Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Epidemiology

Validation of a FFQ for estimating ω-3, ω-6 and trans fatty acid intake during pregnancy using mature breast milk and food recalls

European Journal of Clinical Nutrition volume 66, pages 1259–1264 (2012)Cite this article

Subjects

Abstract

BACKGROUND/OBJECTIVES:

To assess the performance of a food frequency questionnaire (FFQ) for estimating ω-3, ω-6 and trans fatty acid intake during pregnancy. Moreover, we determined whether the fatty acid composition of mature breast milk represents a valuable biomarker for fatty acid intake during pregnancy.

SUBJECTS/METHODS:

A prospective study in 41 pregnant women, aged 18–35 years, was conducted. Food intake during pregnancy was evaluated by three 24-h recalls (24 hR), and 2 FFQ. The fatty acid composition of mature breast milk was determined by gas chromatography. The method of triads and joint classification between quartiles of intake were applied.

RESULTS:

The FFQ was accurate for estimating docosahexanoic (DHA), linoleic and total ω-6 fatty acids according to validity coefficients. Higher agreements (>70%) into the same or adjacent quartiles between the dietary methods were found for α-linolenic, total ω-3, linoleic and trans fatty acid intake. High validity coefficients for eicosapentanoic (EPA) and DHA acids of human milk were found (0.61 and 0.73, respectively), and the method was adequate for categorizing the intake of α-linolenic, total ω-3 and trans fatty acids compared with FFQ estimates, and for arachidonic acid and trans fatty acids compared with food recall estimates, during pregnancy.

CONCLUSIONS:

The FFQ was an accurate tool for categorizing α-linolenic, total ω-3 and trans fatty acid intake. According to the validity coefficients observed, the FFQ accurately estimated DHA, linoleic and total ω-6 fatty acids and the composition of mature breast milk was shown to be a suitable biomarker for EPA and DHA fatty acid intake during pregnancy.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Meltzer HM, Brantsaeter AL, Nilsen RM, Magnus P, Alexander J, Haugen M . Effect of dietary factors in pregnancy on risk of pregnancy complications: results from the Norwegian Mother and Child Cohort Study. Am J Clin Nutr 2011; 4: 1S–5S.

    Article  Google Scholar 

  2. Yajnik CS, Deshmukh US . Maternal nutrition, intrauterine programming and consequential risks in the offspring. Rev Endocr Metab Disord 2008; 9: 203–211.

    Article  CAS  Google Scholar 

  3. Haggarty P . Fatty acid supply to the human fetus. Ann Rev Nutr 2010; 30: 237–255.

    Article  CAS  Google Scholar 

  4. Larque E, Zamora S, Gil A . Dietary trans fatty acids in early life: a review. Early Human Dev 2001; 65: 31–41.

    Article  Google Scholar 

  5. Decsi T, Campoy C, Demmelmair H, Szabó E, Marosvölgyi T, Escolano M et al. Inverse association between trans isomeric and long-chain polyunsaturated fatty acids in pregnant women and their newborns: data from three European countries. Ann Nutr Metab 2011; 59: 107–116.

    Article  CAS  Google Scholar 

  6. Meltzer HM, Brantsaeter AL, Ydersbondi TA, Alexander J, Haugen M, The MoBa Dietary Support Group. Methodological challenges when monitoring the diet of pregnant women in a large study: experiences from the Norwegian Mother and Child cohort Study (MoBa). Matern Child Nutr 2008; 4: 14–27.

    Article  Google Scholar 

  7. Pinto E, Ramos E, Severo M, Casal S, Dos Santos Silva I, Lopes C et al. Measurement of dietary intake of fatty acids in pregnant women: comparison of self-reported intakes with adipose tissue levels. Ann Epidemiol 2010; 20: 599–603.

    Article  Google Scholar 

  8. Fawzi WW, Rifas-Shiman SL, Rich-Edwards JW, Willett WC, Gillman MW . Calibration of a semi-quantitative food frequency questionnaire in early pregnancy. Ann Epidemiol 2004; 14: 754–762.

