Validity and Calibration of Food Frequency Questionnaires Used with African-American Adults in the Jackson Heart Study

Objective

To examine the relative validity of two food frequency questionnaires (FFQs) developed for use in investigating diet and disease relationships within the adult African-American population in the southern United States.

Design

Cross-sectional analyses of dietary nutrient intake data, comparing four 24-hour dietary recalls with an FFQ developed by the Lower Mississippi Delta Nutrition Intervention Research Initiative, and its shorter version adapted for use in the Jackson Heart Study.

Subjects

A representative subset of participants (n=499, aged 35 to 81 years) from the baseline Jackson Heart Study cohort (N=5,302) was selected for this study. Data collection took place between winter 2000 and spring 2004.

Statistical analyses

Pearson's correlation coefficients (energy adjusted and de-attenuated) for 26 nutrients estimates from each of the FFQs, comparing them with the mean of four 24-hour dietary recalls. The ability of the FFQs to rank individuals based on nutrient intakes was compared to that of the mean of four 24-hour dietary recalls and attenuation coefficients were also calculated.

Results

Median nutrient intake estimates tended to be higher on the long and lower on the short FFQ compared to the median for the mean of four 24-hour dietary recalls. Energy adjusted and deattenuated correlations of FFQ intake estimates with recalls ranged from 0.20 for sodium to 0.70 for carbohydrate for the short FFQ and from 0.23 for polyunsaturated fat to 0.75 for dietary fiber and magnesium for the long. Attenuation coefficients for men on average were 0.42 for the short and 0.49 for the long FFQ. For women, these were 0.31 for the short and 0.42 for the long FFQ.

Conclusions

Both FFQs appear to be reasonably valid for assessment of dietary intake of adult African Americans in the South. The Lower Mississippi Delta Nutrition Intervention Research Initiative FFQ exhibited higher intake estimates and stronger correlations with recalls than the Jackson Heart Study FFQ for most nutrients analyzed, more so for women than men.     

Comparison of Energy Intake in Toddlers Assessed by Food Frequency Questionnaire and Total Energy Expenditure Measured by the Doubly Labeled Water Method

The ability of parents to accurately report energy intake in toddlers has rarely been validated using the gold-standard doubly labeled water (DLW) method to assess total energy expenditure (TEE). The aim of the study was to evaluate the accuracy of toddler energy intake (EI), estimated using the Australian Child and Adolescent Eating Survey (ACAES) food frequency questionnaire (FFQ) by parent report compared with a weighed food record (WFR) and TEE measured by DLW. Twelve toddlers had TEE assessed over 10 days using DLW. Usual energy intake was estimated by the primary caregiver, using standard toddler portions in ACAES-FFQ and a 4-day WFR and daily EI (in kilocalories) derived using national nutrient databases. Accuracy of reporting was calculated from absolute (EI-TEE) and percentage (EI/TEE×100) differences between EI and TEE and Pearson correlations and limits of agreement from Bland-Altman plots. Toddlers (n=12, 7 boys) had a mean age of 3.2±0.5 years, body mass index 16.2±0.9 kg, body mass index z score 0.1±0.8, EI from ACAES-FFQ 1,183±281kcal/day, and WFR 1,179±278 kcal/day and DLW TEE 1,251±149 kcal/day. The mean difference and limits of agreement (±2 standard deviations) compared with DLW was ?68 (?623, 488) kcal/day for the FFQ and for the WFR ?72 (?499, 354) kcal/day. Although both a semiquantitative FFQ and WFR can adequately estimate toddler energy intake at the group level in this population, toddler-specific portion size estimates should be assigned to foods listed in the FFQ. Choice of method is likely to depend on practical issues, including cost and burden.     

