Comparison of dietary share of ultra-processed foods assessed with a food frequency questionnaire against a 24-hour dietary recall in adults: Results from KNHANES 2016

Document Type

Journal Article

Publication Date



Public Health Nutrition




24-hour dietary recall; food frequency questionnaire; Korea National Health and Nutrition Examination Survey; Relative validity; ultra-processed foods


Objective: To evaluate the performance of an FFQ for estimating dietary contributions of NOVA groups to individuals' diets with a specific focus on UPFs compared to a single 24-h dietary recall (24HR). Design: All consumed foods and beverages assess with both a 109-item FFQ and a single 24HR were classified into one of four NOVA groups: natural or minimally processed foods (MPFs), processed culinary ingredients (PCIs), processed foods (PFs), and ultra-processed foods (UPFs). The contributions of each NOVA group to daily intakes of energy, protein, fat, saturated fat, carbohydrate, fibre, and sodium were expressed as crude intake, energy-adjusted intake, and percent intake. Mean differences, correlation coefficients, and joint classification were calculated for intakes of energy and nutrients from each NOVA group between the FFQ and the 24HR. Setting: The Korea National Health and Nutrition Examination Survey 2016 Participants: Adults aged 19-64 years (n 3189) Results: The smallest group-mean differences between the two methods were observed in UPFs (2-40%). The greatest average Pearson's correlation coefficients between the FFQ and 24HR were shown in dietary contributions of UPFs (r=0.22-0.25 for MPFs; r=0.02-0.05 for PCIs; r=0.11-0.18 for PFs; r=0.26-0.30 for UPFs). The greatest agreement in quartile classification between the FFQ and the 24HR was observed in dietary contributions of UPFs (70.0-71.5% for MPFs; 64.2-68.8% for PCIs; 66.9-69.2% for PFs; 71.8-73.9% for UPFs). Conclusions: The use of the FFQ for estimating absolute intake of UPFs may not be encouraged in its current form, but it still may be used for relative comparisons such as quantile categorization.