    Article  Google Scholar 

  9. Parra MS, Schnaas L, Meydani M, Perroni E, Martínez S, Romieu I . Erthocyte cell membrane phospholipid levels compared against reported dietary intakes of polyunsaturated fatty acids in pregnant Mexican women. Public Health Nutr 2002; 5: 931–937.

    Article  Google Scholar 

  10. Brantsaeter AL, Haugen M, Thomassen Y, Ellingsen DG, Ydersbond TA, Hagve TA et al. Exploration of biomarkers for total fish intake in pregnant Norwegian women. Public Health Nutr 2009; 13: 54–62.

    Article  Google Scholar 

  11. Mikkelsen TB, Osler M, Olsen SF . Validity of protein, retinol, folic acid and n-3 fatty acid intakes estimated from the food-frequency questionnaire udes in the Danish National Birth Cohort. Public Halth Nutr 2006; 9: 771–778.

    Google Scholar 

  12. Kaaks R . Biochemical markers as additional measurements in studies of the accuracy of dietary questionnaire measurements: conceptual issues. Am J Clin Nutr 1997; 65 (Suppl), 1232S–1239S.

    Article  CAS  Google Scholar 

  13. Yokota RTC, Miyazaki ES, Ito MK . Applying the triads method in the validation of dietary intake using biomarkers. Cad Saúde Pública 2010; 26: 2027–2037.

    Article  Google Scholar 

  14. Kabagambe EK, Baylin A, Allan DA, Siles X, Spiegelman D, Campos H . Application of the method of triads to evaluate the performance of food frequency questionnaires and biomarkers as indicators of long-term dietary intake. Am J Epidemiol 2001; 154: 1126–1135.

    Article  CAS  Google Scholar 

  15. Brevik A, Vieierod MB, Drevon CA, Andersen LF . Evaluation of the odd fatty acids 15:0 and 17:0 in serum and adipose tissue as markers of intake of milk and dairy fat. Eur J Clin Nutr 2005; 59: 1417–1422.

    Article  CAS  Google Scholar 

  16. McNaughton SA, Hughes MC, Marks GC . Validation of a FFQ to estimate the intake of PUFA using plasma phospholipid fatty acids and weighed food records. Br J Nutr 2007; 97: 561–568.

    Article  CAS  Google Scholar 

  17. Zhang B, Wang P, Chen CG, He QQ, Zhuo SY, Chen YM et al. Validation of an FFQ to estimate the intake of fatty acids using erythrocyte membrane fatty acids and multiple 3 d dietary records. Public Health Nutr 2010; 13: 1546–1552.

    Article  Google Scholar 

  18. Arab L, Akbar J . Biomarkers and the measurement of fatty acids. Public Health Nutr 2002; 5: 865–871.

    Article  Google Scholar 

  19. Baylin A, Kabagambe EK, Siles X, Campos H . Adipose tissue biomarkers of fatty acid intake. Am J Clin Nutr 2002; 76: 750–757.

    Article  CAS  Google Scholar 

  20. Van Goor SA, Dijck-Brouwer DA, Hadders-Algra M, Doornbos B, Erwich JJ, Schaafsma A et al. Human milk arachidonic acid and docosahexanoic acid contents increase following supplementation during pregnancy and lactation. Prostaglandins Leukot Essent Fatty Acids 2009; 80: 65–69.

    Article  CAS  Google Scholar 

  21. Institute of Medicine. Weight Gain During Pregnancy: Reexamining the Guidelines. National Academy Press: Washington, 2009.

  22. Cade J, Thompson R, Burley V, Warm D . Development, validation and utilization of food-frequency questionnaires- a review. Public Health Nutr 2002; 5: 567–587.

    Article  Google Scholar 

  23. Barbieri P, Nishimura RY, Crivellenti LC, Sartorelli DS . Relative validation of a quantitative food frequency questionnaire for use in Brazilian pregnant women. Public Health Nutr 2012 e-pub ahead of print 16 August 2012.

  24. Serra-Majem L, Andersen LF, Hénrique-Sánchez P, Doreste-Alonso J, Sánchez-Villegas A, Ortiz-Andrelluchi A et al. Evaluating the quality of dietary intake validation studies. Brit J Nutr 2009; 102: S3–S9.

