DEVELOPMENT AND VALIDATION OF FFQ SCREENER SOFTWARE FOR SODIUM INTAKE AMONG PALESTINIAN POPULATION
Loading...
Date
2023-07-17
Authors
Razan Arafat Mohammad Awwad
Journal Title
Journal ISSN
Volume Title
Publisher
An - Najah National University
Abstract
Background: A high intake of sodium leads to cardiovascular, renal, and immune system effects. It also increases mortality from cardiovascular disease. Traditional sodium evaluation methods such as food frequency questionnaires (FFQ), 24-hour recall, and 24-hour records are inefficient and prone to error. Smartphone applications and software enhance the efficiency and accuracy of dietary assessment. The study aims to design and test a software-based FFQ screener to evaluate Palestinian sodium intake. Also, the relationship between dietary sodium intake, practices, and the FFQ screener, 3-day food recall, and 24-hour urine sodium levels was evaluated.
Methodology: The study consists of four phases. In Phase 1, Palestinian foods were classified and subclassified by method of consumption, sodium concentration, and food group. The Palestinian food culture determined serving size and frequency, whereas a database of food composition evaluated sodium levels. Three databases of food composition were used to validate the values. In Phase 2, four nutrition experts and three related researchers assessed the content validity of the FFQ screener. The screener was revised in response to their recommendations. In Phase 3, a pilot study assessed the reliability of test-retests. In Phase 4, the criteria validity of the screener was evaluated by comparing FFQ sodium intake data to 24-hour urine sodium test (Gold standard 1) and 3-day recall (Gold standard 2) results. SPSS was used to compare and evaluate the results.
Results: The FFQ sodium screener included 41 food items organized into nine categories, with photo-based estimations of portion size and frequency of consumption for each. The reliability test revealed a Pearson correlation coefficient of 0.70 (p0.01) between the test and retest results for 22 individuals. The correlation value between FFQ screener software dietary sodium consumption and 24-hour urine sodium test was 0.6 (p0.000) for criterion validity. The correlation between the FFQ screener software and 3-day recall sodium intake was 0.3 (p0.0001). A significant correlation exists between sodium intake, preferences for low-sodium foods, and previous salt reduction (p0.05). FFQ sodium was unrelated to salting after cooking, salted meal selection, or sodium on product labels (p > 0.05).
Conclusions: Software FFQ screeners are a valid and reliable method for measuring sodium intake. Validation assures a reliable and innovative approach to measuring sodium in the diet. Photo-based portion size estimation improves the accuracy of diet evaluation.