Abstract
Objectives:
Ethnic minorities are often not included in studies of diet and health because of a lack of validated instruments to assess their habitual diets. Given the increased ethnic diversity in many high-income countries, insight into the diets of ethnic minorities is needed for the development of nutritional policies and interventions. In this paper, we describe the development of ethnic-specific food frequency questionnaires (FFQs) to study the diets of Surinamese (African and South Asian), Turkish, Moroccan and ethnic Dutch residents of The Netherlands.
Methods:
An existing Dutch FFQ was adapted and formed the basis for three new FFQs. Information on food intake was obtained from single 24 h recalls. Food items were selected according to their percentage contribution to and variance in absolute nutrient intake of the respective ethnic groups. A nutrient database for each FFQ was constructed, consisting of data from the Dutch Food Composition table; data on ethnic foods were based on new chemical analyses and available international data.
Results:
We developed four ethnic-specific FFQs using a standardised approach that included ~200 food items each and that covered more than 90% of the intake of the main nutrients of interest.
Conclusions:
The developed FFQs will enable standardised and comparable assessment of the diet of five different ethnic groups and provide insight into the role of diet in differences in health between ethnic groups. The methodology described in this paper and the choices made during the development phase may be useful in developing similar FFQs in other settings.
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References
Gilbert PA, Khokhar S . Changing dietary habits of ethnic groups in Europe and implications for health. Nutr Rev 2008; 66: 203–215.
Stronks K . Public health research among immigrant populations: still a long way to go. Eur J Epidemiol 2003; 18: 841–842.
Research and Statistics. Population on the Basis of Origin. Amsterdam Research and Statistics Service 2012. Available from: http://www.os.amsterdam.nl/grafiek/6119/. (accessed 21 June 2013).
Mozaffarian D, Wilson PW, Kannel WB . Beyond established and novel risk factors: lifestyle risk factors for cardiovascular disease. Circulation 2008; 117: 3031–3038.
Agyemang C, Bindraban N, Mairuhu G, Montfrans G, Koopmans R, Stronks K . Prevalence, awareness, treatment, and control of hypertension among Black Surinamese, South Asian Surinamese and White Dutch in Amsterdam, The Netherlands: the SUNSET study. J Hypertens 2005; 23: 1971–1977.
Bos V, Kunst AE, Keij-Deerenberg IM, Garssen J, Mackenbach JP . Ethnic inequalities in age- and cause-specific mortality in The Netherlands. Int J Epidemiol 2004; 33: 1112–1119.
Nicolaou M . Diet and Overweight Perception: An Explorative Study among Turkish, Moroccan and Surinamese Migrants Living in the Netherlands. Amsterdam, The Netherlands: Vrije Universiteit, 2009.
Uitewaal PJ, Manna DR, Bruijnzeels MA, Hoes AW, Thomas S . Prevalence of type 2 diabetes mellitus, other cardiovascular risk factors, and cardiovascular disease in Turkish and Moroccan immigrants in North West Europe: a systematic review. Prev Med 2004; 39: 1068–1076.
Ujcic-Voortman JK, Schram MT, Jacobs-van der Bruggen MA, Verhoeff AP, Baan CA . Diabetes prevalence and risk factors among ethnic minorities. Eur J Public Health 2009; 19: 511–515.
Willett W . Nutritional Epidemiology2nd ednNew York, NY: Oxford University Press, 1998.
Siebelink E, Geelen A, de Vries JH . Self-reported energy intake by FFQ compared with actual energy intake to maintain body weight in 516 adults. Br J Nutr 2011; 106: 274–281.
van Dam RM, Nicolaou M, Stronks K . Study of the diet of Surinamese Amsterdammers. Ned Tijdschr Diet 2005; 60: 98–102.
Ministry of Health WaS. Healthy Diet, from the Begining Till the End. Ministry of Health, Welfare and Sport and Ministry of Agriculture, Nature and Food Quality: The Hague 2008.
Health Council of The Netherlands. Towards an Adequate Intake of Vitamins and Minerals. Health Council of The Netherlands: The Hague; April 27 2009. Report No.: 2009/06E 2009.
Palsma AH, Nicolaou M, van Dam RM, Stronks K . (De Voeding van Turkse en Marokkaanse Nederlanders in de leeftijd van 18-30 jaar: prioriteiten voor interventies). Tijdschr Gez Wetenschap 2006; 84: 415–422.
Brussaard JH, van Erp-Baart MA, Brants HA, Hulshof KF, Lowik MR . Nutrition and health among migrants in The Netherlands. Public Health Nutr 2001; 4: 659–664.
