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Relative validity of a semi-quantitative food-frequency questionnaire in an elderly Mediterranean population of Spain

  • Joan D. Fernández-Ballart (a1) (a2), Josep Lluís Piñol (a3), Itziar Zazpe (a4), Dolores Corella (a2) (a5), Paula Carrasco (a2) (a5), Estefanía Toledo (a4), Manuel Perez-Bauer (a3), Miguel Ángel Martínez-González (a4), Jorge Salas-Salvadó (a1) (a2) and José M. Martín-Moreno (a6)...

The aim of the present study was to assess reproducibility and relative validity of a self-administered FFQ used in the PREDIMED Study, a clinical trial for primary prevention of CVD by Mediterranean diet in a population at high cardiovascular risk. The FFQ was administered twice (FFQ1 and FFQ2) to explore reproducibility at 1 year. Four 3 d dietary records (DR) were used as reference to explore validity; participants therefore recorded their food intake over 12 d in the course of 1 year. The degree of misclassification in the FFQ was also evaluated by a contingency table of quintiles comparing the information from the FFQ2 and the DR. A total of 158 men and women (aged 55–80 years) were asked not to modify their dietary habits during the study period. Reproducibility for food groups, energy and nutrient intake, explored by the Pearson correlation coefficient (r) ranged 0·50–0·82, and the intraclass correlation coefficient (ICC) ranged from 0·63 to 0·90. The FFQ2 tended to report higher energy and nutrient intake than the DR. The validity indices of the FFQ in relation to the DR for food groups and energy and nutrient intake ranged (r) from 0·24 to 0·72, while the range of the ICC was between 0·40 and 0·84. With regard to food groups, 68–83 % of individuals were in the same or adjacent quintile in both methods, a figure which decreased to 55–75 % for energy and nutrient intake. We concluded that FFQ measurements had good reproducibility and a relative validity similar to those of FFQ used in other prospective studies.

