Abstract
Background: Reliability or validity studies are important for the evaluation of measurement error in dietary assessment methods. An approach to validation known as the method of triads uses triangulation techniques to calculate the validity coefficient of a food-frequency questionnaire (FFQ).
Objective: To assess the validity of an FFQ estimates of carotenoid and vitamin E intake against serum biomarker measurements and weighed food records (WFRs), by applying the method of triads.
Design: The study population was a sub-sample of adult participants in a randomised controlled trial of β-carotene and sunscreen in the prevention of skin cancer. Dietary intake was assessed by a self-administered FFQ and a WFR. Nonfasting blood samples were collected and plasma analysed for five carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lutein, lycopene) and vitamin E. Correlation coefficients were calculated between each of the dietary methods and the validity coefficient was calculated using the method of triads. The 95% confidence intervals for the validity coefficients were estimated using bootstrap sampling.
Results: The validity coefficients of the FFQ were highest for α-carotene (0.85) and lycopene (0.62), followed by β-carotene (0.55) and total carotenoids (0.55), while the lowest validity coefficient was for lutein (0.19). The method of triads could not be used for β-cryptoxanthin and vitamin E, as one of the three underlying correlations was negative.
Conclusions: Results were similar to other studies of validity using biomarkers and the method of triads. For many dietary factors, the upper limit of the validity coefficients was less than 0.5 and therefore only strong relationships between dietary exposure and disease will be detected.
Sponsorship: National Health and Medical Research Council.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Armstrong BK, White E & Saracci R (1992): Principles of Exposure Measurement in Epidemiology. New York: Oxford University Press.
Ashton B, Ambrosini GL, Marks GC, Harvey PW & Bain C (1997): Development of a dietary supplement database. Aust. NZ. J. of Public Health 21, 699–702.
Ashton BA, Marks GC, Battistutta D, Green AC & the Nambour Study Group (1996): Under-reporting of energy intake in two methods of dietary assessment in the Nambour Trial. Aust. J. Nutr. Diet. 53, 53–60.
Booth SL, Tucker KL, McKeown NM, Davidson KW, Dallal GE & Sadowski JA (1997): Relationships between dietary intakes and fasting plasma concentrations of fat-soluble vitamins in humans. J. Nutr. 127, 587–592.
Brown CC, Kipnis V, Freedman LS, Hartman AM, Schatzkin A & Wacholder S (1994): Energy adjustment methods for nutritional epidemiology: the effects of categorization. Am. J. Epidemiol. 139, 323–338.
Castenmiller JJM & West CE (1998): Bioavailability and bioconversion of carotenoids. Annu. Rev. Nutr. 18, 19–38.
Castenmiller JJM, West CE, Linssen JPH, Van Het Hof KH & Voragen AGJ (1999): The food matrix of spinach is a limiting factor in determining the bioavailability of b-carotene and to a lesser extent in humans. J. Nutr. 129, 349–355.
Crews H, Alink G, Andserson R, Braesco V, Holst B, Maiani G, Oversen L, Scotter M, Solfrizzo M, Van Der Berg R, Verhagen H & Williamson G (2001): A critical assessment of some biomarker approaches linked with dietary intake. Br. J. Nutr. 86, S5–S35.
Daures JP, Gerber M, Scali J, Asre C, Bonifacj C & Kaaks R (2000): Validation of a food-frequency questionnaire using mulitple-day records and biochemical markers: application of the triads method. J. Epidemiol. Biostat. 5, 109–115.
Delcourt C, Cubeau J, Balkau B & Papoz L (1994): Limitations of the correlation coefficient in the validation of diet assessment methods. Epidemiology 5, 518–524.
Dixon ZR, Burri BJ & Neidlinger TR (1996): Nutrient density estimates from an average of food frequency and food records correlate well with serum concentration of vitamins E and the carotenoids in free-living adults. Int. J. Food Sci. Nutr. 47, 477–484.
EPIC Group of Spain (1997): Relative validity and reproducibility of a diet history questionnaire in Spain. III. Biochemical markers. Int. J. Epidemiol. 26, S110–S117.
Green A, Battistutta D, Hart V, Leslie D, Marks G, Williams G, Gaffney P, Parsons P, Hirst L, Frost C & the Nambour Prevention Study Group (1994): The Nambour Skin Cancer and Actinic Eye Disease Prevention Trial: design and baseline characteristics of participants. Control. Clin. Trials 15, 512–522.
Green A, Wiiliams G, Neale R, Hart V, Leslie D, Parsons P, Marks GC, Gaffney P, Battistuta D, Frost C, Lang C & Russell A (1999): Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised trial. Lancet 354, 723–729.
