Development and Validation of a Self-Administered Simplified Food Frequency Questionnaire for FODMAP Intake Evaluation (FFQ-FODMAP-BE)

Pauline Van Ouytsel; Amandine Szalai; Axel Egret; Paulus Kristanto; Hubert Louis; Hubert Piessevaux

doi:10.1007/s10620-025-09460-7

Development and Validation of a Self-Administered Simplified Food Frequency Questionnaire for FODMAP Intake Evaluation (FFQ-FODMAP-BE)

Dig Dis Sci. 2025 Oct 15. doi: 10.1007/s10620-025-09460-7. Online ahead of print.

Authors

Pauline Van Ouytsel^{1

2}, Amandine Szalai³, Axel Egret³, Paulus Kristanto⁴, Hubert Louis⁵, Hubert Piessevaux⁶

Affiliations

¹ Department of Dietetics, Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles, (H.U.B), CUB Hôpital Erasme (ULB), Route de Lennik 808, 1070, Brussels, Belgium. pauline.vanouytsel@hubruxelles.be.
² Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B), CUB Hôpital Erasme (ULB), Brussels, Belgium. pauline.vanouytsel@hubruxelles.be.
³ Department of Dietetics, Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles, (H.U.B), CUB Hôpital Erasme (ULB), Route de Lennik 808, 1070, Brussels, Belgium.
⁴ Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B), Institut Jules Bordet, Brussels, Belgium.
⁵ Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B), CUB Hôpital Erasme (ULB), Brussels, Belgium.
⁶ Department of Hepato-Gastroenterology, Cliniques Universitaires Saint-Luc (UCLouvain), Brussels, Belgium.

PMID: 41091284
DOI: 10.1007/s10620-025-09460-7

Abstract

Purpose: A practical tool to estimate the frequency of high-Fermentable Oligo-Di-Mono-saccharides and Polyols (FODMAP) food intake in Europe is lacking. The aim of this study is to develop and validate a self-administered questionnaire evaluating high-FODMAP food consumption frequency (FFQ-FODMAP-BE) in a Belgian adult population of healthy volunteers (HV) and irritable bowel syndrome (IBS) patients.

Methods: The developed FFQ was submitted prospectively twice during two weeks to Belgian HV and IBS patients. In parallel, a food history performed by a dietician and 5-day food diaries were collected. Reproducibility was evaluated using Intra Class Correlation (ICC). Spearman and Kendall correlations were used to analyze associations. Sensitivity and specificity analyses and ROC have been used to determine a threshold of the FFQ-FODMAP-BE score.

Results: Sixty-four participants were included (32 HV, 32 IBS patients; 73% female). Mean daily total FODMAP intake was 11.9 (6.2) grams. The ICC showed a good agreement between the two FFQ-FODMAP-BE scores (ICC = 0.86, 95%CI [0.78-0.91]). A correlation was observed between FFQ-FODMAP-BE score and the dietician score (Spearman rho = 0.33, 95%CI [0.10-0.56]) (Kendall Tau-b = 0.25, 95% CI [0.07-0.43]) and also with average daily FODMAP consumption (Spearman rho = 0.36, 95%CI [0.06-0.66]) (Kendall Tau-b = 0.26, 95% CI [0.05-0.46]). Using a threshold of 1.80, the FFQ-FODMAP-BE has a sensitivity of 80% and specificity of 73% to discriminate low (< 9g/d) from moderate/high consumers (≥ 16g/d) (J = 0.53).

Conclusion: The FFQ-FODMAP-BE questionnaire is reproducible and correlated to the subjective assessment by expert dieticians. This tool may help to identify moderate/high-FODMAP consumers.

Keywords: Belgian; Dieticians; FODMAP; Food frequency questionnaire; IBS.