Does The Australian Eating Survey FFQ Estimate Nutrient Intake Accurately in South Asians Living in Australia? A Comparative Validity Study

<p dir="ltr">INTRODUCTION: Accurate dietary assessment is essential for understanding nutrition-related health risks in migrant populations. The Australian Eating Survey Food Frequency Questionnaire (AES) is widely used but has not yet been validated among South Asian (SA) migrants, the second-largest migrant group in Australia. This study aimed to evaluate the comparative validity of the AES for estimating nutrient intake within this culturally diverse group. </p><p dir="ltr">METHODS: A cross-sectional validation study was conducted among SA adults residing in Victoria, Australia. Participants completed the AES and a 3-day weighed food record (WFR). Energy and nutrient estimates derived from both methods were compared using paired t-tests or Wilcoxon signed-rank tests. Associations between values from each method were tested via Pearson/Spearman correlations, and levels of agreement were evaluated via Bland-Altman analysis. </p><p dir="ltr">RESULTS: 218 participants completed the initial questionnaire (63.0% response rate), with 21 providing complete dietary data. Moderate agreement between AES-FFQ and WFR was observed for protein (p = 0.024), niacin (p = 0.029), vitamin B12 (p = 0.030), and beta-carotene (p = 0.036). However, discrepancies were identified for fats (p = 0.98), energy (p = 0.246), added sugar (p = 0.573), and sodium (p = 0.688), alongside inconsistent estimation for several micronutrients. Bland-Altman plots demonstrated systematic underestimation by AES-FFQ for key nutrients. </p><p dir="ltr">CONCLUSION: The AES demonstrates acceptable validity for certain nutrients among SA migrants but shows significant limitations in accurately estimating intake of fats, energy, sugar, sodium, and some micronutrients. These findings underscore the need for culturally tailored dietary assessment tools or refined adaptations of existing instruments to better capture dietary patterns in this population.</p>