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Corresponding author
*Corresponding author: Dr Joan D. Fernandez-Ballart, fax +34 977759322, email
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1 Agudo A, Cabrera L, Amiano P, et al. (2007) Fruit and vegetable intakes, dietary antioxidant nutrients, and total mortality in Spanish adults: findings from the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). Am J Clin Nutr 85, 16341642.
2 Fernández-Jarne E, Martínez-Losa E, Prado-Santamaría M, et al. (2002) Risk of first non-fatal myocardial infarction negatively associated with olive oil consumption: a case–control study in Spain. Int J Epidemiol 31, 474480.
3 Kant AK, Graubard BI & Schatzkin A (2004) Dietary patterns predict mortality in a national cohort: The National Health Interview Surveys, 1987 and 1992. J Nutr 134, 17931799.
4 Martin-Moreno JM, Willett WC, Gorgojo L, et al. (1994) Dietary fat, olive oil intake and breast cancer risk. Int J Cancer 58, 774780.
5 Miller AB, Berrino F, Hill M, et al. (1994) Diet in the aetiology of cancer: a review. Eur J Cancer 30A, 207220.
6 Shimazu T, Kuriyama S, Hozawa A, et al. (2007) Dietary patterns and cardiovascular disease mortality in Japan: a prospective cohort study. Int J Epidemiol 36, 600609.
7 Estruch R, Martinez-Gonzalez MA, Corella D, et al. (2006) Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Ann Intern Med 145, 111.
8 Knoops KT, de Groot LC, Kromhout D, et al. (2005) Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women. JAMA 292, 14331439.
9 Martínez-González MA, Fernández-Jarne E, Serrano-Martínez M, et al. (2002) Mediterranean diet and reduction in the risk of a first acute myocardial infarction: an operational healthy dietary score. Eur J Clin Nutr 41, 153160.
10 Scarmeas N, Luchsinger JA, Mayeux R, et al. (2007) Mediterranean diet and Alzheimer disease mortality. Neurology 69, 10841093.
11 Trichopoulou A, Costacou T, Bamia C, et al. (2003) Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 348, 25992608.
12 Trichopoulou A, Bamia C & Trichopoulos D (2005) Mediterranean diet and survival among patients with coronary herat disease in Greece. Arch Intern Med 165, 929935.
13 Willett WC (1998) Nutritional Epidemiology. New York: Oxford University Press.
14 Sullivan BL, Brown J, Williams PG, et al. (2008) Dietary validation of a new Australian food-frequency questionnaire that estimates long-chain n-3 polyunsaturated fatty acids. Br J Nutr 99, 660666.
15 Ishihara J, Todoriki H, Inoue M, et al. (2009) Validity of a self-administered food-frequency questionnaire in the estimation of amino acid intake. Br J Nutr 101, 13931399.
16 Zazpe I, Sanchez-Tainta A, Estruch R, et al. (2008) A large randomized individual and group intervention conducted by registered dietitians increased adherence to Mediterranean-type diets: the PREDIMED study. J Am Diet Assoc 108, 11341144.
17 Martin-Moreno JM, Boyle P, Gorgojo L, et al. (1993) Development and validation of a food frequency questionnaire in Spain. Int J Epidemiol 22, 512519.
18 Moreiras O, Carbajal A, Cabrera L, et al. (2005) Tablas de Composición de Alimentos (Food Composition Tables). Madrid: Ediciones Pirámide, S.A.
19 Beaton GH, Milner J, Corey P, et al. (1979) Sources of variance in 24-hour dietary recall data: implications for nutrition study design and interpretation. Am J Clin Nutr 32, 25462559.
20 Bland JM & Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet i, 307310.
21 Black AE, Coward WA, Cole TJ, et al. (1996) Human energy expenditure in affluent societies: an analysis of 574 doubly-labelled water measurements. Eur J Clin Nutr 50, 7292.
22 Bingham SA (1987) The dietary assessment of individuals; methods, accuracy, new techniques and recommendations. Nutr Abstr Rev (Series A: Hum Nutr) 57, 705742.
23 Cena H, Roggi C & Turconi G (2008) Development and validation of a brief food frequency questionnaire for dietary lutein and zeaxanthin intake assessment in Italian women. Eur J Nutr 47, 19.
24 Cade J, Thompson R, Burley V, et al. (2002) Development, validation and utilisation of food-frequency questionnaires – a review. Public Health Nutr 5, 567587.
25 Kaaks R, Riboli E & van Staveren W (1995) Calibration of dietary measurements in prospective cohort studies. Am J Epidemiol 142, 548556.
26 Kipnis V, Subar AF, Midthune D, et al. (2003) Structure of dietary measurement error: results of the OPEN biomarker study. Am J Epidemiol 158, 1421.
27 Willett W (2003) Invited Commentary: OPEN questions. Am J Epidemiol 158, 2224.
28 Subar AF, Thompson FE, Kipnis V, et al. (2001) Comparative validation of the Block, Willett, and National Cancer Institute food frequency questionnaires – The Eating at America's Table Study. Am J Epidemiol 154, 10891099.
29 Klipstein-Grobusch K, den Breeijen JH, Goldbohm RA, et al. (1998) Dietary assessment in the elderly: validation of a semiquantitative food frequency questionnaire. Eur J Clin Nutr 52, 588596.
30 Molag ML, de Vries JH, Ocké MC, et al. (2007) Design characteristics of food frequency questionnaires in relation to their validity. Am J Epidemiol 166, 14681478.
31 Tsubono Y, Nishino Y, Fukao A, et al. (1995) Temporal change in the reproducibility of a self administered food frequency questionnaire. Am J Epidemiol 142, 12311235.
32 Johansson I, Hallmans G, Wikman A, et al. (2002) Validation and calibration of food-frequency questionnaire measurements in the Northern Sweden Health and Disease cohort. Public Health Nutr 5, 487496.
33 Ahn Y, Kwon E, Shim JE, et al. (2007) Validation and reproducibility of food frequency questionnaire for Korean genome epidemiologic study. Eur J Clin Nutr 61, 14351441.
34 Chen Y, Ahsan H, Parvez F, et al. (2004) Validity of a food-frequency questionnaire for a large prospective cohort study in Bangladesh. Br J Nutr 92, 851859.
35 Dumartheray EW, Krieg MA, Cornuz J, et al. (2006) Validation and reproducibility of a semi-quantitative food frequency questionnaire for use in elderly Swiss women. J Hum Nutr Diet 19, 321330.
36 Ogawa K, Tsubono Y, Nishino Y, et al. (2003) Validation of a food-frequency questionnaire for cohort studies in rural Japan. Public Health Nutr 6, 147157.
37 Shu XO, Yang G, Jin F, et al. (2004) Validity and reproducibility of the food frequency questionnaire used in the Shanghai Women's Health Study. Eur J Clin Nutr 58, 1723.
38 McNaughton SA, Hughes MC & Marks GC (2007) Validation of a FFQ to estimate the intake of PUFA using plasma phospholipid fatty acids and weighed foods records. Br J Nutr 97, 561568.
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British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
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