Development and Evaluation of a Culturally Sensitive Food Frequency Questionnaire for the Assessment of Prebiotic and Probiotic Intake of Urban-living, Low-to-medium-income Women

Cecile Leah T. Bayaga1*, Marietoni B. Pico1, Demetria C. Bongga1,
Erniel B. Barrios2, and Alonzo A. Gabriel3

1Breastmilk Research Laboratory, Department of Food
Science and Nutrition, College of Home Economics, University of the Philippines,
Diliman, Quezon City 1101 Philippines 2School of Statistics,
University of the Philippines, Diliman, Quezon City 1101 Philippines
3Laboratory of Food Microbiology and Hygiene, Department of Food
Science and Nutrition, College of Home Economics, University of the Philippines,
Diliman, Quezon City 1101 Philippines

*Corresponding author: This email address is being protected from spambots. You need JavaScript enabled to view it.; 981-8500 local 3412




Modern food product development has introduced maternal consumers to functional foods.  Prebiotics and probiotics are well-known functional food components. This study developed a culturally sensitive, qualitative food frequency questionnaire (FFQ) to assess the prebiotic and probiotic intakes of healthy, urban-living Filipino women.  Food items in the developed FFQ were based on five datasets of information.  Reproducibility was tested by comparing respondents’ (n = 73) responses on Day 30 (FFQ1) and Day 31 (FFQ2). Verification of the developed tool was conducted by comparing responses from the FFQs with multiple food recalls obtained from the same respondents and sampling time. Thirteen (13) food groups with 39 unique food items were included in the developed FFQ. Binomial results showed matched responses of food items (38/39) between FFQ1 and FFQ2. Comparison of the results of FFQ and multiple food recalls showed highly similar responses. The developed FFQ to assess prebiotic and probiotic intakes of women was reproducible and has been verified.



Good nutrition during pregnancy has long been recognized as important for adequate fetal growth and desirable pregnancy outcomes (Marangoni et al. 2016).  Weight gain during pregnancy is determined by overall nutrition adequacy, which is highly dependent on a sufficient supply of calories and essential nutrients (Baer et al. 2005). Therefore, adequate maternal intake of macronutrients such as carbohydrates, protein, and fatty acids – and micronutrients such as zinc, iron, folate, vitamin C, and calcium – has been recommended (Jensen 1995, Baer et al. 2005, Bayaga and Gavino 2006, Ballard and Morrow 2013). . . . . read more



