Validation of the Malay chrononutrition questionnaire (M-CNQ) among adults in Malaysia
Nur Islami Mohd Fahmi Teng, Nur Afiqah Mohamad Jamil, Fatin Nasuha Mohd Lotfi, Mardhiyyah Azman, Emmy Hainida Khairul Ikram, Rosmaliza Mohamed, Norsham Juliana Nordin, Norfadilah Abdul Mosamad, Syamilah MusaBACKGROUND:
Chrononutrition highlights the importance of meal timing, frequency, and regularity in relation to circadian rhythm, which influences cardiometabolic health. In Malaysia, validated tools to assess chrononutrition behaviors are limited, particularly for shift workers who are vulnerable to circadian misalignment. This study aimed to translate, adapt, and validate a Malay version of the Chrononutrition Questionnaire (M-CNQ) for use among Malaysian adults, including shift workers.
MATERIALS AND METHODS:
This cross-sectional validation study involved forward-backward translation of the original CNQ, followed by expert review. Content validity was assessed by expert panels, while face validity was evaluated through pilot testing in both groups. Test–retest reliability was examined over a 2-week interval among 147 Malaysian adults. Internal consistency and reliability were evaluated using Cronbach alpha, intraclass correlation coefficient (ICC), and Bland–Altman analysis.
RESULTS:
The M-CNQ demonstrated good content validity (S-CVI/Ave = 0.98) and acceptable face validity across both groups (S-FVI/Ave = 0.91–1.00). Sleep-related variables demonstrated moderate reliability (α and ICC = 0.42–0.67) in the general population and good to excellent reliability (0.74–1.0) in shift workers. Temporal eating pattern variables exhibited lower reliability among general adults but higher reliability across specific shift-work categories. The M-CNQ was able to classify key chrononutrition behaviors, including chronotype, eating window duration, and variability in meal timing.
CONCLUSION:
The M-CNQ is a valid and reliable instrument for assessing chrononutrition behaviors among Malaysian adults. It provides a useful tool for future research and public health initiatives targeting circadian-aligned eating practices.