TY - JOUR
T1 - A comparison of a food frequency questionnaire with a 24-hour recall for use in an epidemiological cohort study
T2 - Results from the biomarker-based Observing Protein and Energy Nutrition (OPEN) study
AU - Schatzkin, Arthur
AU - Kipnis, Victor
AU - Carroll, Raymond J.
AU - Midthune, Douglas
AU - Subar, Amy F.
AU - Bingham, Sheila
AU - Schoeller, Dale A.
AU - Troiano, Richard P.
AU - Freedman, Laurence S.
PY - 2003/12
Y1 - 2003/12
N2 - Background. Most large cohort studies have used a food frequency questionnaire (FFQ) for assessing dietary intake. Several biomarker studies, however, have cast doubt on whether the FFQ has sufficient precision to allow detection of moderate but important diet-disease associations. We use data from the Observing Protein and Energy Nutrition (OPEN) study to compare the performance of a FFQ with that of a 24-hour recall (24HR). Methods. The OPEN study included 484 healthy volunteer participants (261 men, 223 women) from Montgomery County, Maryland, aged 40-69. Each participant was asked to complete a FFQ and 24HR on two occasions 3 months apart, and a doubly labelled water (DLW) assessment and two 24-hour urine collections during the 2 weeks after the first FFQ and 24HR assessment. For both the FFQ and 24HR and for both men and women, we calculated attenuation factors for absolute energy, absolute protein, and protein density. Results. For absolute energy and protein, a single FFQs attenuation factor is 0.04-0.16. Repeat administrations lead to little improvement (0.08-0.19). Attenuation factors for a single 24HR are 0.10-0.20, but four repeats would yield attenuations of 0.20-0.37. For protein density a single FFQ has an attenuation of 0.3-0.4; for a single 24HR the attenuation factor is 0.15-0.25 but would increase to 0.35-0.50 with four repeats. Conclusions. Because of severe attenuation, the FFQ cannot be recommended as an instrument for evaluating relations between absolute intake of energy or protein and disease. Although this attenuation is lessened in analyses of energy-adjusted protein, it remains substantial for both FFQ and multiple 24HR. The utility of either of these instruments for detecting important but moderate relative risks (between 1.5 and 2.0), even for energy-adjusted dietary factors, is questionable.
AB - Background. Most large cohort studies have used a food frequency questionnaire (FFQ) for assessing dietary intake. Several biomarker studies, however, have cast doubt on whether the FFQ has sufficient precision to allow detection of moderate but important diet-disease associations. We use data from the Observing Protein and Energy Nutrition (OPEN) study to compare the performance of a FFQ with that of a 24-hour recall (24HR). Methods. The OPEN study included 484 healthy volunteer participants (261 men, 223 women) from Montgomery County, Maryland, aged 40-69. Each participant was asked to complete a FFQ and 24HR on two occasions 3 months apart, and a doubly labelled water (DLW) assessment and two 24-hour urine collections during the 2 weeks after the first FFQ and 24HR assessment. For both the FFQ and 24HR and for both men and women, we calculated attenuation factors for absolute energy, absolute protein, and protein density. Results. For absolute energy and protein, a single FFQs attenuation factor is 0.04-0.16. Repeat administrations lead to little improvement (0.08-0.19). Attenuation factors for a single 24HR are 0.10-0.20, but four repeats would yield attenuations of 0.20-0.37. For protein density a single FFQ has an attenuation of 0.3-0.4; for a single 24HR the attenuation factor is 0.15-0.25 but would increase to 0.35-0.50 with four repeats. Conclusions. Because of severe attenuation, the FFQ cannot be recommended as an instrument for evaluating relations between absolute intake of energy or protein and disease. Although this attenuation is lessened in analyses of energy-adjusted protein, it remains substantial for both FFQ and multiple 24HR. The utility of either of these instruments for detecting important but moderate relative risks (between 1.5 and 2.0), even for energy-adjusted dietary factors, is questionable.
KW - 24-hour recall
KW - Attenuation factor
KW - Cohort study
KW - Dietary measurement error
KW - Doubly labelled water
KW - Energy intake
KW - Food frequency questionnaire
KW - Nutritional epidemiology
KW - Protein intake
KW - Urinary nitrogen
UR - http://www.scopus.com/inward/record.url?scp=0347985261&partnerID=8YFLogxK
U2 - 10.1093/ije/dyg264
DO - 10.1093/ije/dyg264
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C2 - 14681273
AN - SCOPUS:0347985261
SN - 0300-5771
VL - 32
SP - 1054
EP - 1062
JO - International Journal of Epidemiology
JF - International Journal of Epidemiology
IS - 6
ER -