A Mobile Phone Based Method to Assess Energy and Food Intake in Young Children: A Validation Study against the Doubly Labelled Water Method and 24 h Dietary Recalls

Mobile phones are becoming important instruments for assessing diet and energy intake. We developed the Tool for Energy Balance in Children (TECH), which uses a mobile phone to assess energy and food intake in pre-school children. The aims of this study were: (a) to compare energy intake (EI) using TECH with total energy expenditure (TEE) measured via doubly labelled water (DLW); and (b) to compare intakes of fruits, vegetables, fruit juice, sweetened beverages, candy, ice cream, and bakery products using TECH with intakes acquired by 24 h dietary recalls. Participants were 39 healthy, Swedish children (5.5 ± 0.5 years) within the ongoing Mobile-based Intervention Intended to Stop Obesity in Preschoolers (MINISTOP) obesity prevention trial. Energy and food intakes were assessed during four days using TECH and 24 h telephone dietary recalls. Mean EI (TECH) was not statistically different from TEE (DLW) (5820 ± 820 kJ/24 h and 6040 ± 680kJ/24 h, respectively). No significant differences in the average food intakes using TECH and 24 h dietary recalls were found. All food intakes were correlated between TECH and the 24 h dietary recalls (ρ = 0.665–0.896, p < 0.001). In conclusion, TECH accurately estimated the average intakes of energy and selected foods and thus has the potential to be a useful tool for dietary studies in pre-school children, for example obesity prevention trials.     

Measurements of daily energy intake and total energy expenditure in people with dementia in care homes: The use of wearable technology

Objective

To estimate daily total energy expenditure (TEE) using a physical activity monitor, combined with dietary assessment of energy intake to assess the relationship between daily energy expenditure and patterns of activity with energy intake in people with dementia living in care homes.

Design and setting

A cross-sectional study in care homes in the UK.

Participants

Twenty residents with confirmed dementia diagnosis were recruited from two care homes that specialised in dementia care.

Measurements

A physical activity monitor (Sensewear? Armband, Body Media, Pittsburgh, PA) was employed to objectively determine total energy expenditure, sleep duration and physical activity. The armband was placed around the left upper triceps for up to 7 days. Energy intake was determined by weighing all food and drink items over 4 days (3 weekdays and 1 weekend day) including measurements of food wastage.

Results

The mean age was 78.7 (SD ± 11.8) years, Body Mass Index (BMI) 23.0 (SD ± 4.2) kg/m²; 50% were women. Energy intake (mean 7.4; SD ± 2.6) MJ/d) was correlated with TEE (mean 7.6; SD ± 1.8 MJ/d; r=0.49, p<0.05). Duration of sleeping ranged from 0.4-12.5 (mean 6.1) hrs/d and time spent lying down was 1.3-16.0 (8.3) hrs/d. On average residents spent 17.9 (6.3-23.4) hrs/d undertaking sedentary activity. TEE was correlated with BMI (r=0.52, p<0.05) and body weight (r=0.81, p<0.001) but inversely related to sleep duration (r=-0.59, p<0.01) and time lying down (r=-0.62, p<0.01). Multiple linear regression analysis revealed that after taking BMI, sleep duration and time spent lying down into account, TEE was no longer correlated with energy intake.

Conclusions

The results show the extent to which body mass, variable activity and sleep patterns may be contributing to TEE and together with reduced energy intake, energy requirements were not satisfied. Thus wearable technology has the potential to offer realtime monitoring to provide appropriate nutrition management that is more person-centred to prevent weight loss in dementia.

     

Dutch food bank recipients have poorer dietary intakes than the general and low-socioeconomic status Dutch adult population

Purpose

Food-assistance program users are a specific group of nutritional concern, as they are often food insufficient and have poorer diet quality compared to non-food-assistance program users. The aim of our study was to assess dietary intake of Dutch food bank recipients (n = 167) and to compare this with dietary intake of a representative sample of the general population (Dutch National Food Consumption Survey (DNFCS-all): n = 1933), including a low-socioeconomic status (SES) sample (DNFCS-low SES: n = 312), using data from the DNFCS 2007–2010.

Methods

In this cross-sectional study, 12 food banks throughout The Netherlands participated. Food bank recipients’ characteristics were assessed with a self-administered questionnaire. Dietary intake data were collected through three 24-h recalls. Habitual dietary intake (mean, percentiles, and 95% CI) was estimated for all samples. Differences between samples were determined by comparing the 95% CIs.

