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Validity and reliability of a new food frequency questionnaire compared to 24 h recalls and biochemical measurements: pilot phase of Golestan cohort study of esophageal cancer

Abstract

Background:

A pilot study was carried out to evaluate validity and reproducibility of a food frequency questionnaire (FFQ), which was designed to be used in a prospective cohort study in a population at high risk for esophageal cancer in northern Iran.

Methods:

The FFQ was administered four times to 131 subjects, aged 35–65 years, of both sexes. Twelve 24-h dietary recalls for two consecutive days were administered monthly during 1 year and used as a reference method. The excretion of nitrogen was measured on four 24-h urine samples, and plasma levels of β-carotene, retinol, vitamin C and α-tocopherol was measured from two time points. Relative validity of FFQ and 24-h diet recall was assessed by comparing nutrient intake derived from both methods with the urinary nitrogen and plasma levels of β-carotene, retinol, vitamin C and α-tocopherol.

Results:

Correlation coefficients comparing energy and nutrients intake based on the mean of the four FFQ and the mean of twelve 24-h diet recalls were 0.75 for total energy, 0.75 for carbohydrates, 0.76 for proteins and 0.65 for fat. Correlation coefficients between the FFQ-based intake and serum levels of β-carotene, retinol, vitamin C and vitamin E/α-tocopherol were 0.37, 0.32, 0.35 and 0.06, respectively. Correlation coefficients between urinary nitrogen and FFQ-based protein intake ranged from 0.23 to 0.35. Intraclass correlation coefficients used to measure reproducibility of FFQ ranged from 0.66 to 0.89.

Conclusion:

We found that the FFQ provides valid and reliable measurements of habitual intake for energy and most of the nutrients studied.

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Acknowledgements

This study was supported by funds from DDRC, Iran and IARC, France. We thank Dr Farhad Islami, Dr Hajiamin Marjani, Dr Omid Mozaffari, and Dr Elham Jafari for their logistic assistance. We sincerely thank our interviewers; Ailar Jamali, Anita Ramiar, Azin Kor, Akram Mohamadi, Afsane Mosadegh, Halime Pourghaz, Aijamal Gorgani, Fahime Igder, Saiideh Valaee, Homeira Davoodpour and Hesam Aman baee. We also enjoyed the close collaboration of Golestan health deputy Dr Mohamad Naemi, Dr Ali Aghapor, Mr J Kabir and Dr Jalil Pestei, Chief of Gonbad Health District.

We specially thank and appreciate Mrs Yoosefi and Mr Maramaie (local health workers of Behvarz) in the study areas. We also express appreciations to all the kind people of Gonbad for their collaboration in this study. We are deeply grateful to Elio Riboli and Nadia Slimani from IARC for their valuable comments.

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Correspondence to R Malekzadeh.

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Guarantor: R Malekzadeh.

Contributors: The authors have contributed to the manuscript by planning the study (DDRC, IARC, NCI, NNFRI), collecting data (DDRC, NNFRI), calculating the nutritional components (DDRC, NNFRI), serum vitamin measurements (Edouard Herriot Hospital, Addenbrooke's Hospital in Cambridge,UK), analysis of data (DDRC, IARC,NCI), and preparation and revision of the manuscript (all authors). DDRC: Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; IARC: International Agency for Research on Cancer, Lyon, France; NNFR: National Nutrition and Food Science Research Institute of Shaheed Beheshti University of Medical Science, Iran; NCI: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute, Bethesda, MD, USA; Edouard Herriot Hospital and EA 3090, Lyon, France; Addenbrooke's Hospital, Unit of Clinical Biochemistry, Cambridge, UK.

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Malekshah, A., Kimiagar, M., Saadatian-Elahi, M. et al. Validity and reliability of a new food frequency questionnaire compared to 24 h recalls and biochemical measurements: pilot phase of Golestan cohort study of esophageal cancer. Eur J Clin Nutr 60, 971–977 (2006). https://doi.org/10.1038/sj.ejcn.1602407

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