The estimation of cholesterol intake in elderly: reliability and validity of short, Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ)

Purpose: High intake of cholesterol leads to cardiovascular disruption. Estimating the actual intake of cholesterol can be beneficial for nutrition intervention. This research aimed to develop Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ) to estimate cholesterol intake and analyze its reliability and validity. Methods: SQ-FFQ was developed by sorting high cholesterol food items in Indonesian food database and food items' availability. A total of 30 older adults were randomly chosen from Public Health Center in Jagir District, Surabaya, Indonesia to test its validity. Reliability test was done by measuring the same developed SQ-FFQ in one-month period, while validity test was done by comparing SQ-FFQ results with 6-days food record. Statistical analysis used for reliability test was paired t-test, the Intra-class Correlation Coefficient (ICC), and Cronbach's α to measure the internal consistency. Meanwhile, validity of developed SQ-FFQ was analyzed using paired t-test and Bland-Altman. Results: Reliability of 2 administered SQ-FFQs showed a good agreement based on paired t-test analysis (p = 0.200), ICC (0.609), and Cronbach's α (0.757). Strong agreement was found in most of food items, but agreements for egg yolk and fried duck were poor. Significant difference was found between those food items (p = 0.001 vs. p < 0.001, respectively) with mean difference were -25.3 mg and 46.2 mg. Validity of developed SQ-FFQ2 compared to 6-days food diary records also found a strong agreement based on paired t-test and the Bland-Altman analysis. Conclusion: This baseline research provides a reasonably valid and repeatable measure of cholesterol intake estimation that can be widely used in nutrition and public health study, especially in Indonesia. No study has been conducted in Indonesia on the development of tools to estimate the cholesterol intake.