjects (84 males and 88 females) were selected for the final analysis, excluding those with an intake less than 500 kcal and urine output less than 500 ml. Dietary sodium assessment methods used for comparing with the 24-hour urinary sodium excretion are as follows: 1) face-to-face 24-hour dietary recall, 2) 24-hour dietary recall using the mobile app, 3) face-to-face 24-hour dietary recall considering liquid intakes from soup, stew, water kimchi and noodle, etc (liquid-based dishes), 4) 24-hour dietary recall using the mobile app considering liquid intakes from liquid-based dishes, and 5) food frequency questionnaire. Repeated ANOVA with Bonferroni method was used for comparing the average sodium intake, and Pearson’s correlation was applied to correlate the methods used.
Results
In women, no significant difference was observed in the average sodium intake between all methods. Moreover, analysis in men and total adults revealed no significant difference between the 24-hour urinary sodium secretion, and 24-hour dietary recall using the app and 24-hour dietary recall using the app considering liquid intakes. Sodium intake by food frequency questionnaire was significantly different when compared with the intake determined from 24-hour urinary sodium excretion. Sodium intake from all methods (except food frequency questionnaire) significantly correlated with values obtained from 24-hour urine sodium excretion.
Conclusions
Results of this study validated a mobile phone app using a 24-hour dietary recall with meal photos to better estimate dietary sodium intakes. It is believed that further studies in the future will enable the application as a tool to more accurately determine sodium intake.

Citations

Citations to this article as recorded by

Dietary Sodium and Fluid Restriction for Patients with Heart Failure
Eloisa Colin-Ramirez, Amitai Segev, Meghan Rozmahel, Justin Ezekowitz
Current Treatment Options in Cardiovascular Medicine.2024;[Epub] CrossRef
Comparison between 24-hour diet recall and 24-hour urine collection for estimating sodium and potassium intakes and their ratio among Korean adults
Taisun Hyun, Mi-Kyeong Choi, Young-Ran Heo, Heekyong Ro, Young-Hee Han, Yeon-Kyung Lee
Nutrition Research and Practice.2023; 17(2): 284. CrossRef
Validity of Interviewer-Administered 24-h Dietary Recalls in Older Korean Women: A Pilot Study
Seunghee Kim, Clara Y. Park
Nutrients.2023; 15(7): 1757. CrossRef

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Original Articles

[English]
A Study on Development and Validation of Food Frequency Questionnaire for Estimating Energy Intake of Women in Child-Bearing Age: Sun Kyung Ji, Hyung Sook Kim, Hay Mie Choi; Korean J Community Nutr 2008;13(1):111-124. Published online February 29, 2008

Abstract PDF: This study was conducted to develop a computerized food frequency questionnaire (FFQ) for assessing nutritional status of women of child-bearing age. Computerized food frequency questionnaire (FFQ) that reflect intakes of energy, carbohydrate, fat and protein was developed for women of child-bearing age. This FFQ is composed of 61 foods or food groups containing 192 dish items. To estimate of energy intake easily, we have developed a computer program that can be viewed on a computer screen in an actual size of dish items. Nutrient intakes of the last three months by the FFQ was validated with comparing the result of a 3-day diet record through 92 college students aged from 20 to 30. The level of energy, carbohydrate and sodium of estimating by the FFQ method was significantly higher than the level of a 3-day diet records method (p < 0.01). Pearson's correlation coefficients between the two methods were 0.50 for carbohydrate (p < 0.01), 0.55 for energy (p < 0.01) and 0.56 for protein (p < 0.01). Spearman's correlation coefficients were 0.53 for carbohydrate (p < 0.01), 0.55 for energy (p < 0.01) and 0.52 for protein (p < 0.01). The percent of subject in the lowest quartile in a 3-day diet record belonged to the first and second lowest quartile in food frequency questionnaire is 78.2% in energy, 91.3% in carbohydrate, 78.2% in protein, 69.5% in fat. Also, the percent of subject in the highest quartile in a 3-day diet record belong to the first and second highest quartile in food frequency questionnaire is 78.3% in energy, 73.9% in carbohydrate, 82.6% in protein, and 73.9% in fat. On the whole, the result of this study seemed to be in good agreement with other studies. Therefore, the FFQ developed by this study is considered to be a reliable tool to assess nutrients and food intakes for women of child-bearing age.

