Validation of the European Prospective Investigation into Cancer (EPIC) FFQ for use among adults in Lebanon

Objective: To validate the European Prospective Investigation into Cancer (EPIC) FFQ in Lebanon. Design: Validation of the EPIC FFQ was done against three 24-h recalls (24-HR). Unadjusted and energy-adjusted correlations, Bland-Altman plots and weighed kappa statistics were used to assess the agreement between the two methods. Setting: Lebanon. Participants: 119 adults (staff and students) at a Lebanese University. Results: Good unadjusted and energy-adjusted correlation coefficients were found between data from the two methods which ranged from -0 center dot 002 (vitamin A) to 0 center dot 337 (carbohydrates) and were all statistically significant except for vitamin D, vitamin E, vitamin A, Se and niacin. Slight/fair agreement was reported through weighed kappa estimates for unadjusted data ranging from -0 center dot 05 (vitamin C) to 0 center dot 248 (Mg) and for energy-adjusted data ranging from -0 center dot 034 (vitamin A) to 0 center dot 203 (P). Individuals were categorised into exact and adjacent quartiles with an average of 78 % for unadjusted data and 70 % for energy-adjusted data, indicating a very good agreement between the EPIC FFQ and the average of the 24-HR data. The visual inspection of the Bland-Altman plots revealed an overestimation of energy, carbohydrates, protein and fat intakes by the FFQ method. Conclusion: Overall, when all tests were taken into consideration, the current study demonstrated an acceptable agreement of the EPIC FFQ with the 24-h dietary recall method and significantly good correlations between dietary intakes. Therefore, the EPIC FFQ can be considered a valid tool for assessing diet in epidemiological studies among Lebanese adults.