Gender differences in food and energy intake among adult villagers in northwestern Bangladesh: a food frequency questionnaire survey

This study aimed to elucidate gender differences in dietary intake of rural Bangladeshi adults. A food frequency questionnaire (FFQ) survey using 15 food/dish items, together with anthropometric measurements, was conducted for 230 adults and adolescents (95 males and 135 females). To estimate the portion sizes of these foods/dishes, the samples consumed by 25 subjects were weighed. The FFQ revealed that rice was eaten two to three times (or more) per day by 98% of the subjects, providing nearly 60% of energy for both sexes. Puri (fried bread), meats, eggs, pulses, milk, fresh vegetables, fruits, tea with milk and sugar, and soft drinks were consumed more frequently by males. Males' larger portion sizes of rice, fish dish, potato dish, and vegetable dish resulted in larger daily energy intake per body weight in males (235 +/- 41 kJ/kg) than in females (161 +/- 28 kJ/kg). Despite males' larger energy intake, the proportion of chronically energy deficient persons (<18.5 kg/m2 in body mass index) was similar between males (35.8%) and females (37.8%), attributing to males' larger energy expenditure. Females' less-frequent consumption of nutritious foods and smaller energy intake were considered vulnerable to micronutrient deficiency.     

Validation of energy intake estimated from a food frequency questionnaire: a doubly labelled water study

OBJECTIVE: The validation of dietary assessment methods is critical in the evaluation of the relation between dietary intake and health. The aim of this study was to assess the validity of a food frequency questionnaire by comparing energy intake with energy expenditure measured with the doubly labelled water method. DESIGN: Total energy expenditure was measured with the doubly labelled water (DLW) method during a 10 day period. Furthermore, the subjects filled in the food frequency questionnaire about 18-35 days after the DLW phase of the study was completed. SUBJECTS: Twenty-one healthy, non-pregnant females volunteered to participate in the study; only 17 subjects completed the study. RESULTS: The group energy intake was on average 10% lower than the energy expenditure, but the difference was not statistically significant. However, there was a wide range in reporting accuracy: seven subjects were identified as acceptable reporters, eight as under-reporters and two were identified as over-reporters. The width of the 95% confidence limits of agreement in a Bland and Altman plot for energy intake and energy expenditure varied from -5 to 3 MJ. CONCLUSION: The data showed that there was substantial variability in the accuracy of the food frequency questionnaire at the individual level. Furthermore, the results showed that the questionnaire was more accurate for groups than individuals.     

Development of a semiquantitative food frequency questionnaire to assess food, energy and nutrient intake in Denmark.

Foods to be included in a Danish self-administered semiquantitative food frequency questionnaire were identified from food tables developed, together with data collected, for the survey 'Dietary habits in Denmark, 1985'. The questionnaire was to be used in a prospective study on diet, cancer and health, and the aim was to rank individuals with regard to intake of 19 different nutrients considered of prime importance in human carcinogenesis. The questionnaire for the dietary survey included 247 foods and recipes. From stepwise multiple regression analyses with the intake of each of the 19 nutrients as the dependent variable and the intake of the 247 foods and recipes as independent variables, the foods in the models explaining 90% of the between-person variability were considered for the final questionnaire. All relevant analyses were performed for the study group as a whole, for men and women separately, and in each gender for subgroups of energy intake. Taken together, the models explaining 90% of the between-person variability identified a total of 74 foods or recipes, which were important predictors of the intake of one or more of the nutrients considered. A few foods were excluded and a few foods were added to the final questionnaire based on common biological background information, and on information on foods providing important amounts of given nutrients, but which failed to contribute to regression analyses. The 92 foods and recipes, which were included in the final questionnaire provided altogether 81% of the average total supply of the nutrients.(ABSTRACT TRUNCATED AT 250 WORDS)     

