title: Development of a food frequency questionnaire for Sri Lankan adults.
abstract: BACKGROUND
  Food Frequency Questionnaires (FFQs) are commonly used in epidemiologic studies to assess long-term nutritional exposure. Because of wide variations in dietary habits in different countries, a FFQ must be developed to suit the specific population. Sri Lanka is undergoing nutritional transition and diet-related chronic diseases are emerging as an important health problem. Currently, no FFQ has been developed for Sri Lankan adults. In this study, we developed a FFQ to assess the regular dietary intake of Sri Lankan adults.
  
  
  METHODS
  A nationally representative sample of 600 adults was selected by a multi-stage random cluster sampling technique and dietary intake was assessed by random 24-h dietary recall. Nutrient analysis of the FFQ required the selection of foods, development of recipes and application of these to cooked foods to develop a nutrient database. We constructed a comprehensive food list with the units of measurement. A stepwise regression method was used to identify foods contributing to a cumulative 90% of variance to total energy and macronutrients. In addition, a series of photographs were included.
  
  
  RESULTS
  We obtained dietary data from 482 participants and 312 different food items were recorded. Nutritionists grouped similar food items which resulted in a total of 178 items. After performing step-wise multiple regression, 93 foods explained 90% of the variance for total energy intake, carbohydrates, protein, total fat and dietary fibre. Finally, 90 food items and 12 photographs were selected.
  
  
  CONCLUSIONS
  We developed a FFQ and the related nutrient composition database for Sri Lankan adults. Culturally specific dietary tools are central to capturing the role of diet in risk for chronic disease in Sri Lanka. The next step will involve the verification of FFQ reproducibility and validity.
authors.affiliation: Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia. ranil7@gmail.com
authors.forename: Ranil
authors.initials: R
authors.lastname: Jayawardena
authors.forename: Sumathi
authors.initials: S
authors.lastname: Swaminathan
authors.forename: Nuala M
authors.initials: NM
authors.lastname: Byrne
authors.forename: Mario J
authors.initials: MJ
authors.lastname: Soares
authors.forename: Prasad
authors.initials: P
authors.lastname: Katulanda
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Hills
mesh_terms: D000328:Adult; D003296:Cooking; D016208:Databases, Factual; D004032:Diet / Q000208:ethnology*; D004034:Diet Surveys / Q000379:methods*; D002149:Energy Intake / Q000208:ethnology; D005247:Feeding Behavior / Q000208:ethnology*; D005260:Female; D005504:Food Analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D010865:Pilot Projects; D012727:Sex Characteristics; D013188:Sri Lanka; D011795:Surveys and Questionnaires; D014507:Urbanization