A food frequency questionnaire for hemodialysis patients in Bangladesh (BDHD-FFQ): development and validation

Diet is a recognized risk factor and cornerstone for chronic kidney disease (CKD) management; however, a tool to assess dietary intake among Bangladeshi dialysis patients is scarce. This study aims to validate a prototype Bangladeshi Hemodialysis Food Frequency Questionnaire (BDHD-FFQ) against 3-day...

Full description

Bibliographic Details
Main Authors: Ahmed, Shakil, Rahman, Tanjina, Ripon, Md Sajjadul Haque, Rashid, Harun Ur, Kashem, Tasnuva, Md Ali, Mohammad Syafiq, Khor, Ban Hock, Khosla, Pramod, Karupaiah, Tilakavati, Mat Daud, Zulfitri 'Azuan
Format: Article
Published: Multidisciplinary Digital Publishing Institute 2021
Online Access:http://psasir.upm.edu.my/id/eprint/95740/
_version_ 1848862213751701504
author Ahmed, Shakil
Rahman, Tanjina
Ripon, Md Sajjadul Haque
Rashid, Harun Ur
Kashem, Tasnuva
Md Ali, Mohammad Syafiq
Khor, Ban Hock
Khosla, Pramod
Karupaiah, Tilakavati
Mat Daud, Zulfitri 'Azuan
author_facet Ahmed, Shakil
Rahman, Tanjina
Ripon, Md Sajjadul Haque
Rashid, Harun Ur
Kashem, Tasnuva
Md Ali, Mohammad Syafiq
Khor, Ban Hock
Khosla, Pramod
Karupaiah, Tilakavati
Mat Daud, Zulfitri 'Azuan
author_sort Ahmed, Shakil
building UPM Institutional Repository
collection Online Access
description Diet is a recognized risk factor and cornerstone for chronic kidney disease (CKD) management; however, a tool to assess dietary intake among Bangladeshi dialysis patients is scarce. This study aims to validate a prototype Bangladeshi Hemodialysis Food Frequency Questionnaire (BDHD-FFQ) against 3-day dietary recall (3DDR) and corresponding serum biomarkers. Nutrients of interest were energy, macronutrients, potassium, phosphate, iron, sodium and calcium. The BDHD-FFQ, comprising 132 food items, was developed from 606 24-h recalls and had undergone face and content validation. Comprehensive facets of relative validity were ascertained using six statistical tests (correlation coefficient, percent difference, paired t-test, cross-quartiles classification, weighted kappa, and Bland-Altman analysis). Overall, the BDHD-FFQ showed acceptable to good correlations (p < 0.05) with 3DDR for the concerned nutrients in unadjusted and energy-adjusted models, but this correlation was diminished when adjusted for other covariates (age, gender, and BMI). Phosphate and potassium intake, estimated by the BDHD-FFQ, also correlated well with the corresponding serum biomarkers (p < 0.01) when compared to 3DDR (p > 0.05). Cross-quartile classification indicated that <10% of patients were incorrectly classified. Weighted kappa statistics showed agreement with all but iron. Bland-Altman analysis showed positive mean differences were observed for all nutrients when compared to 3DDR, whilst energy, carbohydrates, fat, iron, sodium, and potassium had percentage data points within the limit of agreement (mean ± 1.96 SD), above 95%. In summary, the BDHD-FFQ demonstrated an acceptable relative validity for most of the nutrients as four out of the six statistical tests fulfilled the cut-off standard in assessing dietary intake of CKD patients in Bangladesh.
first_indexed 2025-11-15T13:13:27Z
format Article
id upm-95740
institution Universiti Putra Malaysia
institution_category Local University
last_indexed 2025-11-15T13:13:27Z
publishDate 2021
publisher Multidisciplinary Digital Publishing Institute
recordtype eprints
repository_type Digital Repository
