Relative validity of a semi-quantitative food-frequency questionnaire in an elderly Mediterranean population of Spain
Open accessAbstract
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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The FFQ used for nutritional assessment was a validated 143-item food frequency questionnaire from the PREDIMED study, adapted for the Spanish population.
“A validated 143-item food frequency questionnaire (FFQ) from the PREDIMED study, adapted for the Spanish population [22], was used to collect data on the participants’ habitual dietary patterns over the previous year.”
From Efficacy of Power Training on Sarcopenic Obesity in Community-Dwelling Older Women: A 32-Week Randomized Clinical Trial (2025) · cites this paper as [22]
The Materials and methods section says the PREDIMED FFQ was adapted from a previously validated Spanish questionnaire, and the Discussion reports acceptable validity. But both sections identify it as a 137-item FFQ, not a 143-item one. The Results section confirms that the FFQ assessed intake over the previous year; page numbers are unavailable in our copy. (LLM, conf=0.94)
Experimental — accuracy not yet measuredAt baseline and each annual visit, a 14-item MedDiet adherence questionnaire, a 137-item validated food frequency questionnaire, and the validated Spanish version of the Minnesota Leisure-Time Physical Activity questionnaire were administered.
“At baseline and at each annual visit we administered 1 ) a short-questionnaire about lifestyle variables, medical conditions, and medication use, 2 ) a 14-item questionnaire of adherence to the MedDiet ( 12 ), 3 ) a 137-item validated food frequency questionnaire ( 13 ), and 4 ) the validated Spanish version of the Minnesota Leisure-Time Physical Activity questionnaire ( 14 ).”
From Reduction in the Incidence of Type 2 Diabetes With the Mediterranean Diet (2011) · cites this paper as [13]
A previously modified, adapted and validated food frequency questionnaire with portion sizes and food groups usually consumed by the Spanish child population was used.
“A previously modified, adapted and validated food frequency questionnaire (FFQ) with the portion sizes and food groups usually consumed by the Spanish child population was used [30].”
From Dietary Patterns, Eating Behavior, and Nutrient Intakes of Spanish Preschool Children with Autism Spectrum Disorders (2021) · cites this paper as [30]
Fiber intake was calculated using the Spanish food composition tables and through a validated food frequency questionnaire.
“Fiber intake was calculated using the Spanish food composition tables and through a validated food frequency questionnaire [29].”
From Intestinal Microbiota Is Influenced by Gender and Body Mass Index (2016) · cites this paper as [29]
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Self-citationPolyphenol intake and mortality risk: a re-analysis of the PREDIMED trial
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Self-citationMitjavila, M. T., Fandos, M., Salas‐Salvadó, J., Covas, M., Borrego, S., Estruch, R., Lamuela-Raventós, R. M., Corella, D., Martínez‐González, M. Á., Sánchez, J. M., et al. (2012) · Clinical Nutrition · doi:10.1016/j.clnu.2012.08.002 · Cited by 200 · see citing works
Self-citationEstruch, R., Martínez‐González, M. Á., Corella, D., Salas‐Salvadó, J., Fitó, M., Chiva‐Blanch, G., Fiol, M., Gómez‐Gracia, E., Arós, F., Lapetra, J., et al. (2016) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(16)30085-7 · Cited by 195 · see citing works
Self-citationRetractedLasa, A., Miranda, J., Bulló, M., Casas, R. M., Salas‐Salvadó, J., Larretxi, I., Estruch, R., Ruíz-Gutiérrez, V., & Portillo, M. P. (2014) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2014.1 · Cited by 182 · see citing works
Self-citationHardman, R. J., Kennedy, G., Macpherson, H., Scholey, A. B., & Pipingas, A. (2016) · Frontiers in Nutrition · doi:10.3389/fnut.2016.00022 · Cited by 179 · see citing works
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Self-citationSala‐Vila, A., Guasch‐Ferré, M., Hu, F. B., Sánchez‐Tainta, A., Bulló, M., Serra‐Mir, M., López‐Sabater, M. C., Sorlí, J. V., Arós, F., Fiol, M., et al. (2016) · Journal of the American Heart Association · doi:10.1161/jaha.115.002543 · Cited by 180 · see citing works
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Validity and Reproducibility of a Spanish Dietary History
