Adaptation of a food frequency questionnaire to assess dietary intake in the Caribbean Coast of Costa Rica

Health claims in popular media promote intake of coconut oil to prevent and control almost any health problem. Thus, diet-disease studies in tropical regions likely to consume coconut and its derivatives are highly needed. The objective of this study was to develop a food frequency questionnaire for the population living in the Caribbean Coast of Costa Rica (Caribbean FFQ), by adapting an FFQ previously developed and validated in the Central Valley of Costa Rica. The FFQ included 92 food items, questions on the intake of coconut products and the preparation of traditional recipes that included coconut oil and/or coconut milk, and open-ended questions. This adapted version was administered to 34 subjects (mean age 57+9) to identify food items that should be added or deleted based on the frequency of intake and variance. A total of 21 food items were removed because they were rarely consumed and 12 were removed because they explained less than 1% of the variance within the food group. Food items that were added included coconut fruit, 13 recipes containing coconut oil and/or coconut milk and 11 other foods that were frequently reported in the open-ended questions. In sum, we developed an FFQ to assess dietary intake in the Caribbean Coast of Costa Rica. Future studies will need to validate the use of this questionnaire to assess dietary intake in this population and to determine whether dietary intake in the region is suitable for future epidemiological studies on coconut intake and chronic disease.