Abstract
Objective:
To evaluate the validity of the Inter99 food frequency questionnaire (FFQ) compared with a 28-days' diet history and biomarkers.
Subjects:
A random sample of 13 016 individuals were drawn from a general population and invited for a health screening programme. Participation rate was 52.5%. All high-risk individuals were re-invited for assessment after 1 and 3 years and completed a 198-item FFQ at all three occasions. Participants attending for 3 years follow-up were invited to participate in the validation study, including a 28-days' diet history, a 24-h urine collection and a fasting blood sample. Overall, 264 subjects participated.
Results:
Spearman's rank correlation coefficients between the two dietary methods ranged from 0.31(β-carotene) to 0.64 (fruits) in men and from 0.31 (polyunsaturated fat and sodium) to 0.64 (fruits) for women. The proportion of individuals classified in the same or adjacent quintiles were, on average, 72% for men and 69% for women. Gross misclassification was found on average in 2%. The correlation coefficients of the residuals ranged from 0.27 (sodium) to 0.61 (fruits) for men and from 0.21 (sodium) to 0.62 (B12-vitamin) for women. Correlation coefficients between fruit and vegetable intake and carotenoids ranged from −0.08 (lycopene) to 0.44 (α-carotene). For the residuals the correlation coefficients ranged from −0.004 (lycopene) to 0.47 (α-carotene).
Conclusion:
The Inter99 FFQ and the residuals of the intake provide acceptable classification of individuals according to their dietary intakes and the FFQ gives a good quantitative measurement of key dietary components.
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References
Al Delaimy WK, Ferrari P, Slimani N, Pala V, Johansson I, Nilsson S et al. (2005). Plasma carotenoids as biomarkers of intake of fruits and vegetables: individual-level correlations in the European Prospective Investigation into Cancer and Nutrition (EPIC). Eur J Clin Nutr 59, 1387–1396.
Andersen L, Jensen H, Haraldsdottir J (1996). Nutritional research on the weight of foods [Näringsforskning om vægte på madvarer]. Näringsforskning 40, 129–152.
Bellach B (1993). Remarks on the use of Pearson's correlation coefficient and other association measures in assessing validity and reliability of dietary assessment methods. Eur J Clin Nutr 47 Suppl 2, S42–S45.
Biltoft-Jensen A (2004). The National Dietary Survey of Denmark 2000–2002. Technical report (Unpublished work).
Bingham S, Cummings J (1983). Urine nitrogen as an independent validatory measure of dietary intake: a study of nitrogen balance in individuals consuming their normal diet. Am J Clin Nutr 42, 1276–1289.
Bingham SA, Gill C, Welch A, Cassidy A, Runswick SA, Oakes S et al. (1997). Validation of dietary assessment methods in the UK arm of EPIC using weighed records, and 24-h urinary nitrogen and potassium and serum vitamin C and carotenoids as biomarkers. Int J Epidemiol Suppl 1, S137–S151.
Black AE, Goldberg GR, Jebb SA, Livingstone MB, Cole TJ, Prentice AM (1991). Critical evaluation of energy intake data using fundamental principles of energy physiology: 2. Evaluating the results of published surveys. Eur J Clin Nutr 45, 583–599.
Black AE, Welch AA, Bingham SA (2000). Validation of dietary intakes measured by diet history against 24 h urinary nitrogen excretion and energy expenditure measured by the doubly-labelled water method in middle-aged women. Br J Nutr 83, 341–354.
Bland JM, Altman DG (1986). Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1, 307–310.
Bland JM, Altman DG (2003). Applying the right statistics: analyses of measurement studies. Ultrasound Obstet Gynecol 22, 85–93.
Block G, Hartman AM (1989). Issues in reproducibility and validity of dietary studies. Am J Clin Nutr 50, 1133–1138.
Block G, Woods M, Potosky A, Clifford C (1990). Validation of a self-administered diet history questionnaire using multiple diet records. J Clin Epidemiol 43, 1327–1335.