Results

Mean age of the study population (62.9% female) was 48.6 years (SD:10.1). Mean energy intake was 1986 (95% CI 1830–2089) kcal. The majority of the Dutch food bank recipients had lower intakes than dietary reference intakes for dietary fiber, fruit, vegetables, and fish (range 86.6–99.3%), and a higher intake for saturated fat [88.1% (95% CI 84.1–98.9)]. Furthermore, mean intakes of energy, fiber, fruit, and vegetables were significantly lower in Dutch food bank recipients than in the DNFCS-all and the DNFCS-low-SES [e.g., daily mean fruit intake (g) food bank recipients 62.8 (95% CI 45.5–76.5), DNFCS-all 105.8 (95% CI 105.4–117.9), and DNFCS-low-SES 85.1 (95% CI 78.7–100.2)]. Fish intake was significantly lower compared with the DNFCS-all, but not compared with the DNFCS-low-SES.

Conclusions

Dutch food bank recipients, who largely rely on the content of food parcels, are not able to meet the nutritional guidelines for a healthy diet, and their dietary intake is poorer than the general as well as the low-SES sample of the Dutch adult population. More research is needed on how to improve the dietary intake of this vulnerable population subgroup, by, e.g., revising the content of the food parcels, and to develop effective intervention activities.

     

Reproducibility and Relative Validity of Food Group Intake in a Food Frequency Questionnaire Developed for the Tehran Lipid and Glucose Study

Objective

To examine the validity and reproducibility of food groups in the semi-quantitative food frequency questionnaire (FFQ) developed for the Tehran Lipid and Glucose Study (TLGS).

Methods

To evaluate the reproducibility of food groups included in the FFQ, 132 subjects (61 men and 71 women) aged 20 years or older twice completed a 168-item FFQ (FFQ1, FFQ2), with a 14-month interval between FFQ1 and FFQ2. Over the 1-year interval, 12 dietary recalls (DRs) were collected (1 each month) to assess the validity of the FFQ. Seventeen food groups were derived from the FFQ based on methods described in previous studies. Age-adjusted and deattenuated Spearman correlation coefficients were used to assess the validity of the FFQ.

Results

The mean (SD) age and body mass index of subjects were 35.5 (16.8) years and 25.5 (5.2) kg/m², respectively. Validity correlation coefficients ranged from 0.03 (liquid oil) to 0.77 (simple sugars) in men (median, 0.44), and from 0.12 (snacks) to 0.79 (simple sugars) in women (median, 0.37). The energy-adjusted intraclass correlation coefficient, which reflects the reproducibility of the FFQ, was 0.51 in men and was highest for tea and coffee (0.91); in women it was 0.59 and was highest for simple sugars (0.74). The highest percentage of complete agreement and disagreement was observed for snacks and desserts (60.6%) and potatoes and dairy products (12.8%), respectively, in men, and tea and coffee (62.9%) and legumes (15.7%) in women.

Conclusions

The FFQ that was designed for the TLGS was found to be reliable and valid for assessing the intake of several food groups.Key words: food frequency questionnaire, validity and reproducibility, food group, Tehran     

Validation of a food frequency questionnaire for Japanese pregnant women with and without nausea and vomiting in early pregnancy

Background

No previous study has shown the validity of a food frequency questionnaire (FFQ) in early pregnancy with consideration of nausea and vomiting during pregnancy (NVP). The aim of this study was to evaluate the validity of a FFQ in early pregnancy for Japanese pregnant women.

Differences between Food Group Reports of Low-Energy Reporters and Non-Low-Energy Reporters on a Food Frequency Questionnaire

Background

Low-energy reporters (LERs) and non-LERs differ with respect to several characteristics, including self-reported intake of foods. Limited data exist regarding food intake difference between LERs and non-LERs identified using doubly labeled water (DLW).

Objective

In the Observing Protein and Energy Nutrition Study (September 1999-March 2000), differences were examined between food group reports of LERs and non-LERs on a food frequency questionnaire (FFQ) (n=440).