Molag ML, de Vries JH, Duif N, Ocke MC, Dagnelie PC, Goldbohm RA et al. Selecting informative food items for compiling food-frequency questionnaires: comparison of procedures. Br J Nutr 2010; 104: 446–456.
van Rossum CTM, Fransen HP, Verkaik-Kloosterman J, Buurma-Rethans EJM, Ocke MC . Dutch National Food Composition Survey 2007-2010. Bilthoven, The Netherlands: National Institute for Public Health and the Environment, 2011.
de Jong M . Reader Feedback in Text Design. Validity of the Plus-Minus Method for the Pretesting of Public Information Brochures. Amsterdam, Atlanta (GA): Rodopi, 1998.
Lentz L, de Jong M . The evaluation of text quality: expert-focused and reader-focused methods compared. IEEE Trans Prof Commun 1997; 40: 224–234.
Subar AF, Thompson FE, Smith AF, Jobe JB, Ziegler RG, Potischman N et al. Improving food frequency questionnaires: a qualitative approach using cognitive interviewing. J Am Diet Assoc 1995; 95: 781–788.
Caspar RA, Lessler JT, Willis GB . Cognitive interviewing: a 'how to' guide. Reducing survey error through research on the cognitive and decision processes in surveys. Short course presented at the 1999 Meeting of the American Statistical Association–Research Triangle Institute, 1999. Available at http://appliedresearch.cancer.gov/archive/cognitive/interview.pdf.
Beatty PC, Willis GB . Research synthesis: the practice of cognitive interviewing. Public Opin Q 2007; 71: 287–311.
Dutch Food Composition Table 2011. National Institute for Public Health and the Netherlands Nutrition Centre: The Hague 2011.
Shahar D, Shai I, Vardi H, Brener-Azrad A, Fraser D . Development of a semi-quantitative Food Frequency Questionnaire (FFQ) to assess dietary intake of multiethnic populations. Eur J Epidemiol 2003; 18: 855–861.
Kim SH, Choi HN, Hwang JY, Chang N, Kim WY, Chung HW et al. Development and evaluation of a food frequency questionnaire for Vietnamese female immigrants in Korea: the Korean Genome and Epidemiology Study (KoGES). Nutr Res Pract 2011; 5: 260–265.
Tucker KL, Maras J, Champagne C, Connell C, Goolsby S, Weber J et al. A regional food-frequency questionnaire for the US Mississippi Delta. Public Health Nutr 2005; 8: 87–96.
Hankin JH, Stram DO, Arakawa K, Park S, Low SH, Lee HP et al. Singapore Chinese Health Study: development, validation, and calibration of the quantitative food frequency questionnaire. Nutr Cancer 2001; 39: 187–195.
Kelemen LE, Anand SS, Vuksan V, Yi Q, Teo KK, Devanesen S et al. Development and evaluation of cultural food frequency questionnaires for South Asians, Chinese, and Europeans in North America. J Am Diet Assoc 2003; 103: 1178–1184.
Kolonel LN, Henderson BE, Hankin JH, Nomura AM, Wilkens LR, Pike MC et al. A multiethnic cohort in Hawaii and Los Angeles: baseline characteristics. Am J Epidemiol 2000; 151: 346–357.
Karamali N, Tamsma J, de Groot C, Ariens G, Kanbai H, Middelkoop B . The risk of diabetes and heart disease among Hindustanis: Resuilts of the India-study, a study among Hindustani pregnant women and their newborn baby. Epidemiol Bull 2012; 47: 2–12.
Dekker LH, Snijder MB, Beukers MH, de Vries JH, Brants HA, de Boer EJ et al. A prospective cohort study of dietary patterns of non-western migrants in the Netherlands in relation to risk factors for cardiovascular diseases: HELIUS-Dietary Patterns. BMC Public Health 2011; 11: 441.
Stronks K, Snijder MB, Peters RJ, Prins M, Schene AH, Zwinderman AH . Unravelling the impact of ethnicity on health in Europe: the HELIUS study. BMC Public Health 2013; 13: 402.
Acknowledgements
This study was funded by The Netherlands Organisation for Health Research and Development, grant number 115100005.
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Beukers, M., Dekker, L., de Boer, E. et al. Development of the HELIUS food frequency questionnaires: ethnic-specific questionnaires to assess the diet of a multiethnic population in The Netherlands. Eur J Clin Nutr 69, 579–584 (2015). https://doi.org/10.1038/ejcn.2014.180
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DOI: https://doi.org/10.1038/ejcn.2014.180
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