Validation of a self-administered food-frequency questionnaire administered in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study: comparison of energy, protein, and macronutrient intakes estimated with the doubly labeled water, urinary nitrogen, and repeated 24-h dietary recall methods
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Background The validation of dietary assessment instruments is critical in the evaluation of diet as a chronic disease risk factor.Objective The objective was to assess the validity of a self-administered food-frequency questionnaire by comparison with dietary recall, urinary nitrogen excretion, and total energy expenditure data.Design Over a 1-y period, data from twelve 24-h dietary recalls, a food-frequency questionnaire, and four 24-h urine samples were obtained from 134 study participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) Study in Potsdam, Germany. In a substudy of 28 participants, total energy expenditure from doubly labeled water measurements was assessed.Results Energy-adjusted, deattenuated correlation coefficients between the questionnaire and the recalls ranged from 0.54 for dietary fiber to 0.86 for alcohol. Cross-classification of quintiles of nutrient intakes from the questionnaire and recalls indicated severe misclassification to be <4%. Reported protein intake correlated with estimated protein excretion (r = 0.46). Energy intake and total energy expenditure were also significantly correlated (r = 0.48); however, all but one subject underreported their energy intake. The magnitude of underreporting varied considerably, by 22% on average, and increased slightly with increasing energy intake. A similar pattern of underreporting was observed when energy intakes from the 24-h dietary recalls were compared with total energy expenditure.Conclusions These data indicate an acceptable relative validity of the food-frequency questionnaire in this study population. Compared with measurements of total energy expenditure and protein excretion, however, only moderate agreement with both the food-frequency questionnaire and the 24-h dietary recalls was observed.
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Habitual diet was assessed with validated semiquantitative food-frequency questionnaires.
“Habitual diet was assessed with validated semiquantitative food-frequency questionnaires.”
From Amino acids, lipid metabolites, and ferritin as potential mediators linking red meat consumption to type 2 diabetes (2015) · cites this paper as [16]
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- Authors
- Kroke, A., Klipstein-Grobusch, K., Voss, S., Möseneder, J., Thielecke, F., Noack, R., & Boeing, H.
- Affiliations
- German Institute of Human Nutrition (DE)
- Corresponding author
- Kroke, Anja
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 1999-10
- Volume
- 70
- Issue
- 4
- Pages
- 439-447
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W1887821331
- Cited by
- 550
- References
- 60
- Citations by year
- 2026: 15 · 2025: 11 · 2024: 12 · 2023: 10 · 2022: 13 · 2021: 21 · 2020: 21 · 2019: 31 · 2018: 20 · 2017: 24 · 2016: 34 · 2015: 34 · 2014: 29 · 2013: 28 · 2012: 15
- FWCI
- 17.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- food frequency questionnaire validation, dietary assessment, energy intake, protein intake, macronutrient intake, doubly labeled water, total energy expenditure, urinary nitrogen excretion, 24-hour dietary recall, dietary fiber intake, alcohol consumption, EPIC cohort
- MeSH terms
- Adult, Aged, Energy Intake, Diet Surveys, Dietary Proteins, Europe, Female, Humans, Life Style, Male, Gas Chromatography-Mass Spectrometry, Middle Aged, Oxygen Radioisotopes, Surveys and Questionnaires, Urea, Reproducibility of Results, Cohort Studies, Biomarkers, Body Mass Index, Deuterium Oxide, Statistics, Nonparametric
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