BAER HJ, BLUM RE, ROCKETT HRH, LEPPERT J, GARDNER JD, SUITOR CW, COLDITZ GA. 2005. Use of a food frequency questionnaire in American Indian and Caucasian pregnant women: A validation study.  BMC Public Health. 5: 135. DOI:10.1186/1471-2458-5-135.
BALLARD O, MORROW AL. 2013. Human Milk Composition: Nutrients and Bioactive Factors. Pediatrics Clinical of North America. 60(1): 49–74.
BAYAGA CLT, GAVINO VC. 2006. Chapter IV: Benefits and Sources of Docosahexaenoic Acid (DHA) in Human Milk. In: Trends in Dietary Fats Research. Landow MV ed. New York: Nova Science Publishers, Inc. p. 69–87.
BIESIEKIERSKI JR, ROSELLA O, ROSE R, LIELS K, BARRETT JS, SHEPHERD SJ, GIBSON PR, MUIR JG. 2011. Quantification of fructans, galacto-oligosacchardies and other short-chain carbohydrates in processed grains and cereals. Journal of Human Nutrition and Dietetics 24: 154–176.
BINGHAM SA, GILL C, WELCH A, DAY K, CASSIDY A, KHAW KT, SNEYD MJ, KEY TJ, ROE L, DAY NE. 1994. Comparison of dietary assessment methods in nutritional epidemiology: Weighed records v. 24 h recalls, food-frequency questionnaires and estimated-diet records.  British Journal of Nutrition 72: 619–643.
BOWER GH. 1981. Mood and Memory. American Psychologist 36: 129–148.
BURROWS TL, HUTCHESSON MJ, ROLLO ME, BOGGESS MM, GUEST M, COLLINS CE. 2015. Fruit and Vegetable Intake Assessed by Food Frequency Questionnaire and Plasma Carotenoids: A Validation Study in Adults. Nutrients 7: 3240–3251.
CADE J, THOMPSON R, BURLEY V, WARM D. 2002. Development, validation and utilisation of food-frequency questionnaires – A review. Public Health Nutrition 5: 567–587.
CAMPBELL JM, BAUER LL, FAHEY GC, HOGARTH AJCL, WOLF BW, HUNTER DE. 1997. Selected Fructooligosaccharide (1-Kestose, Nystose, and 1F-β-Fructofuranosylnystose) composition of foods and feeds. Journal of Agricultural Food Chemistry 45: 3076–3082.
DAVIES SY, LUM JAG, SKOUTERIS H, BYRNE LK, HAYDEN MJ. 2018. Cognitive impairment during pregnancy: A meta-analysis. The Medical Journal of Australia 208(1): 35–40.
[DOST-FNRI] Department of Science and Technology – Food and Nutrition Research Institute. 2013. 8th National Nutrition Survey. Retrieved from
DUNN S, DATTA A, KALLIS S, LAW E, MYERS CE, WHELAN K. 2011. Validation of a food frequency questionnaire to measure intakes of inulin and oligofructose. European Journal of Clinical Nutrition 65: 402–408.
GONZÁLEZ-CARRASCOSA R1, GARCÍA-SEGOVIA P, MARTÍNEZ-MONZÓ J. 2011. Paper and pencil vs online self-administered food frequency questionnaire (FFQ) applied to university population: A pilot study.  Nutrición Hospitalaria 26(6): 1378–1384.
HENRY JF, SHERWIN BB. 2012. Hormones and Cognitive Functioning During Late Pregnancy and Postpartum: A Longitudinal Study. Behavioral Neuroscience 126(1): 73–85.
HILL C, GUARNER F, REID G, GIBSON GR, MERENSTEIN DJ, POT B, MORELLI L, CANANI RB, FLINT HJ, SALMINEN S, CALDER PC, SANDERS ME. 2014. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nature Reviews Gastroenterology and Hepatology 11: 506–514.
HINTZMAN DL. 2010.  How does repetition affect memory? Evidence from judgments of recency. Memory & Cognition 38: 102–115.
JENSEN RG. 1995. Handbook of Milk Composition. San Diego, CA: Academic Press Inc.
KENT K, CHARLTON KE. 2017.  Development, validation and reproducibility of a food frequency questionnaire to measure flavonoid intake in older Australian adults. Nutrition and Dietetics 75(1): 106–116. DOI: 10.1111/1747-0080.12371.
KRALL EA, DWYER JT, COLEMAN KA. 1988. Factors Influencing Accuracy of Dietary Recall. Nutrition Research 8: 829–841.
KROL KM, KAMBOJ SK, CURRAN HV, GROSSMANN T. 2014.  Breastfeeding experience differentially impacts recognition of happiness and anger in mothers.  Scientific Reports 4: 706. DOI:10.1038/srep07006.
MACINTYRE UE, VENTER CS, VORSTER HH. 2000. A culture-sensitive quantitative food frequency questionnaire used in an African population: 1. Development and reproducibility.  Public Health Nutrition 4: 53–62.
MARANGONI F, CETIN I, VERDUCI E, CANZONE G, GIOVANNINI M, SCOLLO P, CORSELLO G, POLI A. 2016. Maternal Diet and Nutrient Requirements in Pregnancy and Breastfeeding. An Italian Consensus Document. Nutrients 8: 629. DOI:10.3390/nu8100629.
MARTÍNEZ-VILLALUENGA C, CARDELLE-COBAS A, CORZO N, OLANO A. 2008. Study of galactooligoscahharide composition in commercial fermented milks. Journal of Food Composition and Analysis 21: 540–544.
MOSHFEGH AJ, FRIDAY JE, GOLDMAN JP, CHUG AHUJA JK. 1999. Presence of Inulin and Oligofructose in the Diets of Americans. Journal of Nutrition 129: 1470S–1411S.
MUIR JG, SHEPHERD SJ, ROSELLA O, ROSE R, BARRETT JS, GIBSON PR. 2007. Fructan and Free Fructose Content of Common Australian Vegetables and Fruit. Journal of Agricultural and Food Chemistry 55: 6619–6627.
MUIR JG, ROSE R, ROSELLA O, LIELS K, BARRETT JS, SHEPHERD SJ, GIBSON PR. 2009. Measurement of Short-Chain Carbohydrates in Common Australian Vegetables and Fruits by High-Performance Liquid Chromatography (HPLC). Journal of Agricultural and Food Chemistry 57: 554–565.
PAKSERESHT M, SHARMA S. 2010. Validation of a culturally appropriate quantitative food frequency questionnaire for Inuvialuit population in the Northwest Territories, Canada. Journal of Human Nutrition & Dietetics 23(S1): 75–82.
PAPAZIAN T, HOUT H, SIBAI D, HELOU N, YOUNES H, EL OSTA N, KHABBAZ LR. 2016. Development, reproducibility and validity of a food frequency questionnaire among pregnant women adherent to the Mediterranean dietary pattern. Clinical Nutrition 35: 1550–1556.
PERES CM, PERES C, MENDOZAA AH, MALCATAA FX. 2012. Review on fermented plant materials as carriers and sources of potentially probiotic lactic acid bacteria – With an emphasis on table olives.  Trends in Food Science & Technology 26: 31–42.
PÉREZ-CORNAGO A, GONZALEZ MAM, CANELA MR, JAURRIETA I, CARLOS S, SAYON-OREA C, BES-RASTROLLO M. 2015. Prebiotic consumption and the incidence of overweight in a Mediterranean cohort: The Seguimiento Universidad de Navarra Project. American Journal of Clinical Nutrition 102: 1554–1562.
SHEEHY T, KOLAHDOOZ F, MTSHALI TL, KHAMIS T, SHARMA S. 2013.  Development of a quantitative food frequency questionnaire for use among rural South Africans in KwaZulu-Natal. Journal of Human Nutrition and Dietetics 27: 443–449.
SHORI AB. 2016. Influence of food matrix on the viability of probiotic bacteria: A review based on dairy and non-dairy beverages.  Food Bioscience 13: 1– 8.
SHU G, HUI Y, CHEN H, MI J, WANG Y. 2014. Effect of carbon sources including lactose, glucose and maltose on growth of B. bifidum in the extract of Fructus tribuli. Journal of Chemical and Pharmaceutical Research 6(4): 617–622.
TEUFEL NI. 1997. Development of culturally competent food-frequency questionnaires. American Journal of Clinical Nutrition 65(Suppl.): 1173S–1178S.
VAN LOO J, COUSSEMENT P, DE LEENHEER L, HOEBREGS H, SMITS G. 1995. On the presence of inulin and oligo-fructose as natural ingredients in the Western diet. Critical Reviews in Food Science and Nutrition 35: 525–552.
WENTZEL-VILJOEN E, LAUBSCHER R, KRUGER A. 2011. Using different approaches to assess the reproducibility of a culturally sensitive quantified food frequency questionnaire.  South African Journal of Clinical Nutrition 24: 143–148.