Design

LERs were identified using DLW. Responses of LERs (n=220) and non-LERs (n=220) for 43 food groups on the FFQ were examined in three ways: whether they reported consuming a food group (yes/no), how frequently they reported consuming it (times per day), and the reported portion size (small, medium, or large). Analyses were adjusted for total energy expenditure from DLW.

Results

LERs, compared to non-LERs, were less likely to report consumption for one food group among women (soft drinks/regular). Among men, there was no difference between LERs and non-LERs with respect to reporting consumption of food groups. Reported mean daily frequency of consumption was lower among LERs compared with non-LERs for 23 food groups among women and 24 food groups among men (18 food groups were similar in men and women). In addition, reported mean portion sizes were smaller for LERs compared with non-LERs for six food groups among women and five food groups among men (three food groups were similar in men and women). Results varied minimally by sex and body mass index.

Conclusions

LERs, compared with non-LERs, were more likely to differ regarding their reported frequency of consumption of food groups than their reported consumption (yes/no) or portion size of food groups. Results did not vary greatly by sex or body mass index. It still remains unclear whether improvement in questionnaire design or additional tools or methods would lead to a decrease in differential reporting due to LER status on an FFQ.     

The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes

BACKGROUND: The US Department of Agriculture Automated Multiple-Pass Method (AMPM) is used for collecting 24-h dietary recalls in What We Eat In America, the dietary interview component of the National Health and Nutrition Examination Survey. Because the data have important program and policy applications, it is essential that the validity of the method be tested. OBJECTIVE: The accuracy of the AMPM was evaluated by comparing reported energy intake (EI) with total energy expenditure (TEE) by using the doubly labeled water (DLW) technique. DESIGN: The 524 volunteers, aged 30-69 y, included an equal number of men and women recruited from the Washington, DC, area. Each subject was dosed with DLW on the first day of the 2-wk study period; three 24-h recalls were collected during the 2-wk period by using the AMPM. The first recall was conducted in person, and subsequent recalls were over the telephone. RESULTS: Overall, the subjects underreported EI by 11% compared with TEE. Normal-weight subjects [body mass index (in kg/m(2)) < 25] underreported EI by <3%. By using a linear mixed model, 95% CIs were determined for the ratio of EI to TEE. Approximately 78% of men and 74% of women were classified as acceptable energy reporters (within 95% CI of EI:TEE). Both the percentage by which energy was underreported and the percentage of subjects classified as low energy reporters (<95% CI of EI:TEE) were highest for subjects classified as obese (body mass index > 30). CONCLUSIONS: Although the AMPM accurately reported EIs in normal-weight subjects, research is warranted to enhance its accuracy in overweight and obese persons.     

Validation of a Food Frequency Questionnaire for Estimating Micronutrient Intakes in an Urban US Sample of Multi-Ethnic Pregnant Women

Objective(s)

To validate the Block98 food frequency questionnaire (FFQ) for estimating antioxidant, methyl-nutrient and polyunsaturated fatty acids (PUFA) intakes in a pregnant sample of ethnic/racial minority women in the United States (US).

Methods

Participants (n = 42) were from the Programming of Intergenerational Stress Mechanisms study. Total micronutrient intakes from food and supplements was ascertained using the modified Block98 FFQ and two 24-h dietary recalls collected at random on nonconsecutive days subsequent to completion of the FFQ in mid-pregnancy. Correlation coefficients (r) corrected for attenuation from within-person variation in the recalls were calculated for antioxidants (n = 7), methyl-nutrients (n = 8), and PUFAs (n = 2).

Result(s)

The sample was largely ethnic minorities (38 % Black, 33 % Hispanic) with 21 % being foreign born and 41 % having less than or equal to a high school degree. Significant and adequate deattenuated correlations (r ≥ 0.40) for total dietary intakes of antioxidants were observed for vitamin C, vitamin E, magnesium, and zinc. Reasonable deattenuated correlations were also observed for methyl-nutrient intakes of vitamin B6, betaine, iron, and n:6 PUFAs; however, they did not reach significance. Most women were classified into the same or adjacent quartiles (≥70 %) for total (dietary + supplements) estimates of antioxidants (5 out of 7) and methyl-nutrients (4 out of 5).

