Development and Cognitive Validation of a Culturally Appropriate Diet Diary for Sri Lankan Population

Abstract Unhealthy dietary practices are a major modifiable risk factor for non-communicable diseases (NCDs) in Sri Lanka. Accurate assessment of dietary intake and eating behaviours is essential for effective prevention strategies; however, existing dietary assessment tools often lack cultural relevance and fail to capture contextual factors. This study aimed to develop and cognitively validate a culturally appropriate, paper-based diet diary for use in the Sri Lankan population. The diet diary was developed through a multi-step process involving a literature review and qualitative exploration of public perceptions on diet and diet recording. Findings informed the design of a structured 7-day diet diary incorporating local food items, photographic portion size guides, meal timing, eating context, hunger level, and mood. Expert review and participant cognitive validation were conducted to finalize the tool. The developed diet diary was found to be culturally relevant, user friendly, and easy to complete. This culturally appropriate diet diary provides a practical and comprehensive tool for dietary assessment in Sri Lanka and has potential application in population-based research and community-level interventions.