Partitioning macronutrient intake estimates from a food frequency questionnaire

In the 1984-1985 University of Michigan Food Frequency Study, 228 black and white men and women ages 24-51 years completed 16 days of food records over the course of a year and then completed a quantitative food frequency questionnaire. The relative validity of macronutrient (fat, protein, and carbohydrate) estimates from the questionnaire was evaluated with the records used as a standard. The two methods differed both in estimated group mean intake and in the relative ranking of individuals. Partitioning of between-method disagreement showed that frequency differences were the main source of poor agreement in relative ranking; serving size differences contributed mainly to disagreement in group mean intake; and differences in nutrient composition had only minor effects. After adjusting for total calorie intake, agreement in group mean intake improved. Agreement in relative ranking and classification also improved, but substantial disagreement remained. The strategy of adjusting for total calorie intake depends on the assumption that macronutrients are reported in similar proportions on both instruments. This assumption did not appear to hold true. Respondents showed considerable variability in the proportionality of reporting, with 46% of respondents reporting fat intake disproportionately. A summary index of proportionality is described and the relation between disproportionate reporting and misclassification is discussed. Disproportionate reporting of macronutrients limits the ability of food frequency questionnaires to rank individuals similarly to a reference method even if estimates are adjusted for total calorie intake.     

Estimating food and nutrient intake from food frequency questionnaire data by reference to a standard weighed diet survey

Introduction The food frequency questionnaire is widely regarded as more appropriate for ranking and grouping individuals according to levels of nutrient intake than for estimating absolute nutrient amounts.
Aims To develop a method for estimation of amount of nutrient intake from food frequency questionnaires by reference to an independent weighed dietary survey.
Method Six stages of the method are described and illustrated in the estimation of total dietary fat from the 1984–85 Health and Lifestyle Survey using the 1986–87 Dietary and Nutritional Survey of British Adults as the reference standard.
Results Several points support the validity of the approach although limitations are identified.     

Reproducibility and validity of food intake measurements from a semiquantitative food frequency questionnaire

Few food frequency questionnaires have been evaluated for their ability to assess intakes of individual foods that may be related to disease independently of their nutrient content. The reproducibility and validity of food intake measurements by a 131-item semiquantitative food frequency questionnaire were evaluated in a sample of 127 men from the Health Professionals Follow-up Study, a large longitudinal study of diet and disease. Each subject completed two questionnaires 1 year apart and two 1-week diet records 6 months apart during the intervening year. Pearson correlations assessing reproducibility between food intakes from the two questionnaires ranged from .31 for pie to .92 for coffee (mean = .59). Validity was measured by comparing food intakes from the second questionnaire with those from the diet records. Pearson correlations corrected for within-person weekly variation in diet record data ranged from .17 for other nuts to .95 for bananas (mean = .63). Large within-person variation precluded the calculation of accurate validity correlations for 29 foods. As we previously observed in women, the foods most often overreported were fruits and vegetables, and meats and dairy products were most often underreported. With few exceptions, reasonable levels of reproducibility and validity were observed for intake of individual foods in this extensive food frequency questionnaire.     

Using food frequency questionnaire in past dietary intake assessment

This paper aims to discuss which one is the best estimator of past diet: a retrospective report or a recent diet recall. The analysis included 13 articles published between 1984-1997 and selected from a MEDLINE search and from other reviews on this subject. The selection criterion was the use of a food frequency questionnaire (FFQ) in a validation study of retrospective report of dietary intake in remote past. Literature review shows that even taking into account misclassification, retrospective report of diet usually yields to a more reliable estimate of past diet pattern than current report. Past diet recall was strongly influenced by current intake and by diet patterns change. Analyzed investigations indicate that agreement between original and retrospective report was higher either for foods eaten rarely or frequently and lower for foods moderately consumed. This review allows considering the FFQ as a valuable instrument when studying the role of diet on the etiology of chronic diseases.     

Validation of a short food frequency questionnaire to assess folate intake

A short quantitative food frequency questionnaire (FFQ) to assess folate intake was developed and validated against a 7-d weighed food intake record (7d-WR) and biochemical indices of folate status. Thirty-six men and women completed the self-administered FFQ on two occasions a month apart, kept a 7d-WR and gave two fasting blood samples at the beginning and end of the study for measuring serum and erythrocyte folate, respectively. Mean folate intakes were similar by repeat FFQ and correlated strongly (r 077 and r 072, P<0.001, for men and women, respectively). All other comparisons were done using the results of the FFQ administered on the first occasion. Men reported similar folate intakes on the FFQ and 7d-WR, but women reported greater intakes on the FFQ compared with the 7d-WR (P<0.05). There was a statistically significant correlation (partial, controlling for gender) between folate intakes reported by FFQ and 7d-WR (r 0.53, P<0.01). Folate intakes estimated by FFQ correlated significantly with serum (r 0.47, P<0.01), but not erythrocyte folate (r 0.25, P>0.05), the strength of the association was greater in men than in women. Validity coefficients estimated using the method of triads were higher for the FFQ than for the 7d-WR when serum folate was used as the biomarker. Overall, these results suggest that this short FFQ is a useful method for assessing folate intake, particularly in men.     

