IARC 60th Anniversary - 19-21 May 2026
Session : 19/05/26 - Posters
Development and Cultural Adaptation of a Food Frequency Questionnaire for Saudi Pediatric Oncology Patients: A Preparation and Validation Framework
ALMUDAIHIM A. 1,2,3, ALBEDEWI H. 2,4, KOZLAKIDIS Z. 5, HUYBRECHTS I. 5, NICOLAS G. 5, ALWATBAN N. 2,4, ALMOSNID N. 2,6, ALFAWAZ D. 2,7, ALDEGHAITHER D. 2,4
1 Department of Clinical Nutrition, College of Applied Medical Sciences (CAMS), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 2 King Abdullah International Medical Research Center (KAIMRC) , Riyadh, Saudi Arabia; 3 Department of Clinical Nutrition, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia , Riyadh, Saudi Arabia; 4 Department of Public Health, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences , Riyadh, Saudi Arabia; 5 Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC) , Lyon, France; 6 College of Science and Health Professions , King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 7 College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Background
Malnutrition remains a major concern among pediatric oncology patients and associated with poor treatment tolerance, increased infection risk, and reduced survival. Chemotherapy may further alter children’s diet and gut microbiota, impairing digestion and nutrient absorption. Despite these challenges, no validated Food Frequency Questionnaire (FFQ) exists for dietary monitoring among pediatric oncology patients in Saudi Arabia. Existing Saudi FFQs focus on adults or narrow topics, such as free-sugar intake, and therefore lack cultural and age-specific relevance. This study is Phase 1 of a larger longitudinal project investigating nutrition–microbiome interactions and treatment outcomes among pediatric patients with acute lymphoblastic leukemia in Saudi Arabia.
Objectives
To develop, translate, and culturally adapt a Saudi-specific FFQ for pediatric oncology patients; to outline the validation plan integrating dietary, clinical, and microbiome data; and to enable future comparison of Saudi nutritional data with global pediatric cancer datasets in alignment with the World Health Organization (WHO) Childhood Cancer Initiative.
Methods
Phase 1 followed the International Agency for Research on Cancer (IARC)/IIPAN framework for FFQ localization. Sixteen major food categories (~100 items) from the WHO/IARC master list were reviewed and adapted. Multi-stage meetings were conducted between IARC experts (France) and Saudi collaborators at King Saud bin Abdulaziz University for Health Sciences (Riyadh) to ensure cross-cultural equivalence and methodological accuracy. All FFQ components were forward and back-translated by bilingual nutritionists. In Phase 2, as a pilot we will validate the FFQ among 40 pediatric oncology patients, stratified by age and sex into the following categories: 3 years, 4–8 years, 9–13 years, and 14–18 years (5 males and 5 females per category). Participants will complete the FFQ and three non-consecutive food records. Validity will be examined using correlation coefficients, cross-classification, and Bland–Altman plots. Reliability will be analyzed using intraclass correlation and Cronbach’s α. Phase 3 will include 400 pediatric cancer patients and will establish a statical association between pre/post treatment nutrition status and measurable clinical outcomes.
Expected outcome
This FFQ will serve as a validated, reliable tool for dietary assessment in pediatric oncology patients in Saudi Arabia.
Conclusions / Implications
This project introduces the first Saudi-specific FFQ for pediatric oncology, developed as Phase 1 of a larger national study on nutrition and microbiome dynamics among pediatric cancer patients. ?The tool will enable comparison with the global pediatric cancer nutrition dataset. It will also contribute to the WHO Childhood Cancer Initiative and strengthen regional capacity for evidence-based dietary assessment.