Conclusions

The Block98 FFQ is an appropriate dietary method for evaluating antioxidants in pregnant ethnic/minorities in the US; it may be less efficient in measuring methyl-nutrient and PUFA intakes.

     

Development and Validation of a Comprehensive Semi-Quantitative Food Frequency Questionnaire that Includes FODMAP Intake and Glycemic Index

Background

Fermentable, short chain carbohydrates (FODMAPs) have been identified as triggers for functional gastrointestinal symptoms. In addition, excess FODMAP consumption has been implicated in the onset of Crohn's disease, and animal studies suggest that a low glycemic index diet can impair absorption of fructose, a major dietary FODMAP. Such hypotheses cannot be tested without the ability to quantify FODMAP ingestion with a validated dietary assessment tool.

Objective

To assess the validity and reproducibility of a 297-item comprehensive, semi-quantitative food frequency questionnaire (FFQ) in estimating intake of macro- and micronutrients, FODMAPs, and glycemic index/load.

Subjects/setting

One hundred healthy participants were recruited to complete the FFQ on two occasions, plus four 1-week food diaries kept during a 12-month period. Participants exhibiting major dietary change during the study period or low energy reporting on the FFQ were excluded.

Main outcome measures

Validation and reproducibility of the semi-quantitative FFQ by comparison with the mean of four 1-week food diaries.

Statistical analyses performed

Validation was assessed using Wilcoxon signed rank test, Spearman's correlation, Bland-Altman, and weighted κ statistics. Reproducibility was examined using Shrout-Fleiss intraclass correlation coefficient.

Results

Seventy-two participants fulfilled inclusion and exclusion criteria. Demographics of the participants were comparable with 2006 Australian Census data. Consistent with other reported FFQs, the FFQ overestimated nutrient intake by a mean 140% (range=95% to 249%). However, based on the other analyses performed, it demonstrated validity for intake of sugars, fiber, alcohol, glycemic index, glucose, FODMAPs, calcium, folate, phosphate, potassium, iron, and magnesium; moderate validation for energy, total fat, saturated fat, carbohydrates, sodium, thiamin, sucrose, and retinol; poor validation for protein, mono/polyunsaturated fat, starch, glycemic load, niacin, and zinc. Riboflavin intake was not validated. Intraclass correlation coefficients for reproducibility ranged from 0.352 to 0.928.

Conclusions

The FFQ was validated for assessment of a wide range of nutrients, including the new class of carbohydrates, FODMAPs, and glycemic index. This provides a useful tool for dietary research, particularly in the area of gastroenterological disorders.     

Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding

Background

Weight gain in the postpartum period is a risk factor for long-term obesity. Investigations of dietary intake among lactating and nonlactating overweight women might identify nutritional concerns specific to this population.

Objective

To compare nutrient, meal, and snack intakes, food-group servings and prevalence of dieting among fully breastfeeding (BF), mixed breast and formula feeding (MF), and formula feeding (FF) overweight and obese women. The second aim was to compare nutrient intakes and food-group servings to the Dietary Reference Intake and MyPyramid recommendations, respectively.

Design

Data were collected from September 2004 through April 2006 in Durham, NC. Infant feeding practices and dietary information were collected on 450 women between 6 and 9 weeks postpartum. Two 24-hour dietary recalls were completed by phone, using Nutrition Data Systems for Research. Analysis of covariance was used to compare infant feeding groups in dietary quality (nutrient intake per 1,000 kcal) and food-group servings, controlling for prepregnancy body mass index, race, age, education, income, and marital status. χ² analysis was performed to determine differences in meal and snack intake and dieting among infant feeding groups.

Results

BF women consumed more energy (2,107±50 kcal) than MF (1,866±56 kcal) or FF (1,657±50 kcal) women (P<0.001). Adjusted nutrient intake did not differ between groups. All groups were at risk for inadequate intakes of vitamins A, E, C, and folate and did not meet recommended servings of all food groups. BF women consumed lunch and snacks more frequently, were less likely to diet, and reported higher intakes of grains and desserts than MF and FF women.

