Development and Validation of Computerized Semiquantitative Food Frequency Questionnaire for Koreans with High-Risk of Hypercholesterolemia

Cardiovascular disease has the highest mortality rate in South Korea. Previous studies have reported that serum cholesterol level relates to intake of dietary fat and cholesterol. Therefore, in this study we developed a semiquantitative food frequency questionnaire (FFQ) for Koreans with a high-risk of hypercholesterolemia and to validate the FFQ. Semiquantitative FFQ, which includes 160 food items, reflects intakes of energy, fat, saturated fatty acid (SFA), monounsaturated fatty acid (MUPA), polyunsaturated fatty acid (PUPA) and cholesterol. We chose food items from the previous study of our research group (Suh 1999) which reported a nutritional status of Korean adults with normocholesterolemia, borderline and hypercholesterolemia. To validate the FFQ, we compared the results of the FFQ with those of a 3-day food record using a paired t-test. In addition, we calculated Pearson's and Spearmen's correlation coefficients. Intakes assessed by the FFQ and a 3-day food record were classified into quartile and the degree of agreement was obtained. Fifty-five participants responded for the validation study by completing both the FFQ and a 3-day food record. Pearson's correlation coefficients between estimated intakes by respective methods for energy, fat, SF A, MUPA, PUPA and cholesterol were 0.32,0.41,0.37,0.41,0.37 and 0.21, respectively. Spearman's correlation coefficients of energy, fat, SF A, MUPA, PUPA, cholesterol were 0.31, 0.44, 0.39, 0.46, 0.46, and 0.37, respectively. Nutrient densities in 1000kcal were compared. Pearson's correlation coefficient of cholesterol density increased and other values were similar with original values. The average degree of agreement was 67％ that intakes of energy, fat, SF A, MUPA, PUPA and cholesterol assessed by the FFQ and 3-day food records were classified within the same and the adjacent quartile. On the average, 8％ were misclassified into the extreme opposite quartile. The average of weighted kappa was 0.46. In conclusion, the FFQ developed in this study is considered to be a reliable tool to assess nutrient intakes for Koreans with a risk of hypercholesterolemia because the FFQ reflects the intakes of energy, fat, SFA, MUFA, PUPA, and cholesterol.