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[English]
Validation and Calibration of Semi-Quantitative Food Frequency Questionnaire: With Participants of the Korean Health and Genome Study: Younjhin Ahn, Ji Eun Lee, Nam Han Cho, Chol Shin, Chan Park, Berm Seok Oh, Kuchan Kimm; Korean J Community Nutr 2004;9(2):173-182. Published online April 30, 2004

Abstract PDF: We carried out a validation-calibration study of the food frequency questionnaire (FFQ) that we had previously developed for a community-based cohort of the Korean Genome and Health Study of the Korea National Genome Research Institute. We have collected a total of 254 3-day diet records (DRs) from 400 subjects, 200 each randomly selected from the two study cohorts of Ansung and Ansan. FFQ was administered at the time of cohort recruitment in 2001, and DRs were collected during a two month period from January through February of 2002. The mean age was 52.2 years. Farming for men and housewife for women were the most common occupations. The majority of the subjects had undergone 6~12 years of education. The general characteristics including demographic and other data were not different from the total cohort subjects. Absolute levels of consumed nutrients including total energy (energy), protein, fat, carbohydrate, calcium, phosphorus, sodium, potassium, iron, retinol, carotene, vitamin A, thiamin, riboflavin, niacin and vitamin C were compared. The average of energy intake was not significantly different between the data collected by the 2 methods. However, consumptions of protein and fat were higher in data of DRs, whereas that of carbohydrate was higher in FFQ data. Significant correlation of each nutrient consumption between the data sets was observed (p <0.05) except in the case of iron, while the average correlation coefficient between them was 0.22 ranging from 0.33 for energy to 0.11 for iron. The results of cross classification by quantile for exact classification ranged from 25.2% (carotene) to 35.0% (phosphorus), and from 64.6% (vitamin A) to 76.4% (retinol) for adjacent classification. The proportion of completely opposite classification was 8.1% in average. Calibration slope was estimated by regression and calibration parameters ranged from 0.025 for carotene to 0.423 for niacin. We conclude that the FFQ we have developed is an appropriate tool for assessing the nutrient intakes as ranking exposures in epidemiology studies in view that amounts of consumed nutrients obtained by FFQ were similar to those collected by DRs, that correlations between consumed nutrients collected by these methods were significant, and that classification results were relatively fair. The correlation coefficients, however, were lower than expected, which may be mainly due to the survey season. In fact, any short-term dietary survey cannot accurately reflect the overall dietary intakes that change heavily depending on seasons. Further studies including the analysis of chemical indices would be helpful for the studies of causal relationship between the diet and disease.

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[English]
The Development and Validation of a Food Frequency Questionnaire to Assess Diets of Korean Adolescents: Kyeong Sook Yim, Tae Young Lee, Hye Soon Park; Korean J Community Nutr 2003;8(2):149-159. Published online April 30, 2003

Abstract PDF: The purpose of this study was to develop and evaluate the validity of a food frequency questionnaire for Korean adolescents (FFQ-A) which could be used in clinical and epidemiological studies of the lifestyle and health of young people. The FFQ-A was designed to reflect the eating pattern of Korean adolescents, and was based on the 1998 Korean National Health and Nutrition Survey Reports. The FFQ-A had 25 food categories. A total of 125 subjects (aged 13 to 15 years) was recruited from a randomly chosen middle school in a middle-income neighborhood in Anyang, South Korea. Each subject completed a FFQ-A, as well as a three-day dietary record. Data from 117 subjects (boys 47, girls 70) was used in the final analyses. Data on the nutrients was analyzed to estimate the Pearson correlations, Spearman rank-order correlations and agreement with categories. The validity of the FFQ-A was assessed relative to a three-day dietary record. The Pearson correlation coefficients for all the subjects were 0.94, 0.87, 0.77, 0.79, 0.49 and 0.68 for energy, carbohydrate, protein, fat, calcium, and iron, respectively. Similarly the Spearman rank-order correlation coefficients were 0.94, 0.85, 0.79, 0.81, 0.46, and 0.77 for energy, carbohydrate, protein, fat, calcium and iron, respectively. The Kappa values for energy, carbohydrate, protein, fat, calcium, and iron were 0.88, 0.67, 0.63, 0.67, 0.26, and 0.59, respectively. The percentage for misclassification of the lowest quartile into the highest quartile or vice versa ranged from 0% (energy, carbohydrate, or fat) to 16.7% (Vitamin C). Therefore the FFQ-A has a reasonable ability to assess the energy, carbohydrate, protein and fat intakes as estimated from a three-day dietary record of Korean adolescents.

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