spelling upm-957402023-04-06T08:02:20Z http://psasir.upm.edu.my/id/eprint/95740/ A food frequency questionnaire for hemodialysis patients in Bangladesh (BDHD-FFQ): development and validation Ahmed, Shakil Rahman, Tanjina Ripon, Md Sajjadul Haque Rashid, Harun Ur Kashem, Tasnuva Md Ali, Mohammad Syafiq Khor, Ban Hock Khosla, Pramod Karupaiah, Tilakavati Mat Daud, Zulfitri 'Azuan Diet is a recognized risk factor and cornerstone for chronic kidney disease (CKD) management; however, a tool to assess dietary intake among Bangladeshi dialysis patients is scarce. This study aims to validate a prototype Bangladeshi Hemodialysis Food Frequency Questionnaire (BDHD-FFQ) against 3-day dietary recall (3DDR) and corresponding serum biomarkers. Nutrients of interest were energy, macronutrients, potassium, phosphate, iron, sodium and calcium. The BDHD-FFQ, comprising 132 food items, was developed from 606 24-h recalls and had undergone face and content validation. Comprehensive facets of relative validity were ascertained using six statistical tests (correlation coefficient, percent difference, paired t-test, cross-quartiles classification, weighted kappa, and Bland-Altman analysis). Overall, the BDHD-FFQ showed acceptable to good correlations (p < 0.05) with 3DDR for the concerned nutrients in unadjusted and energy-adjusted models, but this correlation was diminished when adjusted for other covariates (age, gender, and BMI). Phosphate and potassium intake, estimated by the BDHD-FFQ, also correlated well with the corresponding serum biomarkers (p < 0.01) when compared to 3DDR (p > 0.05). Cross-quartile classification indicated that <10% of patients were incorrectly classified. Weighted kappa statistics showed agreement with all but iron. Bland-Altman analysis showed positive mean differences were observed for all nutrients when compared to 3DDR, whilst energy, carbohydrates, fat, iron, sodium, and potassium had percentage data points within the limit of agreement (mean ± 1.96 SD), above 95%. In summary, the BDHD-FFQ demonstrated an acceptable relative validity for most of the nutrients as four out of the six statistical tests fulfilled the cut-off standard in assessing dietary intake of CKD patients in Bangladesh. Multidisciplinary Digital Publishing Institute 2021 Article PeerReviewed Ahmed, Shakil and Rahman, Tanjina and Ripon, Md Sajjadul Haque and Rashid, Harun Ur and Kashem, Tasnuva and Md Ali, Mohammad Syafiq and Khor, Ban Hock and Khosla, Pramod and Karupaiah, Tilakavati and Mat Daud, Zulfitri 'Azuan (2021) A food frequency questionnaire for hemodialysis patients in Bangladesh (BDHD-FFQ): development and validation. Nutrients, 13 (12). art. no. 4521. pp. 1-20. ISSN 2072-6643 https://www.mdpi.com/2072-6643/13/12/4521 10.3390/nu13124521
spellingShingle Ahmed, Shakil
Rahman, Tanjina
Ripon, Md Sajjadul Haque
Rashid, Harun Ur
Kashem, Tasnuva
Md Ali, Mohammad Syafiq
Khor, Ban Hock
Khosla, Pramod
Karupaiah, Tilakavati
Mat Daud, Zulfitri 'Azuan
A food frequency questionnaire for hemodialysis patients in Bangladesh (BDHD-FFQ): development and validation
title A food frequency questionnaire for hemodialysis patients in Bangladesh (BDHD-FFQ): development and validation
title_full A food frequency questionnaire for hemodialysis patients in Bangladesh (BDHD-FFQ): development and validation
title_fullStr A food frequency questionnaire for hemodialysis patients in Bangladesh (BDHD-FFQ): development and validation
title_full_unstemmed A food frequency questionnaire for hemodialysis patients in Bangladesh (BDHD-FFQ): development and validation
title_short A food frequency questionnaire for hemodialysis patients in Bangladesh (BDHD-FFQ): development and validation
title_sort food frequency questionnaire for hemodialysis patients in bangladesh (bdhd-ffq): development and validation
url http://psasir.upm.edu.my/id/eprint/95740/
http://psasir.upm.edu.my/id/eprint/95740/
http://psasir.upm.edu.my/id/eprint/95740/