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Dietary Assessment of Older Iowa Women with a Food Frequency Questionnaire: Nutrient Intake, Reproducibility, and Comparison with 24-Hour Dietary Recall Interviews
Abstract
The authors report the results of a dietary survey of 38,121 Iowa women, 55-69 years of age in 1986, based on a semiquantitative food frequency questionnaire previously tested among Boston-area women aged 34-59 years. The Iowa women, compared with the younger Boston-area women, consumed a similar amount of calories (1,767 vs. 1,844 kcal) and a similar amount of total calories from fat (35 vs. 37%) but had markedly greater intake of the following micronutrients after including supplement use: iron (+18%), calcium (+33%), vitamin A (+43%), riboflavin (+46%), thiamine (+50%), and pyridoxine (+122%). The reproducibility of the questionnaire was examined in two more administrations to 44 of the Iowa women in January and June of 1988. Reproducibility was highest for alcohol (Pearson's r = 0.99), caffeine (r = 0.95), and vitamin E (r = 0.90) and lowest for sucrose (r = 0.53), polyunsaturated fat (r = 0.56), and iron (r = 0.59). Micronutrient intakes were generally more reproducible than macronutrient intakes. The agreement between the June 1988 questionnaire and the average of five 24-hour dietary recalls was also assessed in the 44 subjects. The median correlations of energy-adjusted intake were as follows: for macronutrients, r = 0.45; for micronutrients without supplements, r = 0.33; and for micronutrients with supplements, r = 0.64. This food frequency questionnaire appears to be reasonably reproducible and accurate, so that its use may be extended to epidemiologic studies of older women with a broad range of socioeconomic backgrounds.
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“In addition, this validation study had an adequate sample size [15] similar to those used in previous studies [30,45-46].”
From Online dietary intake estimation: reproducibility and validity of the Food4Me Food frequency questionnaire against a 4-day weighed food record (2014) · cites this paper as [45]
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“The FFQ was reliable and valid in this population (Munger et al, 1992).”
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“Cohort participants were asked to report their usual intake frequencies of 127 food items during the past 12 mo (32,33).”
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“Total nutrient and energy intakes were calculated by adding energy and nutrients from all food and supplement sources using Willett’s dietary database [23].”
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“Questions on the food-frequency questionnaire used in the IWHS, although evaluated for reproducibility and validity in 44 study participants (38), did not separate heme iron intake from total dietary iron intake and did not specifically evaluate zinc intake.”
MethodDo Consumers of Savory Snacks Have Poor-quality Diets?
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“The validity and reliability of caffeine assessment are high for the Willett food frequency questionnaire on which the food frequency for the current study was based (Munger et al., 1992), and classification of ‘any’ versus ‘none’ used for this study are likely more accurate than for the amount.”
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“Over-estimation by food frequency questionnaires in comparison with other dietary methods has been cited in many other studies 19,26–28 , particularly for Vitamins A and C, and fruits and vegetables 19,27 , and is a probable consequence of the long lists of fruits and vegetables that are often…”
Jung, A. Y., Poole, E. M., Bigler, J., Whitton, J. A., Potter, J. D., & Ulrich, C. M. (2008) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-07-2608 · Cited by 35
“Dietary intakes over the year prior to polyp diagnosis or reference date was obtained using an adaptation of the Willett semiquantitative food frequency questionnaire, which has been studied previously for validity and repeatability within the Nurses’ Health Study cohort (49), the Iowa Women’s Health Study cohort (50)…”
MethodComparative Validity of a Food Frequency Questionnaire for Adults with IDDM
Riley, M. D., & Blizzard, L. (1995) · Diabetes Care · doi:10.2337/diacare.18.9.1249 · Cited by 35
“In other studies using different FFQs (11-13), correlation coefficients for total energy and macronutrient intakes by FFQs repeated at time intervals of 5-12 months were in the ranges 0.”
ResultRadoï, L., Paget‐Bailly, S., Menvielle, G., et al. (2013) · Cancer Epidemiology · doi:10.1016/j.canep.2013.02.001 · Cited by 34
“Nevertheless, many studies showed that recall of tea [37] and coffee intake [37–39] are satisfactorily reliable and valid.”
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High-Folate Diets and Breast Cancer Survival in a Prospective Cohort Study
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“It also included a 127-item semiquantitative food frequency questionnaire that was virtually identical to that used in the 1984 dietary assessment in the Nurses Health Study (11).”
MethodSelf-citationGenetic variability in prostaglandin synthesis, fish intake and risk of colorectal polyps
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“Among the validation studies of the FFQs [32–39], the median values across studies of the correlation coefficients comparing dietary vitamin intakes estimated using the FFQ versus the reference method (multiple dietary records or 24-h recalls) were 0.”