Huang CJ, Tang YL, Chen CY, Chen ML, Chu CH & Hseu CT (2000): The bioavailability of b-carotene in stir or deep fried vegetables in men determined by measuring the serum response to a single ingestion. J. Nutr. 130, 534–540.
Hunter D (1998): Biochemical indicators of dietary intake. In Nutritional Epidemiology ed., WC Willett, pp 174–243. New York: Oxford University Press.
Kaaks R & Riboli E (1997): Validation and calibration of dietary intake measurements in the EPIC project: methodological considerations. Int. J. Epidemiol. 26, S15–S25.
Kaaks RJ (1997): Biochemical markers as additional measurements in studies of the accuracy of dietary questionnaire measurements: conceptual issues. Am. J. Clin. Nutr. 65, 1232S–1239S.
Kabagambe EK, Baylin A, Allan DA, Siles X, Spiegelman D & Campos H (2001): 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. 154, 1126–1135.
Kanetsky PA, Gammon MD, Mandelblatt J, Zhang ZF, Ramsey E, Dnistrian A, Norkus EP & Wright Jr TC (1998): Dietary intake and blood levels of lycopene: association with cervical dysplasia among non-Hispanic, black women. Nutr. Cancer 31, 31–40.
Katterman R, Jaworek D, Moller G, G A, Bjorkhem I, Svensson L, Borner K, Boerma G, Leijnse B, Desager JP, Harwengt C, Kupke I & Trinder P (1984): Multi-centre study of a new enzymatic method of cholesterol determination. J. Clin. Chem. Clin. Biochem. 22, 245–251.
Le Marchand L, Hankin JH, Carter FS, Essling C, Luffey D, Franke AA, Wilkens LR, Cooney RV & Kolonel LN (1994): A pilot study on the use of plasma carotenoids and ascorbic acid as markers of compliance to a high fruit and vegetable dietary intervention. Cancer Epidemiol. Biomarkers Prev. 3, 245–251.
Mandel CH, Mosca L, Maimon E, Sievers J, Tsai A & Rock CL (1997): Dietary intake and plasma concentrations of vitamin E, vitamin C, and beta carotene in patients with coronary artery disease. J. Am. Diet. Assoc. 97, 655–657.
Margetts BM & Jackson AA (1996): The determinants of plasma beta-carotene interaction between smoking and other lifestyle factors. Eur. J. Clin. Nutr. 50, 236–238.
Meydani SN, Meydani M, Blumberg JB, Leka LS, Pedrosa M & Diamond R (1998): Assessment of the safety of supplementation with different amounts of vitamin E in healthy older adults. Am. J. Clin. Nutr. 68, 311–318.
National Food Authority (1995) NUTTAB95. Nutrient Data Table for use in Australia. Australian Government Publishing Service, Canberra.
Nelson M (1997): The validation of dietary questionnaires. In Design Concepts in Nutritional Epidemiology eds. BM Margetts and M Nelson, pp 241–272. New York: Oxford University Press.
Ocke MC & Kaaks RJ (1997): 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. 65, 1240S–1245S.
Olson JA (1999): Carotenoids. In Modern Nutrition in Health eds. ME Shils, JA Olson, M Shike and AC Ross, pp 525–541. Philadelphia: Lippincott Williams & Wilkins.
Parker RS (1997): Bioavailability of carotenoids. Eur. J. Clin. Nutr. 51, S86–S90.
Peng YM, Peng YS, Lin Y, Moon T, Roe DJ & Ritenbaugh C (1995): Concentrations and plasma-tissue-diet relationships of carotenoids, retinoids, and tocopherols in humans. Nutr. Cancer 23, 233–246.
Porrini M, Gentile MG & Fidanza F (1995): Biochemical validation of a self-administered semi-quantitative food-frequency questionnaire. Br. J. Nutr. 74, 323–333.
Ribaya-Mercado JD (2002): Influence of dietary fat on b-carotene absorption and bioconversion into vitamin A. Nutr. Rev. 60, 104–110.
Scott KJ, Thurnham DI, Hart DJ, Bingham SA & Day K (1996): The correlation between the intake of lutein, lycopene and beta-carotene from vegetables and fruits, and blood plasma concentrations in a group of women aged 50-65 years in the UK. Br. J. Nutr. 75, 409–418.
Siedel J, Hagele EO, Ziegenhorn J & Wahlefeld AW (1983): Reagent for the enzymatic determination of serum total cholesterol with improved efficiency. Clin. Chem. 29, 1075–1080.
Sowell AL, Huff DL, Yeager PR, Caudill SP & Gunter EW (1994): Retinol, α-tocopherol, lutein/zeaxanthin, β-cryptoxanthin, lycopene, α-carotene, trans-β-carotene, and four retinyl esters in serum determined simultaneously by reversed phase HPLC with multi-wavelength detection. Clin. Chem. 40, 411–416.