Evaluation of a semi-quantitative food frequency questionnaire to estimate iodine intake

OBJECTIVE: To evaluate a food frequency questionnaire (FFQ) used to assess the dietary intake of iodine. DESIGN: The iodine intake determined by the FFQ was compared with 4-day dietary records and with iodine excretion in 24 h urine samples in a subgroup of participants in a cross-sectional study of iodine intake and thyroid diseases in Denmark. Furthermore, the intake of fish determined from the FFQ was compared with the intake of fish from a simple record kept for 3 months. SUBJECTS: Women aged 25-30 y and 60-65 y. RESULTS: Median iodine intake was similar when determined from the FFQ and from dietary records and the correlation between these measures was 0.52 (P < 0.001). Iodine intake was higher than iodine excretion (P < 0.001). The cross-check questions in the FFQ (for example the question 'How often did you get any kind of fish?') underestimated the intake. In contrast, the intake of a specific fish tended to be overestimated by the FFQ when compared with the 3 month record of fish intake. CONCLUSION: The FFQ can be used to classify subjects into low and high iodine intake groups, but the level of iodine tends to be overestimated.     

Validation of a questionnaire assessing food frequency and nutritional intake in Greek adolescents

The aim of the study was to develop and validate a specific semi-quantitative food frequency questionnaire to assess nutritional intake of Greek adolescents. The sample of the study consisted of 250 pupils (15.3 +/- 0.7 years), who completed the Youth Adolescent Food Frequency Questionnaire enriched with 22 Greek foods and recipes to include ethnic and racial diversity. A 3-day weighed food recall was used as the criterion to test the validity of the questionnaire. The analysis of correlation revealed significant correlations between the two methods for almost all variables. The Pearson's coefficients ranged from 0.83 for energy intake to 0.34 for folate intake. Non-significant correlations were found for selenium and vitamin D intakes. The findings of the study provide evidence for the validity of the scale and its utility in assessing nutritional intake of Greek adolescents.     

Validation of a questionnaire assessing food frequency and nutritional intake in Greek adolescents

The aim of the study was to develop and validate a specific semi-quantitative food frequency questionnaire to assess nutritional intake of Greek adolescents. The sample of the study consisted of 250 pupils (15.3±0.7 years), who completed the Youth Adolescent Food Frequency Questionnaire enriched with 22 Greek foods and recipes to include ethnic and racial diversity. A 3-day weighed food recall was used as the criterion to test the validity of the questionnaire. The analysis of correlation revealed significant correlations between the two methods for almost all variables. The Pearson's coefficients ranged from 0.83 for energy intake to 0.34 for folate intake. Non-significant correlations were found for selenium and vitamin D intakes. The findings of the study provide evidence for the validity of the scale and its utility in assessing nutritional intake of Greek adolescents.     

南通市青少年近视与高能食物摄入频次的关系

  目的  了解南通市青少年近视发生率及其相关因素,分析食物摄入与青少年近视发生的相关关系,为青少年近视防控提供参考。  方法  采用分层整群随机抽样,选取南通市13所学校,以班级为单位抽取3 437名学生开展健康监测和问卷调查,收集学生社会人口学特征和饮食相关信息。  结果  青少年近视检出2 522名,近视率73.4%,城区青少年近视检出率(74.1%)高于郊区(72.4%),且城区的女生近视率(78.2%)高于郊区(73.6%)。多因素Logistic回归分析显示,城区青少年高能食物摄入频次与近视呈正相关(OR=1.50,P < 0.01),在调整年龄、父母近视、参加课外学习班、户外课间活动等因素后,高能食物摄入频次与近视相关性仍有统计学意义(OR=1.29,P=0.03);郊区青少年高能食物摄入频次与近视呈正相关(OR=1.35,P=0.02),在调整了年龄、父母近视、户外课间活动等因素后发现,高能食物摄入频次与近视发生相关性无统计学意义(P=0.60)。  结论  南通市青少年近视发生与高能食物摄入频次呈正相关。家长、学校及社会应关注青少年近视及高能饮食模式问题,注意引导青少年合理的饮食习惯,多角度防控青少年近视。     