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Does the MIND diet decrease depression risk? A comparison with Mediterranean diet in the SUN cohort
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Self-citationSayón-Orea, C., Razquín, C., Bulló, M., Corella, D., Fitó, M., Romaguera, D., Vioqué, J., Alonso‐Gómez, Á. M., Wärnberǵ, J., Martínez, J. A., et al. (2019) · JAMA · doi:10.1001/jama.2019.14630 · Cited by 171 · see citing works
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Self-citationDamasceno, N. R. T., Sala‐Vila, A., Cofán, M., Pérez-Heras, A., Fitó, M., Ruíz-Gutiérrez, V., Martínez‐González, M. Á., Corella, D., Arós, F., Estruch, R., et al. (2013) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2013.08.014 · Cited by 164 · see citing works
Self-citationPlasma acylcarnitines and risk of cardiovascular disease: effect of Mediterranean diet interventions
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Self-citationSex Differences in the Gut Microbiota as Potential Determinants of Gender Predisposition to Disease
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Self-citationAdherence to the Mediterranean diet and quality of life in the SUN Project
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Self-citationOrtega‐Azorín, C., Sorlí, J. V., Asensio, E. M., Coltell, Ó., Martínez‐González, M. Á., Salas‐Salvadó, J., Covas, M., Arós, F., Lapetra, J., Serra‐Majem, L., et al. (2012) · Cardiovascular Diabetology · doi:10.1186/1475-2840-11-137 · Cited by 154 · see citing works
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Self-citationGarcía‐Mantrana, I., Selma‐Royo, M., González, S., Llorca, A. P., Martínez‐Costa, C., & Collado, M. C. (2020) · Gut Microbes · doi:10.1080/19490976.2020.1730294 · Cited by 155 · see citing works
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Self-citationAlcohol intake, wine consumption and the development of depression: the PREDIMED study
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Self-citationValidation of the German version of the Mediterranean Diet Adherence Screener (MEDAS) questionnaire
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Self-citationValidity of the energy-restricted Mediterranean Diet Adherence Screener
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Self-citationVázquez‐Fresno, R., Llorach, R., Urpí-Sardà, M., Lupianez-Barbero, A., Estruch, R., Corella, D., Fitó, M., Arós, F., Ruiz‐Canela, M., Salas‐Salvadó, J., et al. (2014) · Journal of Proteome Research · doi:10.1021/pr5007894 · Cited by 131 · see citing works
Self-citationNut consumption, weight gain and obesity: Epidemiological evidence
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Dietary inflammatory index and all-cause mortality in large cohorts: The SUN and PREDIMED studies
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Self-citationDietary patterns and difficulty conceiving: a nested case–control study
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Self-citationSánchez‐Villegas, A., Ruiz‐Canela, M., de la Fuente‐Arrillaga, C., Gea, A., Shivappa, N., Hébert, J. R., & Martínez‐González, M. Á. (2015) · British Journal Of Nutrition · doi:10.1017/s0007114515003074 · Cited by 123 · see citing works
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Self-citationSánchez‐Villegas, A., Zazpe, I., Santiago, S., Perez‐Cornago, A., Martínez‐González, M. Á., & Lahortiga‐Ramos, F. (2017) · British Journal Of Nutrition · doi:10.1017/s0007114517003361 · Cited by 124 · see citing works
Self-citationCui, Q., Xia, Y., Wu, Q., Chang, Q., Niu, K., & Zhao, Y. (2021) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-020-01078-4 · Cited by 118 · see citing works
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Self-citationOjeda‐Rodríguez, A., Zazpe, I., Morell‐Azanza, L., Chueca, M., Azcona, C., & Martí, A. (2018) · Nutrients · doi:10.3390/nu10101500 · Cited by 118 · see citing works
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Self-citationUltra-processed foods and type-2 diabetes risk in the SUN project: A prospective cohort study
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Self-citationBabió, N., Sorlí, M., Bulló, M., Basora, J., Ibarrola-Jurado, N., Fernandez-Ballart, J. D., Martínez‐González, M. Á., Serra‐Majem, L., González-Pérez, R., & Salas‐Salvadó, J. (2010) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2010.06.011 · Cited by 114 · see citing works
