Combining a Food Frequency Questionnaire With 24-Hour Recalls to Increase the Precision of Estimation of Usual Dietary Intakes—Evidence From the Validation Studies Pooling Project
Open accessAbstract
Improving estimates of individuals' dietary intakes is key to obtaining more reliable evidence for diet-health relationships from nutritional cohort studies. One approach to improvement is combining information from different self-report instruments. Previous work evaluated the gains obtained from combining information from a food frequency questionnaire (FFQ) and multiple 24-hour recalls (24HRs), based on assuming that 24HRs provide unbiased measures of individual intakes. Here we evaluate the same approach of combining instruments but base it on the better assumption that recovery biomarkers provide unbiased measures of individual intakes. Our analysis uses data from the 5 large validation studies included in the Validation Studies Pooling Project: the Observing Protein and Energy Nutrition Study (1999-2000), the Automated Multiple-Pass Method validation study (2002-2004), the Energetics Study (2006-2009), the Nutrition Biomarker Study (2004-2005), and the Nutrition and Physical Activity Assessment Study (2007-2009). The data included intakes of energy, protein, potassium, and sodium. Under a time-varying usual-intake model analysis, the combination of an FFQ with 4 24HRs improved correlations with true intake for predicted protein density, potassium density, and sodium density (range, 0.39-0.61) in comparison with use of a single FFQ (range, 0.34-0.50). Absolute increases in correlation ranged from 0.02 to 0.26, depending on nutrient and sex, with an average increase of 0.14. Based on unbiased recovery biomarker evaluation for these nutrients, we confirm that combining an FFQ with multiple 24HRs modestly improves the accuracy of estimates of individual intakes.
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Nutritional studies are prone to measurement error, underreporting of dietary consumption, and recall bias.
“Finally, nutritional studies are prone to measurement error, underreporting of dietary consumption, and recall bias [98,99].”
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- Authors
- Freedman, L. S., Midthune, D., Arab, L., Prentice, R. L., Subar, A. F., Willett, W., Neuhouser, M. L., Tinker, L. F., & Kipnis, V.
- Affiliations
- Sheba Medical Center (IL)
- National Institutes of Health (US)
- University of California, Los Angeles (US)
- Fred Hutch Cancer Center (US)
- National Cancer Institute (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Freedman, Laurence S
- ORCID
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-06-18
- Volume
- 187
- Issue
- 10
- Pages
- 2227-2232
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- PMC
- PMC6166211
- OpenAlex
- W2809346922
- Cited by
- 116
- References
- 28
- Citations by year
- 2026: 13 · 2025: 22 · 2024: 24 · 2023: 8 · 2022: 10 · 2021: 11 · 2020: 14 · 2019: 13
- FWCI
- 9.06
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Epidemiology (publishedVersion, public-domain)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, HHSN271201100004C)
- National Cancer Institute (R01 CA119171)
- 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
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Keywords
- food frequency questionnaire, 24-hour dietary recall, validation studies, protein intake, potassium intake, sodium intake, energy intake, dietary assessment accuracy
- MeSH terms
- Adult, Aged, Energy Intake, Diet Surveys, Dietary Proteins, Female, Humans, Male, Middle Aged, Mental Recall, Sex Factors, Sodium, Dietary, Reproducibility of Results, Potassium, Dietary, Self Report
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