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Development and evaluation of a food frequency questionnaire to assess daily total flavonoid intake using a rooibos intervention study model

Thesis (PhD)--Stellenbosch University, 2013.

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Main Author: Venter, Irma
Other Authors: Marnewick, Jeanine L.
Format: Thesis
Language:en_ZA
Published: Stellenbosch : Stellenbosch University 2013
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access_status_str Open Access
author Venter, Irma
author2 Marnewick, Jeanine L.
author_browse Marnewick, Jeanine L.
Venter, Irma
author_facet Marnewick, Jeanine L.
Venter, Irma
author_sort Venter, Irma
collection Thesis
dc_rights_str_mv Stellenbosch University
description Thesis (PhD)--Stellenbosch University, 2013.
format Thesis
id oai:scholar.sun.ac.za:10019.1/80019
institution Stellenbosch University (South Africa)
language en_ZA
last_indexed 2026-06-10T12:46:13.197Z
license_str Other — see source repository
provenance_str_mv Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository
publishDate 2013
publishDateRange 2013
publishDateSort 2013
publisher Stellenbosch : Stellenbosch University
publisherStr Stellenbosch : Stellenbosch University
record_format dspace
source_str SUNScholar — Stellenbosch University Repository
spelling oai:scholar.sun.ac.za:10019.1/80019 Development and evaluation of a food frequency questionnaire to assess daily total flavonoid intake using a rooibos intervention study model Venter, Irma Marnewick, Jeanine L. Herselman, Marietjie G. Nel, Daan G. Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Human Nutrition. Food frequency questionnaire Flavonoids Validity Reproducibility Responsiveness Dissertations -- Nutrition Theses -- Nutrition Rooibos tea -- Therapeutic use Thesis (PhD)--Stellenbosch University, 2013. ENGLISH ABSTRACT: A comprehensive food frequency questionnaire (FFQ) was developed to assess the daily total flavonoid intake over the past fortnight within a 14-week intervention that consisted of four periods to determine the effect of rooibos consumption on oxidative stress in adults (n=40) at intermediate to high coronary heart disease (CHD) risk. Within the intervention the comprehensive FFQ validity (against six estimated dietary records and biomarkers), reproducibility (on administrations in the washout and control periods six weeks apart as these periods had similar flavonoid intake restrictions) and responsiveness (across the four intervention periods of changed dietary conditions) was evaluated. The baseline period dietary record and FFQ dietary sources found to contribute most to the participants’ daily total flavonoid intake, considering the percentage contribution, and the between-person variation in intake, considering the stepwise multiple regression analysis, formed the food list of the resultant abbreviated FFQ. The validity, reproducibility and responsiveness of the latter were also evaluated within the intervention and its validity (against dietary records) and reproducibility (on re-administration two weeks apart) in an additional group (n=90) being at low and intermediate CHD risk to evaluate its external strength. The validity and reproducibility evaluations of the comprehensive and abbreviated FFQs in the intervention and abbreviated FFQ within the additional group comprised paired difference tests (to establish the ability to estimate group intakes), correlation coefficients (to establish the ability to rank individual participants), category agreement and gross misclassification next to the weighted kappa statistic (to establish the ability to classify the participants into tertiles and quintiles of intake) and Bland-Altman plots (as representation of the limits of agreement between the two dietary assessment methods). Correlation coefficients were also used for biomarker validity evaluations in the baseline period. The repeated measures analysis of variance (ANOVA) (Bonferroni correction) was used for the responsiveness evaluations of the comprehensive and abbreviated FFQs across the intervention periods alongside that of the biomarkers as evidence for the changed dietary conditions. The study demonstrated that the comprehensive FFQ could be modified to a format with a brief food list as few items contributed appreciably to the total flavonoid intake and of which most also contributed to the between-person intake variability. The comprehensive and moreover the abbreviated FFQ in the validity evaluations provided sufficiently accurate daily total flavonoid intake estimates. They could determine the intake at group level in correspondence with that of the dietary records. The participant intakes could additionally be categorized and in particular ranked greatly alike to the dietary record intakes. The Bland-Altman plots revealed proportional bias regarding overestimation at the higher intake level. The reproducibility also appeared to be greatly satisfactory although seasonal fruit exclusions from the abbreviated FFQ food list may hamper its repeated administration. Both FFQs also confirmed the changed total flavonoid intakes across the intervention periods in relation to changes in the expected direction concerning the plasma total polyphenol, conjugated diene and thiobarbituric acid reactive substance concentrations. AFRIKAANSE OPSOMMING: ‘n