Development and validation of the FiberScreen: A short questionnaire to screen fibre intake in adults

Iris Rijnaarts, Nicole de Roos, Erwin G Zoetendal, Nicole de Wit, Ben J M Witteman, Iris Rijnaarts, Nicole de Roos, Erwin G Zoetendal, Nicole de Wit, Ben J M Witteman

Abstract

Background: Health effects of dietary fibres are the topic of many studies. Eligibility criteria often include a certain fibre intake, which requires dietary screening during recruitment. However, dietary assessment methods are extensive and burdensome for both the researcher and participant. Therefore, we developed and validated a short questionnaire (FiberScreen) to screen fibre intake.

Methods: The initial five-item questionnaire assessed fruit, vegetable, whole grain, pasta/rice/potato and legume intake. The optimised FiberScreen included 18 items, which further specified intake of the above-mentioned categories, and included nuts and seeds. The FiberScreen was completed during two fibre promoting interventions. In Study A, participants without constipation completed the five-item FiberScreen and a food frequency questionnaire (FFQ) during screening (n = 131), and the 18-item FiberScreen and a FFQ at 3-month follow-up (n = 87). In Study B, 29 constipated participants completed the 18-item FiberScreen at screening and a FFQ during the first study visit.

Results: The fibre estimate from the five-item FiberScreen and the FFQ was moderately correlated (r = 0.356, p < 0.001). Importantly, the 18-item FiberScreen and FFQ, when data of both studies were combined, had a strong correlation (r = 0.563, p < 0.001). The 18-item FiberScreen had a lower fibre estimate compared to the FFQ (Δ = 1.2 ± 5.9 g, p = 0.030) but the difference was relatively small. Bland-Altman plots showed a good agreement between the questionnaires. Completion time of the 18-item FiberScreen was 4.2 ± 2 min.

Conclusions: The 18-item FiberScreen is a suitable short screening questionnaire for ranking the fibre intake of adults. The 18-item FiberScreen can help to reduce screening burden for both the participant and researcher.

Trial registration: ClinicalTrials.gov NCT03848546 NCT04457791.

Keywords: comparability; dietary fibre; food frequency questionnaire; functional bowel disorders; questionnaire; screening.

Conflict of interest statement

The authors declare that there are no conflict of interests.

The lead author affirms that the study has been conducted according to ethical legislation, was reviewed and approved by a medical ethics committee and performed according to the Declaration of Helsinki.

© 2021 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.

Figures

Figure 1
Figure 1
Design and participant flowchart of both Study A and B
Figure 2
Figure 2
(a) Bland–Altman plot of fibre intake of both Study A and B. (b) Bland–Altman plot of fibre intake of both Study A and B, stratified for gender. Both plots show the difference of the fibre estimate between the food frequency questionnaire (FFQ): the 18‐item FiberScreen on the y‐axis versus the average fibre estimate of both questionnaires of the x‐axis. The line represents the regression line
Figure 3
Figure 3
(a) Bland–Altman plot of fibre from fruits of both Study A and B. (b) Bland–Altman plot of fibre from vegetables of both Study A and B. (c) Bland–Altman plot of fibre from whole grain products of both Study A and B. (d) Bland–Altman plot of fibre from pasta, rice and potatoes of both Study A and B. (e) Bland–Altman plot of fibre from legumes of both Study A and B. (f) Bland–Altman plot of fibre from nuts and seeds of both Study A and B. All plots show the difference of the fibre intake from each food category between the food frequency questionnaire (FFQ): the 18‐item FiberScreen on the y‐axis versus the average fibre estimate of each food category of both questionnaires of the x‐axis. The line represents the regression line

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