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Self-citationZheng, Y., Hu, F. B., Ruiz‐Canela, M., Clish, C. B., Dennis, C., Salas‐Salvadó, J., Hruby, A., Liang, L., Toledo, E., Corella, D., et al. (2016) · Journal of the American Heart Association · doi:10.1161/jaha.116.003755 · Cited by 114 · see citing works
Self-citationLiu, X., Zheng, Y., Guasch‐Ferré, M., Ruiz‐Canela, M., Toledo, E., Clish, C. B., Liang, L., Razquín, C., Corella, D., Estruch, R., et al. (2019) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2019.06.005 · Cited by 110 · see citing works
Self-citationBel‐Serrat, S., Mouratidou, T., Pala, V. M., Huybrechts, I., Börnhorst, C., Fernández-Alvira, J. M., Hadjigeorgiou, C., Eiben, G., Hebestreit, A., Lissner, L., et al. (2013) · Public Health Nutrition · doi:10.1017/s1368980012005368 · Cited by 111 · see citing works
Gómez-Delgado, F., Katsiki, N., López‐Miranda, J., & Pérez‐Martínez, P. (2020) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2020.1764487 · Cited by 109 · see citing works
Hu, E. A., Toledo, E., Diez-Espino, J., Estruch, R., Corella, D., Salas-Salvado, J., Vinyoles, E., Gomez-Gracia, E., Aros, F., Fiol, M., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0060166 · Cited by 108 · see citing works
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Self-citationZamora‐Ros, R., Serafini, M., Estruch, R., Lamuela-Raventós, R. M., Martínez‐González, M. Á., Salas‐Salvadó, J., Fiol, M., Lapetra, J., Arós, F., Covas, M. I., et al. (2013) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2012.12.008 · Cited by 108 · see citing works
Self-citationZazpe, I., Sánchez‐Tainta, A., Santiago, S., de la Fuente‐Arrillaga, C., Bes‐Rastrollo, M., Martínez, J. A., & Martínez‐González, M. Á. (2014) · British Journal Of Nutrition · doi:10.1017/s0007114513004364 · Cited by 106 · see citing works
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Cobo‐Cuenca, A. I., Garrido‐Miguel, M., Soriano‐Cano, A., Ferri‐Morales, A., Martínez‐Vizcaíno, V., & Espinosa, N. M. M. (2019) · Nutrients · doi:10.3390/nu11112830 · Cited by 102 · see citing works
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Self-citationBlanco-Rojo, R., Alcala-Diaz, J. F., Wopereis, S., Pérez‐Martínez, P., Quintana‐Navarro, G. M., Marı́n, C., Ordovás, J. M., van Ommen, B., Pérez‐Jiménez, F., Delgado‐Lista, J., et al. (2015) · Diabetologia · doi:10.1007/s00125-015-3776-4 · Cited by 100 · see citing works
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Díaz‐López, A., Bulló, M., Juanola‐Falgarona, M., Martínez‐González, M. Á., Estruch, R., Covas, M., Arós, F., & Salas‐Salvadó, J. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-2472 · Cited by 94 · see citing works
Self-citation
- Authors
- Fernández-Ballart, J. D., Piñol, J. L., Zazpe, I., Corella, D., Carrasco, P., Toledo, E., Perez-Bauer, M., Martínez-González, M. Á., Salas-Salvadó, J., & Martín-Moreno, J. M.
- Affiliations
- Institut Català de la Salut (ES)
- Universitat de València (ES)
- Universidad de Navarra (ES)
- Venue
- British Journal of Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2010-01-27
- Volume
- 103
- Issue
- 12
- Pages
- 1808-1816
- ISSN
- 0007-1145 (ISSN-L)
- 1475-2662
- OpenAlex
- W2140405768
- Cited by
- 898
- References
- 38
- Citations by year
- 2026: 46 · 2025: 57 · 2024: 93 · 2023: 57 · 2022: 75 · 2021: 103 · 2020: 81 · 2019: 74 · 2018: 57 · 2017: 44 · 2016: 40 · 2015: 30 · 2014: 49 · 2013: 34 · 2012: 27
- FWCI
- 29.27
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal Of Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Rovira & Virgili repository (submittedVersion, cc-by)
- Deposito Adademico Digital Universidad De Navarra (University of Navarra) (submittedVersion, other-oa)
- Funders
- Instituto de Salud Carlos III (RD06/0045)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
- Keywords
- food frequency questionnaire, relative validity, reproducibility, dietary assessment, Mediterranean diet, PREDIMED study, older adults, dietary records, energy intake, nutrient intake, food groups, cardiovascular risk
- MeSH terms
- Aged, Diet, Diet Surveys, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Spain, Reproducibility of Results, Multicenter Studies as Topic, Diet Records, Randomized Controlled Trials as Topic, Diet, Mediterranean
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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