Validation of a food frequency questionnaire to assess macro- and micro-nutrient intake among South Asians in the United Kingdom

Summary.Background: The South Asian population is one of the largest minority ethnic groups in the United Kingdom (UK), forming 2.7% of the UK population. Risk of diseases such as CHD, NIDDM is high in South Asians and risk of cancer low in this population compared both to the native UK population and other migrant groups. It is useful to investigate the experience of disease and dietary exposures for aetiological clues in South Asians. The FFQ was designed for a population-based case-control study of diet and breast cancer.Aims: To validate a food frequency questionnaire (FFQ) to assess macro- and micronutrient intake among South Asians in the United Kingdom (UK).Methods: A one-year long study of current diet was conducted using monthly telephone 24-hour recalls followed by administration of an interviewer-administered FFQ to ascertain usual diet during this period. General practices in the Thames and West Midlands regions, England were used to sequentially recruit 100 women from a larger random sample of South Asian migrants from general practitioners patient lists participating as controls in a case-control study of diet and breast cancer.Results: A total of 133 women were invited to achieve the final sample of 100 (76% response rate). The proportion of individuals classified by the two dietary assessment methods into the same or adjacent quartiles was high ranging from 65% (vitamin A) to 96% (protein). Misclassification into opposite quartiles was very low (0 % to 5 %), except for vitamin A (10 %). Energyadjusted Spearman correlation coefficients were reasonable for almost all nutrients being highest for protein (0.76), NSP (0.71), folate (0.70) and cholesterol (0.69). Correction for within-person variation in monthly 24-hour recalls had little effect on the magnitude of the nutrient correlations between the FFQ and the 24-hour recalls. Calibration coefficients to correct relative risks for nutrient-disease associations were above 0.50 for most nutrients indicating that the degree of attenuation introduced by the FFQ would be acceptable.Conclusions: This FFQ was specifically designed for South Asian women in the UK. Despite the diversity of diets, the FFQ had reasonable validity. The role of diet in breast cancer disease aetiology in this population is being assessed with this instrument.Sponsorship: The study was supported by Cancer Research UK.     

Vegetable and fruit food frequency questionnaire serves as a proxy for quantified intake

BACKGROUND: Public health practitioners need valid tools to survey trends in dietary intake. The Rapid Risk Factor Surveillance System (RRFSS) includes an optional six-item vegetable and fruit intake food frequency questionnaire (FFQ) module. Our objectives were 1) to compare reported vegetable and fruit consumption from the FFQ to quantified servings (portions) defined by Canada's Food Guide to Healthy Eating and ascertained by a reference method, and 2) to compare the FFQ with the reference method for their classification of the proportion of respondents consuming five or more servings of vegetables and fruit per day. METHODS: Dietitians administered 24-hour recalls to each of 174 adult respondents who had completed the FFQ as part of the RRFSS. Recalls were conducted over the telephone on three separate occasions using an adaptation of the multiple pass method. RESULTS: The mean total intake of vegetables and fruit for the group was 4.6 times/day from the FFQ versus 4.8 servings/day from the recalls (paired t-test; p = 0.92). Thirty-seven percent of respondents were classified as consuming five or more times/day by the FFQ versus 35% by the 24-hour recall servings. CONCLUSION: The FFQ tool can be used as a proxy for quantified intake of vegetable and fruit consumption.     

Estimating nitrate intake in the Australian diet: Design and validation of a food frequency questionnaire

Background

Dietary nitrates may play a role in mediating several key physiological processes impacting health and/or exercise performance. However, current methods for assessing dietary nitrate (NO₃⁻) consumption are inadequate. The present study aimed to examine the dietary nitrate intake in a sample of 50 healthy adults, as well as test the validity of a purposefully developed food frequency questionnaire (FFQ).

Methods

Dietary nitrate intake was estimated over a week using (i) three 24-h dietary recalls; (ii) a short-term (7-day) FFQ; and (iii) a biomarker (urinary nitrate), in conjunction with a nitrate reference database.

