Validation of the German Version of the Screening Questionnaire for Highly Processed Food Consumption (sQ-HPF)

Abstract

Background and aims

Ultra-processed foods (UPF) and highly processed foods (HPF) are linked to non-communicable diseases and their consumption is rising globally. Currently no validated German tool to assess HPF consumption exists. This study aimed to translate and culturally adapt the validated Screening Questionnaire of Highly Processed Food Consumption (sQ-HPF) into German and evaluate its validity and reliability.

Methods

In this monocentric, cross-sectional study participants completed sociodemographic questionnaires, a food frequency questionnaire (FFQ), the German version of the sQ-HPF, anthropometric data and 25-(OH)-Vitamin D3 levels were measured. The sQ-HPF has been translated into German with the forward-backward method, and its reliability and validity was assessed using Pearson correlation coefficients, intraclass correlation coefficients, and Cronbachʼs α.

Results

N=91 participants completed the questionnaires with n=58 participants completing the follow up questionnaires after an average of six weeks. The sQ-HPF sum scores significantly correlated with sex (p=0.004), waist circumference (p=0.015), 25-(OH)-Vitamin D3 (p=0.008), daily energy intake (kJ) (p<0.001), and the percentage of HPF and UPFD (g/d) as measured by FFQ (HPF p<0.001; UPFD p<0.001). Cronbachʼs α of the German version of the sQ-HPF was 0.723 and showed good test-retest reliability (ICC=0.786 [95% CI: 0.64–0.87]). A Bland-Altman plot showed good general agreement between the percentage of HPF (g/d) measured by FFQ and the percentage of HPF (g/d) measured by sQ-HPF.

Conclusion

The German version of the sQ-HPF is a valid and reliable tool for assessing highly processed food consumption in German-speaking individuals.

Zusammenfassung

Einleitung

Ultra-verarbeitete Lebensmittel (UPF) und hochverarbeitete Lebensmittel (HPF) werden mit nicht-übertragbaren Krankheiten in Verbindung gebracht und ihr Konsum steigt weltweit. Derzeit existiert kein validiertes deutschsprachiges Instrument zur dezidierten Erfassung des HPF-Konsums. Ziel dieser Studie war es, eine deutschsprachige Fassung des international validierten Screening-Fragebogens sQ-HPF zur Verfügung zu stellen, kulturell anzupassen und seine Validität und Reliabilität zu evaluieren.

Methodik

In dieser monozentrischen Querschnittsstudie wurden bei teilnehmende Probanden soziodemografische Fragebögen, ein Food Frequency Questionnaire (FFQ), die deutsche Version des sQ-HPF, anthropometrische Daten und der 25-(OH)-Vitamin D3 Spiegel erhoben. Der sQ-HPF wurde mit der Vorwärts-Rückwärts Methode übersetzt, kulturell ins Deutsche adaptiert und seine Reliabilität und Validität wurde mit Hilfe von Pearson-Korrelationskoeffizienten, Intraklassen-Korrelationskoeffizienten und Cronbachs α bewertet.

Ergebnisse

N=91 Personen füllten die initialen Fragebögen aus, n=58 von diesen Personen füllten die Follow-up-Fragebögen nach durchschnittlich sechs Wochen aus. Die sQ-HPF-Summenwerte korrelierten signifikant mit dem Geschlecht (p=0.004), dem Taillenumfang (p=0.015), dem 25-(OH)-Vitamin D3 Spiegel (p=0.008), der täglichen Energiezufuhr (kJ) (p<0.001) und dem prozentualen Anteil von HPF und UPFD (g/d), gemessen mit dem FFQ (HPF p<0.001; UPFD p<0.001). Das Cronbachs α der deutschen Version des sQ-HPF betrug 0.723 und zeigte eine gute Test-Retest-Reliabilität (ICC=0.79 [95% CI: 0.64–0.87]). Ein Bland-Altman-Plot zeigte eine gute Gesamtübereinstimmung zwischen dem mit dem FFQ gemessenen prozentualen Anteil an HPF (g/d) und dem mit dem sQ-HPF gemessenen prozentualen Anteil an HPF (g/d).

Schlussfolgerung

Die deutschsprachige Version des sQ-HPF ist ein valides und zuverlässiges Instrument zur Erfassung des Verzehrs von hochverarbeiteten Lebensmitteln.

Keywords

highly processed food - ultra-processed food - Patient-reported outcome measures (PROMS) - translation and cultural adaption - validation and reliability

Schlüsselwörter

stark verarbeitete Lebensmittel - ultra-prozessierte Lebensmittel - patientreported outcome measures (PROMS) - Übersetzung und kulturelle Anpassung - Validierung und Zuverlässigkeit

Publication History

Received: 25 October 2024

Accepted: 08 April 2025

Article published online:
12 May 2025

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