Conclusions

To help increase intakes of nutrients lacking in the diet and prevent postpartum weight gain, overweight women should be encouraged to increase fruits, vegetables, low-fat dairy, whole grains, legumes, and healthy types of fat, while decreasing refined grains, regular soda, sweetened beverages, and desserts.     

Feasibility,Acceptability, and Preliminary Validity of Self-Report Dietary Assessment in Adults with Multiple Sclerosis: Comparison with Doubly Labeled Water Measured Total Energy Expenditure

Background: Diet is a modifiable behavior of interest in multiple sclerosis (MS); however, measures of diet in persons with MS have not been vetted for feasibility, acceptability, and validity. Methods: This cross-sectional study examined the Automated Self-Administered 24-H (ASA24) Dietary Assessment Tool in 30 persons with MS and 15 healthy control (HC) participants. Participants were prompted to complete six ASA24 recalls and undergo a standard doubly labeled water (DLW) protocol. Acceptability of ASA24 was assessed using an online questionnaire. Total energy expenditure (TEE) from DLW was compared with ASA24-reported energy intake for assessing validity. Results: All participants completed four or more ASA24 recalls, indicating feasibility of ASA24. Regarding acceptability, the hardest part of completing the ASA24 was remembering everything eaten the previous day. Pearson correlation coefficients between DLW TEE and ASA24 kcal/day were not significant among HC (r = 0.40; p = 0.14) or MS (r = 0.26; p = 0.16) participants. The absolute mean error between DLW TEE and ASA24 among HC participants was 694.96 ± 506.25 mean kcal/day and among MS participants was 585.37 ± 529.02 mean kcal/day; this represents a mean difference of 30 and 25%, respectively. Conclusion: This study established the feasibility and acceptability of ASA24 in persons with MS and provides a foundation regarding the need for further validation research examining appropriate outcomes for supporting dietary interventions.     

Racial differences in misclassification of healthy eating based on food frequency questionnaire and 24-hour dietary recalls

Objectives

To examine the agreement in nutrient intake and alternate healthy eating indices (AHEI) between a self-administered Food Frequency Questionnaire (FFQ) and 24-hour recall (24HR) measurements of diet by race, among urban older women.

Design

Cross-sectional observational study

Setting

Urban neighborhoods in Washington, DC, USA.

Participants

Community-dwelling White and Black women aged 65 and older.

Measurements

In 2014 and 2015, 49 White and 44 Black older women were queried on diet using both FFQ and 24-hour recalls. The correlation coefficients of 55 nutrient intake measures and agreements on healthy eating classification between the two instruments were compared overall and by race.

Results

The mean correlation coefficient (rho) was 0.46 for Whites and 0.23 for Blacks. For 47 measures, rho was lower for Blacks. Whites had a strong correlation of ≥0.5 for 28 items, while Blacks had strong correlations for only 3 items. Based on FFQ, the mean (SD) of AHEI were 54.0 (10.3) for Whites and 45.9 (8.8) for Blacks (P< 0.001). Based on 24HR, the mean (SD) were 43.9 (10.8) for Whites and 33.2 (9.6) for Blacks (P< 0.001). Using 32 as the cutoff (40% of maximum AHEI score), 50% of Blacks and 14% of Whites were classified as eating unhealthy based on the 24HR, versus 2.6% and 0% based on the FFQ.

Conclusion

The FFQ has limited ability to accurately assess nutrient intake among older Black women, and tends to underestimate racial differences in healthy eating. The FFQ should be further improved for use in racial disparities research of healthy eating in older age, using a larger sample of older women with racial and geographic diversities.

     

Feasibility and Acceptability of Dietary Intake Assessment Via 24-Hour Recall and Food Frequency Questionnaire among Women with Low Socioeconomic Status

Background

Comprehensive evaluation of dietary interventions depends on effective and efficient measurement to quantify behavior change. To date, little is known regarding which self-reported measure of dietary intake is most feasible and acceptable for use in evaluation of the effectiveness of diet intervention studies among underserved populations.