Results

Daily dietary nitrate intake estimates were 130.94 mg (average of three 24-h recalls) and 180.62 mg (FFQ). The mean urinary NO₃⁻ excretion was 1974.79 µmol day^–1 (or 917.9 µmol L^–1). Despite the difference between the two dietary assessment methods, there was a moderate positive correlation (r = 0.736, ρ < 0.001) between the two tools. There was also a positive correlation between urinary NO₃⁻ and 24-h recall data (r = 0.632, ρ < 0.001), as well as between urinary NO₃⁻ and FFQ (r = 0.579, ρ < 0.001).

Conclusions

The ability to accurately estimate nitrate intakes depends on having suitable reference methods to estimate the concentrations of nitrate in the food supply, coupled with valid and reliable dietary assessment tools. Based on the findings from the present study, at an individual level, dietary recalls or records may be more accurate in estimating intakes of NO₃⁻. However, given the lower cost and time needed for administration relative to recalls, the FFQ has merit for estimating NO₃⁻ intakes in health interventions, dietary surveys and surveillance programs.

     

Measuring short-term dietary intake: development and testing of a 1-week food frequency questionnaire

Measures typically used to assess short-term intake are 24-hour recalls or records of food intake. However, these methods require a large time commitment from both researchers and subjects. Our study sought to develop a more time-efficient method of assessing short-term intake by developing a 7-day food frequency questionnaire (7DFFQ). We modified Willett's 1-year food frequency questionnaire to assess intake for a 7-day period. Content validity has previously been exhibited in Willett's work. We assessed criterion validity by comparing the 7DFFQ with 24-hour recalls. Twenty-one female and 20 male college students were asked to recall their previous day's intake three times during a 1-week period. After the last recall, subjects completed a 7DFFQ covering the same week. Data were analyzed by comparing each recall and the mean of the three recalls with values obtained on the 7DFFQ. Analyses revealed high correlations between the mean of the three recalls and the 7DFFQ. Further analysis ranked subjects into quartiles for each nutrient on both measures. Most subjects changed either no quartiles or only one quartile for total energy and each nutrient. Test/retest reliability was assessed by administering the 7DFFQ to a group of women for two consecutive weeks and by administering the 7DFFQ to a group twice 3 hours apart. Pearson's r and intraclass correlations for the two administrations show moderately high reliability over the 1-week period and considerable improvement with the 3-hour administration. The 7DFFQ appears to meet several of the criteria for a measure of dietary intake.     

Production and validation of a food frequency questionnaire to estimate dietary fat intake

A quantitative 92-item food frequency questionnaire (FFQ), using photographs to estimate portion size, was developed from a 180-item FFQ and validated by comparison with weighed dietary records of 80 adults. The main aim of the FFQ was to classify subjects according to their fat intake as a percentage of total energy intake. Correlation coefficients and classification of individuals into thirds for fat (g), percentage energy from fat and total energy, showed good agreement between the FFQ and the diet record. There was significant difference in the mean percentage energy from fat but not in grams of fat or total energy intake estimated by the two methods. Intra-class correlation coefficients indicated a significant relationship between an individuals>> percentage energy from fat estimated by the FFQ and diet records. These results suggest that the FFQ was suitable for classifying individuals into groups based on their percentage energy from fat and for estimating the actual average fat and energy intake of groups, and that the FFQ may be useful for estimating the percentage energy from fat for an individual.     

Estimating the relation between dietary intake obtained from a food frequency questionnaire and true average intake

Knowledge of the regression relation between dietary intake reported on a food frequency questionnaire and true average intake is useful in interpreting results from nutritional epidemiologic studies and in planning such studies. Studies which validate a questionnaire against a food record may be used to estimate this regression relation provided the food record is completed by each subject on at least two occasions. Using data collected from women aged 45-69 years during 1985-1986 in the pilot study of the Women's Health Trial, the authors show how variation in diet over time and intraindividual correlation between a questionnaire and food record obtained close together in time affects the estimation of the regression. The authors' method provides estimates of the regression slope and the questionnaire "bias" that are corrected for these effects, together with standard errors. A computer program in the SAS language, for carrying out the analysis, is provided.