SPSS Inc. (1999): Statistical Package for the Social Sciences (SPSS) for Windows. Standard Version. Release 10.05. Chicago: SPSS Inc.
Streiner DL & Norman GR (1991): Health Measurement Scales: A Practical Guide to their Development and Use. New York: Oxford University Press.
Stryker WS, Stampfer MJ, Stein EA, Kaplan L, Louis TA, Sober A & Willett WC (1990): Diet, plasma levels of beta-carotene and alpha-tocopherol, and risk of malignant melanoma. Am. J. Epidemiol. 131, 597–611.
Torronen R, Lehmusaho M, Hakkinen S, Hanninen O & Mykkanen H (1996): Serum b-carotene response to chronic supplementation with raw carrots, carrot juice or purified b-carotene. In Natural Antioxidants and Food Quality in Atherosclerosis and Cancer Prevention eds. JT Kumpulainen and JT Salonen Cambridge, UK: Royal Society of Chemistry.
United States Department of Agriculture (1998) USDA NCC Carotenoid Database for U.S. Foods.
United States Department of Agriculture (1999) USDA Nutrient Database for Standard Reference, Release 13.
Van Het Hof KH, De Boer BCJ, Tijburg LBM, Lucius IZ, West CE, Hautvast JGAJ & Weststrate JA (2000a): Carotenoid bioavailability in humans from tomatoes processed in different ways determined from the carotenoid response in the trigylceride-rich lipoprotein fraction of plasma after a single consumption and in plasma after four days of consumption. J. Nutr. 130, 1189–1196.
Van Het Hof KH, Tijburg LBM, Pietrzik K & Weststrate JA (1999): Influence of feeding different vegetables on plasma levels of carotenoids, folate and vitamin C Effect of disruption of the vegetable matrix. Br. J. Nutr. 82, 203–212.
Van Het Hof KH, West CE, Weststrate JA & Hautvast JGAJ (2000b): Dietary factors that affect the bioavailability of carotenoids. J. Nutr. 130, 503–506.
Van Kappel AL, Steghens JP, Zeleniuch-Jacqotte A, Chajes V, Toniolo P & Riboli E (2001): Serum carotenoids as biomarkers of fruit and vegetable consumption in the New York Women's Health Study. Public Health Nutr. 4, 829–835.
Willett W (ed.) (1998): Nutritional Epidemiology. New York: Oxford University Press.
Willett W (2001): Dietary diaries versus food frequency questionnaires — a case of undigestible data. Int. J. Epidemiol. 30, 317–319.
Willett W & Lenart E (1998): Reproducibilty and validity of food-frequency questionnaires. In Nutritional Epidemiology ed., W Willett, pp 101–147. New York: Oxford University Press.
Willett WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, Hennekens CH & Speizer FE (1985): Reproducibility and validity of a semiquantitative food frequency questionnaire. Am. J. Epidemiol. 122, 51–65.
Willett WC, Stampfer MJ, Underwood BA, Taylor JO & Hennekens CH (1983): Vitamins A, E, and carotene effects of supplementation on their plasma levels. Am. J. Clin. Nutr. 38, 559–566.
Acknowledgements
SA McNaughton was supported by a National Health and Medical Research Council Public Health Postgraduate Research Scholarship.
Author information
Authors and Affiliations
Corresponding author
Additional information
Guarantor: SA McNaughton.
Contributors: AG, GW, GCM and PG were responsible for the design and conduct of the study. SM conducted the data analysis, interpretation of the data and writing of the manuscript. All the authors participated in editing the manuscript and provided advice regarding interpretation of the results. None of the contributing authors had any financial or personal interests in any of the bodies sponsoring this research.
Rights and permissions
About this article
Cite this article
McNaughton, S., Marks, G., Gaffney, P. et al. Validation of a food-frequency questionnaire assessment of carotenoid and vitamin E intake using weighed food records and plasma biomarkers: The method of triads model. Eur J Clin Nutr 59, 211–218 (2005). https://doi.org/10.1038/sj.ejcn.1602060
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ejcn.1602060
Keywords
This article is cited by
-
Estimation of daily intake of lycopene, antioxidant contents and activities from tomatoes, watermelons, and their processed products in Korea
Applied Biological Chemistry (2020)
-
Dietary inflammatory index, risk and survival among women with endometrial cancer
Cancer Causes & Control (2020)
-
The association between the inflammatory potential of diet and risk of developing, and survival following, a diagnosis of ovarian cancer
European Journal of Nutrition (2019)
-
Systematic review of statistical approaches to quantify, or correct for, measurement error in a continuous exposure in nutritional epidemiology
BMC Medical Research Methodology (2017)
-
DIET@NET: Best Practice Guidelines for dietary assessment in health research
BMC Medicine (2017)