The examples in the instrument include activities (for example snow shoveling) that may not be typical and well known in all cultures. Examples and intervals could easily be adapted to fit a different setting by constructing an instrument using methods similar to ours. The ability to validly estimate intensity of physical activity should be universal. Please see the following reference:
Lagerros YT, Mucci LA, Bellocco R, Nyren O, Balter O, Balter KA. Validity and reliability of self-reported total energy expenditure using a novel instrument European Journal of Epidemiology 2006;21(3):227-36.