Omvattende voedsel frekwensie vraelys (VFV) is ontwikkel om die daaglikse totale flavonoïed inname oor twee agtereenvolgende weke te beraam te midde van ‘n 14-week intervensie. Die intervensie het uit vier periodes bestaan wat die effek van rooibosinname op oksidatiewe stres in volwassenes (n=40), met ‘n intermediêre tot hoë koronêre hartsiekte (KHS) risiko, bepaal het. Binne die intervensie is die geldigheid (teen ses geskatte dieetrekords en biochemiese merkers), herhaalbaarheid (op aanwending ses weke uitmekaar in die uitwas en kontrole intervensie periodes met dieselfde flavonoïed inname bepalings) en waarneembaarheid (oor vier intervensie periodes van veranderde dieet bepalings) van die omvattende VFV geëvalueer. Die dieetbronne in die basislyn periode dieetrekords en vraelyste wat die meeste tot die deelnemers se daaglikse totale flavonoïed inname (baseer op die persentasie bydrae) en die tussen-persoon variasie in inname (baseer op die stapsgewyse meervuldige regressie analise) bygedra het, het die voedsellys van die voortvloeiende verkorte VFV gevorm. Die geldigheid, herhaalbaarheid en waarneembaarheid van dié VFV is binne die intervensie geëvalueer en die geldigheid (teen dieetrekords) en herhaalbaarheid (heradministrasie twee weke later) daarvan in ‘n verdere groep (n=90) met lae en intermediêre KHS risiko as evaluasie van die eksterne vermoë van die VFV. Die geldigheid en herhaalbaarheid evaluasies van die omvattende en verkorte VFV in die intervensie en die verkorte VFV in die verdere groep het bestaan uit gepaarde verskil toetse (bepaling van die groepinname skattingsvermoë), korrelasie koëffisiënte (bepaling van individuele deelnemer rangorde skattingsvermoë), kategorie ooreenstemming en erge wanklassifikasie naas die aangepaste kappa statistiek (bepaling van die vermoë om die deelnemer innames in derdes en vyfdes te klassifiseer) en die Bland-Altman karterings (verteenwoordiging van ooreenstemmingslimiete tussen die twee dieetinname metodes). Korrelasie koëffisiënte is ook gebruik vir biochemiese merker geldigheid evaluasies in die basislyn periode. Die herhaalde metings analise van variansie (ANOVA) (Bonferroni regstelling) is gebruik om die waarneembaarheid evaluasies van die omvattende en verkorte VFV oor die intervensie periodes naas dit van die biochemiese merkers te evalueer as bewys van die veranderde dieet bepalings. Die studie het aangedui dat die omvattende VFV gewysig kon word tot ‘n formaat met ‘n verkorte voedsellys omdat slegs ‘n aantal items merkbaar tot die totale flavonoïed inname bygedra het en die meeste hiervan ook tot die tussen-persoon variasie in inname. Die omvattende en die verkorte VFV het in die geldigheid evaluasies daarvan voldoende akkurate daaglikse totale flavonoïed inname skattings opgelewer omdat groep innames bepaal kon word in ooreenstemming met dit verkry van die dieetrekords en die deelnemer innames bykomend kategoriseer en in besonder grootliks eenders rangeer kon word as met hul dieetrekord innames. ‘n Proporsionele oorskatting by die hoër inname vlakke is wel vir al twee getoon in die Bland-Altman karterings. Die herhaalbaarheid was ook grootliks aanvaarbaar, alhoewel seisoenale vrugte uitsluitings in die verkorte VFV voedsellys die heruitvoering kan bemoeilik. Al twee vraelyste kon ook die veranderinge in die daaglikse totale flavonoïed inname oor die intervensie periodes bevestig in ooreenstemming met veranderinge in die verwagte rigting van die plasma totale polifenool, konjugaat diëne en tiobarbituursuur reaktiewe stof konsentrasies. Doctoral 2013-02-18T14:24:20Z 2013-03-15T07:31:49Z 2013-02-18T14:24:20Z 2013-03-15T07:31:49Z 2013-03 Thesis http://hdl.handle.net/10019.1/80019 en_ZA Stellenbosch University 474 p. application/pdf Stellenbosch : Stellenbosch University
spellingShingle Food frequency questionnaire
Flavonoids
Validity
Reproducibility
Responsiveness
Dissertations -- Nutrition
Theses -- Nutrition
Rooibos tea -- Therapeutic use
Venter, Irma
Development and evaluation of a food frequency questionnaire to assess daily total flavonoid intake using a rooibos intervention study model
title Development and evaluation of a food frequency questionnaire to assess daily total flavonoid intake using a rooibos intervention study model
title_full Development and evaluation of a food frequency questionnaire to assess daily total flavonoid intake using a rooibos intervention study model
title_fullStr Development and evaluation of a food frequency questionnaire to assess daily total flavonoid intake using a rooibos intervention study model
title_full_unstemmed Development and evaluation of a food frequency questionnaire to assess daily total flavonoid intake using a rooibos intervention study model
title_short Development and evaluation of a food frequency questionnaire to assess daily total flavonoid intake using a rooibos intervention study model
title_sort development and evaluation of a food frequency questionnaire to assess daily total flavonoid intake using a rooibos intervention study model
topic Food frequency questionnaire
Flavonoids
Validity
Reproducibility
Responsiveness
Dissertations -- Nutrition
Theses -- Nutrition
Rooibos tea -- Therapeutic use
url http://hdl.handle.net/10019.1/80019
work_keys_str_mv AT venterirma developmentandevaluationofafoodfrequencyquestionnairetoassessdailytotalflavonoidintakeusingarooibosinterventionstudymodel