The USDA Automated Multiple-Pass Method accurately estimates group total energy and nutrient intake

The imperative to address the national obesity epidemic has stimulated efforts to develop accurate dietary assessment methods suitable for large-scale applications. This study evaluated the performance of the USDA Automated Multiple-Pass Method (AMPM), the computerized dietary recall designed for the National Health and Nutrition Examination Survey dietary survey, and 2 epidemiological methods [the Block food-frequency questionnaire (Block) and National Cancer Institute's Diet History Questionnaire (DHQ)] using doubly labeled water (DLW) total energy expenditure (TEE) and 14-d estimated food record (FR) absolute nutrient intake as criterion measures. Twenty highly motivated, normal-weight-stable, premenopausal women participated in a free-living study that included 2 unannounced AMPM recalls and completion of the Block and DHQ. AMPM and FR total energy intake (TEI) did not differ significantly from DLW TEE [AMPM: 8982 +/- 2625 kJ; FR: 8416 +/- 2217; DLW: 8905 +/- 1881 (mean +/- SD)]. Conversely, the questionnaires underestimated TEI by approximately 28% (Block: 6365 +/- 2193; DHQ: 6215 +/- 1976; P < 0.0001 vs. DLW). Pearson correlation coefficients for DLW TEE with each dietary method TEI showed a stronger linear relation for AMPM (r = 0.53; P = 0.02) and FR (r = 0.41; P = 0.07) than for the Block (r = 0.25; P = 0.29) and DHQ (r = 0.15; P = 0.53). Most mean absolute FR nutrient intakes were closely approximated by the AMPM but were significantly underestimated by the questionnaires. In highly motivated premenopausal women, the AMPM provides valid measures of group total energy and nutrient intake whereas the Block and DHQ yield underestimations.     

Validity of a self-administered food frequency questionnaire for middle-aged urban cancer screenees: comparison with 4-day weighed dietary records

Background

The validity of estimates of dietary intake calculated using a food frequency questionnaire (FFQ) depends on the specific population. The 138-item FFQ used in the 5-year follow-up survey for the Japan Public Health Center-based Prospective Study was initially developed for and validated in rural residents. However, the validity of estimates based on this FFQ for urban residents, whose diet and lifestyle differ from those of rural residents, has not been clarified. We examined the validity of ranking individuals according to level of dietary consumption, as estimated by this FFQ, among an urban population in Japan.

Methods

Among 896 candidates randomly selected from examinees of cancer screening provided by the National Cancer Center, Japan, 144 participated in the study. In 2007–2008, at an average 2.7 years after cancer screening, participants were asked to respond to the questionnaire and to provide 4-day weighed diet records (4d-DRs) for use as the reference intake. Spearman correlation coefficients (CCs) between the FFQ and 4d-DR estimates were calculated, after correction for intraindividual variation of 4d-DRs.

Results

The median (range) deattenuated CC for men and women was 0.57 (0.23 to 0.89) and 0.47 (0.08 to 0.94), respectively, across 45 nutrients and 0.51 (0.10 to 0.98) and 0.51 (−0.36 to 0.88) for 43 food groups.

Conclusions

Although the FFQ was developed for a rural population, it provided reasonably valid measures of consumption for many nutrients and food groups in middle-aged screenees living in urban areas in Japan.Key words: dietary assessment, food frequency questionnaire, validity     

Relative validity of food frequency questionnaire nutrient estimates in the Black Women's Health Study

PURPOSE: The Black Women's Health Study (BWHS) was designed to investigate determinants of health and disease in US black women. More than 64,000 women are enrolled in the BWHS cohort. This study assessed the relative validity of the 68-item food frequency questionnaire (FFQ) used in the BWHS baseline questionnaire. METHODS: Four hundred and eight BWHS enrollees were asked to provide three telephone, 24-hour recalls and one written 3-day food diary over a one-year period. Means and Pearson correlations were computed to compare estimates for energy, total fat, saturated fat, protein, carbohydrate, dietary fiber, calcium, iron, vitamin C, folate, beta-carotene, and vitamin E from the FFQ, recalls, and diaries. RESULTS: Mean energy intake (kcal) was higher for the diary (1716) than the FFQ (1601) or recalls (1510). Other nutrient estimates (% kcal or per 1000 kcal) were similar across methods, except beta-carotene (FFQ higher). Correlations (energy-adjusted, except for energy, and corrected for intraperson variation) between the FFQ and the recalls were higher than for the diary data and were between 0.5 and 0.8, except for energy and vitamin E (both <0.3). CONCLUSION: The BWHS FFQ will support meaningful analyses of diet-health associations for 10 of the 11 energy-adjusted nutrient intake variables analyzed.     