Broekmans WM, Klopping-Ketelaars IA, Schuurman CR, Verhagen H, van den BH, Kok FJ et al. (2000). Fruits and vegetables increase plasma carotenoids and vitamins and decrease homocysteine in humans. J Nutr 130, 1578–1583.
Brown H, Benedetti J (1977). Sampling Behavior of Tests for Correlation in Two-Way Contingency Tables. J Am Stat Assoc 72, 309–315.
Cade J, Thompson R, Burley V, Warm D (2002). Development, validation and utilisation of food-frequency questionnaires – a review. Public Health Nutr 5, 567–587.
Carstensen B (2004). Comparing and predicting between several methods of measurement. Biostatistics 5, 399–413.
Danish Veterinary Food Administration (1995). Photo Series and Instructions for Food Records. Copenhagen, Denmark.
Delcourt C, Cubeau J, Balkau B, Papoz L (1994). Limitations of the correlation coefficient in the validation of diet assessment methods. CODIAB-INSERM-ZENECA Pharma Study Group. Epidemiology 5, 518–524.
Gibson RS (2005). Principles of Nutritional Assessment, 2nd edn. Oxford University Press: New York.
Haraldsdottir J, Seppänen R, Steinrímsdóttir L, Trygg K, Hagman U (1998). Portion sizes: Nordic Standard Portions of Food Foodstuffs. Nordic Council and Council of Ministers: Copenhagen, Denmark.
Hebert JR, Miller DR (1991). The inappropriateness of conventional use of the correlation coefficient in assessing validity and reliability of dietary assessment methods. Eur J Epidemiol 7, 339–343.
Hoidrup S, Andreasen AH, Osler M, Pedersen AN, Jorgensen LM, Jorgensen T et al. (2002). Assessment of habitual energy and macronutrient intake in adults: comparison of a seven day food record with a dietary history interview. Eur J Clin Nutr 56, 105–113.
Jain M, Howe GR, Rohan T (1996). Dietary assessment in epidemiology: comparison on food frequency and a diet history questionnaire with a 7-day food record. Am J Epidemiol 143, 953–960.
Jakobsen J, Ovesen L, Fagt S, Pedersen AN (1997). Para-aminobenzoic acid used as a marker for completeness of 24 h urine: assessment of control limits for a specific HPLC method. Eur J Clin Nutr 51, 514–519.
Jorgensen T, Borch-Johnsen K, Thomsen TF, Ibsen H, Glumer C, Pisinger C (2003). A randomized non-pharmacological intervention study for prevention of ischaemic heart disease: baseline results Inter99 (1). J Cardiovasc Risk 10, 377–386.
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.
Lauritsen J (1998). FoodCalc 1.3 1998. Available at: www:http:/foodcalc.dk (accessed October 2002).
Mangels AR, Holden JM, Beecher GR, Forman MR, Lanza E (1993). Carotenoid content of fruits and vegetables: an evaluation of analytic data. J Am Diet Assoc 93, 284–296.
McEligot AJ, Rock CL, Flatt SW, Newman V, Faerber S, Pierce JP (1999). Plasma carotenoids are biomarkers of long-term high vegetable intake in women with breast cancer. J Nutr 129, 2258–2263.
McKeown NM, Day NE, Welch AA, Runswick SA, Luben RN, Mulligan AA et al. (2001). Use of biological markers to validate self-reported dietary intake in a random sample of the European Prospective Investigation into Cancer United Kingdom Norfolk cohort. Am J Clin Nutr 74, 188–196.
McNaughton SA, Marks GC, Gaffney P, Williams G, Green A (2005). 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.
Mikkelsen TB, Osler M, Olsen SF (2006). Validity of protein, retinol, folic acid and n-3 fatty acid intakes estimated from the food-frequency questionnaire used in the Danish National Birth Cohort. Public Health Nutr 9, 771–778.
Nath SD, Huffman FG (2005). Validation of a semiquantitative food frequency questionnaire to assess energy and macronutrient intakes of Cuban Americans. Int J Food Sci Nutr 56, 309–314.
Nordic Committee on Food Analysis (2003). Nitrogen. Determination in foods and feeds according to Kjeldahl. 4th edn. Nitrogen Method No. 6.