    Article  CAS  Google Scholar 

  25. Serra-Majem L, Nissensohn M, Overby NC, Fekete K . Dietary methods and biomarkers of omega 3 fatty acids: a systematic review. Br J Nutr 2012; 107: S64–S76.

    Article  CAS  Google Scholar 

  26. ABEP Associação Brasileira de Empresa de Pesquisas [Brazilian Association of Research Institute]. Critério de Classificação Econômica Brasil [Brazilian Classification of Social Classes]. Available at http://www.abep.org (accessed January 2008).

  27. Oliveira T, Marquitti FD, Carvalhaes MABL, Sartorelli DS . Desenvolvimento de um Questionário Quantitativo de Freqüência Alimentar (QQFA) para gestantes usuárias de unidades básicas de saúde de Ribeirão Preto, São Paulo, Brasil. [Development of a quantitative food frequency questionnaire for pregnant women attended by Primary Health Care in Ribeirão Preto, São Paulo State, Brazil] Cad Saúde Pública 2010; 26: 2296–2306.

    Google Scholar 

  28. Núcleo de Estudos e Pesquisa em Alimentação. Tabela Brasileira de composição de alimentos – TACO [Brazilian Food Composition Table]. Versão 2. 2a ed., Universidade Estadual de Campinas: Campinas, 2006.

  29. United States Department of Agriculture Agricultural Research Service. USDA, Nutrient Database for Standard Reference 2001.

  30. Bligh EG, Dyer WJ . A rapid method of total lipid extraction and purification. Can J Biochem Physiol 1959; 37: 911–917.

    Article  CAS  Google Scholar 

  31. Ocké MC, Kaaks RJ . Biochemical markers as additional measurements in dietary validity studies: application of the method of triads with examples from the European prospective Investigation into Cancer and Nutrition. Am J Clin Nutr 1997; 65 (Suppl), 1240S–1245S.

    Article  Google Scholar 

  32. Gil-Sánchez A, Demmelmair H, Parrilla JJ, Koletzko B, Larqué E . Mechanisms involved in the selective transfer of long chain polyunsaturated fatty acids to the fetus. Front Genet 2011; 2: 57.

    Article  Google Scholar 

  33. Nyambose J, Koski KG, Tucker KL . High intra/interindividual variance ratios for energy and nutrient intakes of pregnant women in rural Malawi show that many days are required to estimate usual intake. J Nutr 2002; 132: 1313–1318.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by fellowships from the Fundação de Amparo à Pesquisa do Estado de São Paulo, FAPESP, 2010/12320-1 (to RY Nishimura) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, CAPES (to P Barbieri). Grant was obtained from the Fundação de Apoio ao Ensino Pesquisa e Assistência do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, FAEPA.

Author information

Authors and Affiliations

  1. Department of Social Medicine, School of Medicine of Ribeirão Preto (FMRP), University of São Paulo (USP), Ribeirão Preto, São Paulo state, Brazil

    D S Sartorelli

  2. Post-Graduation in Community Health, FMRP, USP, Ribeirão Preto, São Paulo state, Brazil

    D S Sartorelli, R Y Nishimura & P Barbieri

  3. Post-Graduation in Internal Medicine, FMRP, USP, Ribeirão Preto, São Paulo state, Brazil

    G S F Castro & A A Jordão

  4. Department of Internal Medicine, FMRP, USP, Ribeirão Preto, São Paulo state, Brazil

    A A Jordão

Authors
  1. D S Sartorelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R Y Nishimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G S F Castro
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P Barbieri
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A A Jordão
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D S Sartorelli.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sartorelli, D., Nishimura, R., Castro, G. et al. Validation of a FFQ for estimating ω-3, ω-6 and trans fatty acid intake during pregnancy using mature breast milk and food recalls. Eur J Clin Nutr 66, 1259–1264 (2012). https://doi.org/10.1038/ejcn.2012.127

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2012.127

Keywords

This article is cited by

Search

Advanced search

Quick links