Relative validity of a FFQ in measuring carbohydrate fractions, dietary glycaemic index and load: exploring the effects of subject characteristics

FFQ require validation as part of epidemiological research of diet–disease relationships. Studies exploring associations between carbohydrate type and chronic diseases are rapidly increasing, but information on the validity of carbohydrate fractions, dietary glycaemic index (GI) and the glycaemic load (GL) estimated by FFQ is scarce. Likewise, the effects of subject characteristics on FFQ validity have been poorly documented. The present study evaluates the relative validity of an 131-item FFQ in relation to two 3 d food records (FR) performed 6 months apart focusing on the intake of carbohydrate fractions, dietary GI and the GL. Furthermore, we assessed the extent to which subjects' age, education and BMI explain differences between these methods. The study sample comprised 218 men and 292 women aged 25–74 years participating in a large population-based survey in Finland. Energy-adjusted Spearman's rank correlations ranged from 0·27 (sugars) to 0·70 (lactose) for men and from 0·37 (sugars) to 0·69 (lactose) for women. On average, 73 % of the subjects were categorised into the same or adjacent distribution quintile based on the two methods. In general, the FFQ overestimated the intakes compared with FR. Especially in women, FFQ validity for some nutrients was associated with the level of intake, subjects' age and, to a lesser extent, education but not BMI. In conclusion, the FFQ appears to be reasonably valid in the assessment of carbohydrate exposure variables, but the findings show a need for adjustment of diet–disease relationships for subjects' age and education.

[1]  S A Bingham,et al.  Validation of weighed records and other methods of dietary assessment using the 24 h urine nitrogen technique and other biological markers , 1995, British Journal of Nutrition.

[2]  E Riboli,et al.  The Malmö Food Study: validity of two dietary assessment methods for measuring nutrient intake. , 1997, International journal of epidemiology.

[3]  G. Block,et al.  Issues in reproducibility and validity of dietary studies. , 1989, The American journal of clinical nutrition.

[4]  M. Hughes,et al.  The effect of personal characteristics on the validity of nutrient intake estimates using a food-frequency questionnaire , 2006, Public Health Nutrition.

[5]  M. Marmot,et al.  Dietary assessment in Whitehall II: comparison of 7 d diet diary and food-frequency questionnaire and validity against biomarkers , 2001, British Journal of Nutrition.

[6]  G. Mcneill,et al.  Diet and cognitive function in later life: a challenge for nutrition epidemiology , 2009, European Journal of Clinical Nutrition.

[7]  A. Tjønneland,et al.  Validation of a semiquantitative food frequency questionnaire developed in Denmark. , 1991, International journal of epidemiology.

[8]  J. A. Hunt,et al.  Determinants of diet glycemic index calculated retrospectively from diet records of 342 individuals with non-insulin-dependent diabetes mellitus. , 1994, The American journal of clinical nutrition.

[9]  C. la Vecchia,et al.  Evaluating the quality of dietary intake validation studies , 2009, British Journal of Nutrition.

[10]  W Willett,et al.  Total energy intake: implications for epidemiologic analyses. , 1986, American journal of epidemiology.

[11]  N E Day,et al.  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. , 2001, The American journal of clinical nutrition.

[12]  Jeanne H M de Vries,et al.  Misreporting of energy and micronutrient intake estimated by food records and 24 hour recalls, control and adjustment methods in practice , 2009, British Journal of Nutrition.

[13]  U. Nöthlings,et al.  Dietary carbohydrates, glycemic index, glycemic load, and endometrial cancer risk within the European Prospective Investigation into Cancer and Nutrition cohort. , 2007, American journal of epidemiology.

[14]  S. Männistö,et al.  Glycaemic index values in the Finnish food composition database: an approach to standardised value documentation , 2010, European Journal of Clinical Nutrition.

[15]  E. Rimm,et al.  Dietary Fiber, Glycemic Load, and Risk of NIDDM in Men , 1997, Diabetes Care.

[16]  S. Männistö,et al.  Reproducibility and validity of a food frequency questionnaire in a case-control study on breast cancer. , 1996, Journal of clinical epidemiology.