Register of dietary assessment calibration-validation studies: a status report
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“While there have been several investigations examining the validity of FFQs in older cohorts (30-34), few amongst these have specifically examined the role of cognition status on observed associations.”
Medgyesi, D. N., Trabert, B. L., Sampson, J. N., Weyer, P. J., Prizment, A. E., Fisher, J. A., Freeman, L. E. B., Ward, M. H., & Jones, R. R. (2022) · Environmental Health Perspectives · doi:10.1289/ehp10207 · Cited by 30
“As previously described, estimates of dietary macro- and micronutrients were derived from a food frequency questionnaire administered at enrollment, and they have shown good reproducibility in later surveys.(37) Total dietary nitrate (converted to NO3-N for comparison with drinking water) and nitrite (mg/day) were cal…”
MethodEvaluation of a Validated Food Frequency Questionnaire for Self-Defined Vegans in the United States
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“The validity and reproducibility of the Harvard FFQ have been shown in the IWHS population (31).”
MethodCuestionario de frecuencia de consumo de alimentos para estimación de ingestión de folato en México
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“The food frequency questionnaire was an adaptation of the Willett semiquantitative food frequency questionnaire, which has been studied previously for validity and repeatability within the Nurses' Health Study cohort (45), the Iowa Women's Health Study cohort (46), and the Health Professionals Follow-up Study cohort (…”
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“The validity and reliability of the FFQ in the study population were previously reported((12)).”
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“…have attempted to estimate iron intake, and a small review of general questionnaires that measured iron intake in women gave a range of Spearman correlation coefficients (relation between new questionnaires and reference method) from 0.07 (Munger et al, 1992) to 0.54 (Masson et al, 2003).”
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Self-citationPolymorphisms in WNT6 and WNT10A and Colorectal Adenoma Risk
Galbraith, R. L., Poole, E. M., Duggan, D. J., et al. (2011) · Nutrition and Cancer · doi:10.1080/01635581.2011.542539 · Cited by 25
“The dietary questionnaire was adapted from the Willett Semi-Quantitative Food Frequency Questionnaire, which has been evaluated for validity and repeatability within this study (24,25), as well as the Nurses’ Health Study cohort (26), the Iowa Women’s Health Study cohort (27), and the Health Professionals FollowUp Stu…”
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“It also included a 127-item semi-quantitative food frequency questionnaire that was virtually identical to that used in the 1984 dietary assessment in the Nurses Health Study [17].”
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Petimar, J., O’Reilly, É. J., Adami, H., van den Brandt, P. A., Buring, J. E., English, D. R., Freedman, D. M., Giles, G. G., Håkansson, N., Kurth, T., et al. (2018) · European Journal of Neurology · doi:10.1111/ene.13840 · Cited by 21
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“frequency questionnaire and correlation with 24-hour dietary recall data in the IWHS cohort has been previously reported (36).”
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Park, K., Harnack, L., & Jacobs, D. R. (2009) · American Journal of Epidemiology · doi:10.1093/aje/kwn410 · Cited by 20
“At baseline, a 127-food-item Harvard food frequency questionnaire was used to assess women’s usual food and nutrient intake (18).”
MethodTGF 1 polymorphism (L10P) and risk of colorectal adenomatous and hyperplastic polyps
Sparks, R. (2004) · International Journal of Epidemiology · doi:10.1093/ije/dyh102 · Cited by 20
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“6, depending on the study population [15-21].”
Subar, A. F., Kushi, L. H., Lerman, J., & Freedman, L. S. (2017) · American Journal of Epidemiology · doi:10.1093/aje/kwx072 · Cited by 19
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“However, the literature does support the validity of this tool for measuring alcohol intake (Johannson et al., 2002; Munger et al., 1992), and a strong relationship existed between alcohol intake measured through the 24- h recalls and self-reported alcohol intake on the Weight and Lifestyle…”
Urban vs rural residency and allergy prevalence among adult women
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No interaction of body mass index and smoking on diabetes mellitus risk in elderly women
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“Previous studies have supported the reliability and validity of our food frequency questionnaire (Munger et al., 1992) and measurement of waist and hip circumferences (Kushi et al., 1988).”
Challenges in Research in Nutritional Epidemiology
Jacobs, D. R. (2012) · Humana Press eBooks · doi:10.1007/978-1-61779-894-8_2 · Cited by 16
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“Dietary intakes and vitamin and mineral supplement use were collected at baseline using a 127-item semiquantitative Willett food frequency questionnaire (FFQ), for which the validity and reliability in the study population was previously reported(42).”