Validity of a Self-Administered Food-Frequency Questionnaire for Assessing Amino Acid Intake in Japan: Comparison With Intake From 4-Day Weighed Dietary Records and Plasma Levels

Background

Interest in the physiological roles of amino acids and their impact on health outcomes is substantial and growing. This interest has prompted assessment of the habitual intake of amino acids for use in epidemiologic studies and in clarifying the association between habitual intake and plasma levels of amino acids. Here, we investigated the validity of ranking individuals according to dietary amino acid intake as estimated using a food frequency questionnaire (FFQ) in comparison with intakes from dietary records (DRs) and plasma levels.

Methods

A total of 139 men and women selected from examinees of the cancer screening program at the Research Center for Cancer Prevention and Screening, National Cancer Center, Japan, provided 4-day weighed DRs, a semi-quantitative FFQ, and plasma samples. Plasma levels of amino acids were measured using the UF-Amino Station system.

Results

Spearman rank correlation coefficients of energy-adjusted intake of amino acids from the DR and FFQ ranged from 0.40 to 0.65 for men and from 0.35 to 0.46 for women. Correlation coefficients of energy-adjusted intake from the DR and plasma levels ranged from −0.40 to 0.25 for men and from −0.16 to 0.11 for women. Similarly, no significant positive correlation coefficients were observed between intake from the FFQ and plasma levels for either men or women.

Conclusions

We confirmed that this FFQ has moderate validity in estimating amino acid intake when 4-day weighed DRs are used as a reference method, suggesting that it is suitable for ranking individuals living in urban areas in Japan by amino acid intake.Key words: amino acids, food frequency questionnaire, plasma level, validity     

Evaluation of Dietary Assessment Tools Used to Assess the Diet of Adults Participating in the Communities Advancing the Studies of Tribal Nations Across the Lifespan Cohort

Background

Accurate assessment of dietary intake is essential for researchers and public health practitioners to make advancements in public health. This is especially important in Native Americans who display disease prevalence rates that are dramatically higher than the general US population.

Objective

To evaluate three dietary assessment tools: dietary records, a food frequency questionnaire (FFQ), and a shellfish assessment survey among Native American adults from the Communities Advancing the Studies of Tribal Nations Across the Lifespan (CoASTAL) cohort.

Design

The CoASTAL cohort was composed of randomly selected individuals from three tribal registries of Pacific Northwest Tribal Nations. This cross-sectional study used data from the baseline of CoASTAL and was restricted to the non-pregnant adults (aged 18 years or older) who completed the shellfish assessment survey (n=500), an FFQ (n=518), dietary records (n=444), weight measures (n=493), and height measures (n=496). Paired t tests, Pearson correlation coefficients, and percent agreement were used to evaluate the dietary records and the FFQ with and without accounting for plausibility of reported energy intake (rEI). Sensitivity and specificity as well as Spearman correlation coefficients were used to evaluate the shellfish assessment survey and the FFQ compared to dietary records.

Results

Statistically significant correlations between the FFQ and dietary records for selected nutrients were not the same by sex. Accounting for plausibility of rEI for the dietary records and the FFQ improved the strength of the correlations for percent energy from protein, energy from carbohydrate, and calcium for both men and women. In addition, the association between rEI (dietary records and FFQ) and weight became significant when the sample was limited to plausible rEI. The shellfish assessment survey was found to similarly assess shellfish consumption in comparison to the FFQ.

Conclusions

These results support the benefit of multiple measures of diet, including regional and culturally specific surveys, especially among Native Americans. Accounting for plausibility of rEI may ensure more accurate estimations of dietary intakes.