[17]  Veikko Salomaa,et al.  Thirty-five-year trends in cardiovascular risk factors in Finland. , 2010, International journal of epidemiology.

[18]  D. van der A,et al.  Reproducibility and relative validity of dietary glycaemic index and glycaemic load assessed by the food-frequency questionnaire used in the Dutch cohorts of the European Prospective Investigation into Cancer and Nutrition , 2009, British Journal of Nutrition.

[19]  L. Houtkooper,et al.  The psychosocial and behavioral characteristics related to energy misreporting. , 2006, Nutrition reviews.

[20]  K. Overvad,et al.  Reproducibility and relative validity of a self-administered semiquantitative food frequency questionnaire applied to younger women. , 1997, Journal of clinical epidemiology.

[21]  V. Burley,et al.  Development, validation and utilisation of food-frequency questionnaires – a review , 2002, Public Health Nutrition.

[22]  P. van’t Veer,et al.  Design characteristics of food frequency questionnaires in relation to their validity. , 2007, American journal of epidemiology.

[23]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[24]  A. Schatzkin,et al.  Observational Epidemiologic Studies of Nutrition and Cancer: The Next Generation (with Better Observation) , 2009, Cancer Epidemiology Biomarkers & Prevention.

[25]  A. Wolk,et al.  Reproducibility and validity of dietary glycemic index, dietary glycemic load, and total carbohydrate intake in 141 Swedish men. , 2007, The American journal of clinical nutrition.

[26]  S. Männistö,et al.  Validity of a food frequency questionnaire varied by age and body mass index. , 2006, Journal of clinical epidemiology.

[27]  L. Valsta,et al.  Dietary survey methodology of FINDIET 2007 with a risk assessment perspective , 2010, Public Health Nutrition.

[28]  P. Mitchell,et al.  Glycemic index, glycemic load, and chronic disease risk--a meta-analysis of observational studies. , 2008, The American journal of clinical nutrition.

[29]  B. Venn,et al.  Glycemic index and glycemic load: measurement issues and their effect on diet–disease relationships , 2007, European Journal of Clinical Nutrition.

[30]  J. Palmgren,et al.  Reproducibility and validity of dietary assessment instruments. I. A self-administered food use questionnaire with a portion size picture booklet. , 1988, American journal of epidemiology.

[31]  J. Virtamo,et al.  Glycaemic index database for the epidemiological Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study , 2008, British Journal of Nutrition.

[32]  W. Willett,et al.  Reproducibility and validity of a semiquantitative food frequency questionnaire. , 1985, American journal of epidemiology.

[33]  P. Mitchell,et al.  Validity of carbohydrate, glycaemic index and glycaemic load data obtained using a semi-quantitative food-frequency questionnaire , 2008, Public Health Nutrition.

[34]  Victor Kipnis,et al.  Use of the Predictive Sugars Biomarker to Evaluate Self-Reported Total Sugars Intake in the Observing Protein and Energy Nutrition (OPEN) Study , 2011, Cancer Epidemiology, Biomarkers & Prevention.

[35]  Michael B. Smith Carbohydrates , 2001, Public Health Nutrition.

[36]  C. Dethlefsen,et al.  Intake of carbohydrates compared with intake of saturated fatty acids and risk of myocardial infarction: importance of the glycemic index. , 2010, The American journal of clinical nutrition.

[37]  M. Longnecker,et al.  The Reproducibility and Validity of a Self‐Administered Semiquantitative Food Frequency Questionnaire in Subjects from South Dakota and Wyoming , 1993, Epidemiology.

[38]  T. Wolever,et al.  The glycemic index: methodology and clinical implications. , 1991, The American journal of clinical nutrition.

[39]  P. Gibson,et al.  Development and validation of a comprehensive semi-quantitative food frequency questionnaire that includes FODMAP intake and glycemic index. , 2010, Journal of the American Dietetic Association.

[40]  C Summerbell,et al.  FAO/WHO Scientific Update on carbohydrates in human nutrition: conclusions , 2007, European Journal of Clinical Nutrition.