營養流行病學飲食評估法中，利用飲食頻率問卷(food frequency questionnaire, FFQ)評估長期飲食攝取狀況十分常見。本研究室研發食材為主飲食頻率問卷(food and ingredients-based food frequency questionnaire, FIFFQ)以及餐次結構食譜為主飲食頻率問卷(meal and dish-based food frequency questionnaire, MDFFQ)，以更符合臺灣飲食型態。本研究主要目的為評估兩種成人飲食頻率問卷之效度(validity)，由於營養領域中所有飲食評估方法都有誤差(bias)，因此是藉由和相對準確的方法比較以測量相對效度(relative validity)。另外，本研究亦探討熱量校正前後的效度差異以及MDFFQ與二十四小時飲食回憶法(24-hour dietary recall, 24HDR)的餐次分布情形。

本研究受試者共150位，執行141項食物項目之MDFFQ後，間隔5個月後再進行161項(食物項目為109項)之FIFFQ。利用24HDR作為標準評估兩種FFQ與24HDR的相對效度。此外，將兩種FFQ以24HDR進行熱量校正，再將校正後的FFQ分別與24HDR進行效度評估。利用斯皮爾曼等級相關係數(Spearman rank correlation coefficient)、一致性比例(agreement %)、加權卡帕(weighted kappa, Kw)係數、布蘭德-奧特曼差異圖(Bland-Altman difference plot)進行效度分析。

研究結果顯示FIFFQ與24HDR之28項營養素攝取平均相關係數為0.03，校正FIFFQ之後，27項營養素平均相關係數為0.25，範圍從0.06(膽固醇)至0.43(醣類)，有64%的項目達顯著正相關(p < 0.05)。FIFFQ與24HDR之六個食物類別攝取量平均相關係數為0.17，校正FIFFQ後為0.32，範圍從0.01(油脂與堅果種子類)至0.51(飲料及凍圓類)。MDFFQ與24HDR營養素攝取平均相關係數為0.03，校正MDFFQ之後為0.25，範圍從0.06(多元不飽和脂肪酸)至0.46(膳食纖維)，有77%的項目達顯著正相關(p < 0.05)。兩種FFQ與24HDR三大營養素和礦物質的相關性結果普遍優於維生素，且整體相關性為可接受的(acceptable)。

關於一致性agreement %的研究結果如下，FIFFQ和24HDR之28項營養素攝取平均agreement %為35%，校正FIFFQ之後27項營養素攝取平均agreement %為41%，範圍從31%(膽固醇)至53%(鋅)。FIFFQ與24HDR食物類別攝取平均agreement %為37%，校正FIFFQ後平均agreement %為43%，範圍從33%(油脂與堅果種子類)至48%(主食類和奶類及其製品)。MDFFQ和24HDR營養素攝取平均agreement %為33%，校正MDFFQ後攝取平均agreement %為41%，範圍從31%(菸鹼酸)至52%(鋅及鉀)。以加權kappa結果而言，FIFFQ和24HDR之Kw範圍從-0.19(熱量)至0.27(維生素C)，校正FIFFQ後Kw範圍為-0.01(膽固醇)至0.40(鐵)。FIFFQ與24HDR食物類別攝取量之Kw範圍從-0.12(主食類)至0.32(飲料及凍圓類)，校正FIFFQ後Kw範圍為0.00(油脂與堅果種子類)至0.39(飲料及凍圓類)。MDFFQ和24HDR之Kw範圍從-0.17(維生素B12)至0.26(膳食纖維)，校正MDFFQ後Kw範圍為0.02(多元不飽和脂肪酸)至0.43(鋅)。另外，三大營養素和礦物質的一致性結果普遍優於維生素。

MDFFQ和24HDR三餐之熱量攝取佔整日熱量攝取之百分比分別為早餐19.53%和25.91%、午餐39.73%和37.70%、晚餐40.75%和36.39%。結果顯示校正後之MDFFQ和24HDR熱量與三大營養素攝取量在三餐皆有達顯著正相關(p < 0.05)。整體而言，不論在營養素、食物種類的相關性與一致性，或是餐次分布之相關性，經過校正之後的FFQ優於校正之前，兩者與24DHDR的效度結果均為可接受的(acceptable)。因此，建議以飲食頻率問卷探討飲食與其他結果變項(如：疾病)之關聯時，利用定量的飲食評估工具(如：飲食紀錄法、二十四小時飲食回憶法)進行熱量校正可能是必須的。

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