Ocke MC, Bueno-de-Mesquita HB, Pols MA, Smit HA, van Staveren WA, Kromhout D (1997). The Dutch EPIC food frequency questionnaire. II Relative validity and reproducibility for nutrients. Int J Epidemiol 26 Suppl 1, S49–S58.
Olsen J, Melbye M, Olsen SF, Sorensen TI, Aaby P, Andersen AM et al. (2001). The Danish National Birth Cohort--its background, structure and aim. Scand J Public Health 29, 300–307.
Pijls LT, de Vries H, Donker AJ, van Eijk JT (1999). Reproducibility and biomarker-based validity and responsiveness of a food frequency questionnaire to estimate protein intake. Am J Epidemiol 150, 987–995.
Resnicow K, Odom E, Wang T, Dudley WN, Mitchell D, Vaughan R et al. (2000). Validation of three food frequency questionnaires and 24-h recalls with serum carotenoid levels in a sample of African-American adults. Am J Epidemiol 152, 1072–1080.
Saxholt E, Møller A, Ygil K (2005). Danish Food Composition Databank Version 6.0 [Fødevaredatabanken Version 6.0]. Department of Nutrition, The Danish Institute for Food and Veterinary Research: Søborg, Denmark http://www.foodcomp.dk.
Schmidt ME, Steindorf K (2006). Statistical methods for the validation of questionnaires--discrepancy between theory and practice. Methods Inf Med 45, 409–413.
Sevak L, Mangtani P, McCormack V, Bhakta D, Kassam-Khamis T, dos SSI (2004). Validation of a food frequency questionnaire to assess macro- and micro-nutrient intake among South Asians in the United Kingdom. Eur J Nutr 43, 160–168.
Shatenstein B, Nadon S, Godin C, Ferland G (2005). Development and validation of a food frequency questionnaire. Can J Diet Pract Res 66, 67–75.
Tjonneland A, Overvad K, Haraldsdottir J, Bang S, Ewertz M, Jensen OM (1991). Validation of a semiquantitative food frequency questionnaire developed in Denmark. Int J Epidemiol 20, 906–912.
Tucker KL, Chen H, Vogel S, Wilson PW, Schaefer EJ, Lammi-Keefe CJ (1999). Carotenoid intakes, assessed by dietary questionnaire, are associated with plasma carotenoid concentrations in an elderly population. J Nutr 129, 438–445.
Van Horn L (1960). On the combination of independent two-sample tests of Wilcoxon. Bull Int Stat Inst 37, 351–361.
van Liere MJ, Lucas F, Clavel F, Slimani N, Villeminot S (1997). Relative validity and reproducibility of a French dietary history questionnaire. Int J Epidemiol 26 Suppl 1, S128–S136.
Willett W (1998). Nutritional Epidemiology. In: Willet W (ed). Oxford University Press: New York.
Willett WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J et al. (1985). Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 122, 51–65.
Acknowledgements
We thank Eva Aggernæs for performing all the diet history interviews, Gitte Stage for processing the data and Henning Østerby for technical assistance and all members of the Inter99 team who recruited the participants for the study and did the entire laboratory work. Furthermore, we acknowledge the steering group for the Inter99 study.
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Guarantor: U Toft.
Contributors: TJ was responsible for the design and conduct of the Inter99 study. LK was responsible for the design and conduct of the validation study. AB and JJ were responsible for the biochemical analyses. UT was responsible for conducting 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.
Appendix A
Appendix A
The two regressions defining the residuals can be written as
where i denotes method and j numbers the measurements, Yij are the logs of the crude measurements, αi, βi are regression coefficients and ɛij are error terms. We set
and assume
It follows that
and
When the regressions are identical, that is βi=βσi=σ and ρi=ρ its easy to see that
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Toft, U., Kristoffersen, L., Ladelund, S. et al. Relative validity of a food frequency questionnaire used in the Inter99 study. Eur J Clin Nutr 62, 1038–1046 (2008). https://doi.org/10.1038/sj.ejcn.1602815
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DOI: https://doi.org/10.1038/sj.ejcn.1602815
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