Coathup, V., Wheeler, S., & Smith, L. A. (2015) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2015.159 · Cited by 13
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Familial correlation of dietary intakes among postmenopausal women
Vachon, C. M., Sellers, T. A., Kushi, L. H., & Folsom, A. R. (1998) · Genetic Epidemiology · doi:10.1002/(sici)1098-2272(1998)15:6 · Cited by 13
Self-citationGallois, S., Heger, T., Henry, A. G., et al. (2021) · PLoS ONE · doi:10.1371/journal.pone.0247108 · Cited by 12
Sources of Variability in the Reproducibility of Food Frequency Questionnaires
Joachim, G. (1998) · Nutrition and Health · doi:10.1177/026010609801200303 · Cited by 12
“The literature indicates that data regarding some foods demonstrates high reproducibility, while data regarding other foods are not well reproduced (Willett 1990b, Pietinen et al. 1988, Munger et al. 1992, Salvini et al. 1989, Subar et al. 1994, Ziegler et al. 1987). Pietinen et al. (1988) found that reproducibility w…”
BackgroundPrediagnostic Calcium Intake and Lung Cancer Survival: A Pooled Analysis of 12 Cohort Studies
Yu, D., Takata, Y., Smith‐Warner, S. A., et al. (2017) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-16-0863 · Cited by 11
Whole grain intake, incident hip fracture and presumed frailty in the Iowa Women's Health Study
Jacobs, D. R., Hohe, C., Mursu, J., et al. (2010) · British Journal Of Nutrition · doi:10.1017/s0007114510002382 · Cited by 11
“A 127-item semi-quantitative FFQ was also included, which was adapted from the Nurses’ Health Study, developed and validated within a subgroup of nurses aged 34–59 years of the Boston area((18)) and tested for reliability in 1988 within a subset of the present study’s cohort of forty-four women giving several 24 h rec…”
MethodSelf-citationItzhaki, D., Rennert, H. S., Rozen, G. S., & Rennert, G. (2008) · The Open Nutrition Journal · doi:10.2174/1874288200802010009 · Cited by 11
“78, which is comparable, and even superior, to those found in many other studies [4, 12-19] (Table 7).”
ResultZhu, S., Toyoshima, H., Kondo, T., et al. (2002) · Journal of Epidemiology · doi:10.2188/jea.12.120 · Cited by 11
Reproducibility of a food frequency questionnaire: Korea Nurses' Health Study
Song, S., Kim, B., Pang, Y., Kim, O., & Lee, J. E. (2022) · Nutrition Research and Practice · doi:10.4162/nrp.2022.16.1.106 · Cited by 10
“7 for energy and nutrients [26,27,33-35,37-49] and ranged from 0.”
BackgroundRelative validity of the geisinger rural aging study food frequency questionnaire
Mitchell, D. C., Tucker, K. L., Maras, J. E., Lawrence, F., Smiciklas‐Wright, H., Jensen, G. L., Still, C. D., & Hartman, T. J. (2012) · The journal of nutrition health & aging · doi:10.1007/s12603-012-0030-3 · Cited by 9
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“Dietary and supplement intakes over the previous 12 mo, were collected through a 127-item Willett food frequency questionnaire (FFQ), for which the validity and reliability in the study population was previously reported (23).”
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Comparison of Dietary Assessment Methods in a Low-Fat Dietary Intervention Program
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“040 No affected 1st-degree relative 16 (35) 12 (22) 1 affected 1st-degree relative 28 (61) 32 (58) 1 affected 1st-degree relative 2 (4) 11 (20) Prior breast biopsy 0.”
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“Similar semi-quantitative food frequency questionnaires have been shown to provide reasonable estimates of usual dietary intake of micronutrients and foods among populations of varied ages and demographic characteristics including the elderly (17-20).”
BackgroundSelf-citationGupta, A., Vuyyuru, S. K., Kante, B., Kumar, P., Farooqui, M. N. I., Ranjan, M. K., Singh, N., Mundhra, S. K., Madan, D., Golla, R., et al. (2023) · Journal of Clinical and Experimental Hepatology · doi:10.1016/j.jceh.2023.10.004 · Cited by 7
Vitamin D Receptor Polymorphism and the Risk of Colorectal Adenomas
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Mitochondrial hyperpolarization and ATP depletion in patients with systemic lupus erythematosus
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“45, 583–599.range from 28% in the NHIS (Block & Subar, Black, A.E., Prentice, A.M., Goldberg, G.R., Jebb,1992) to 60% in the Iowas Women Study S.A., Bingham, S.A., Livingstone, M.B.E. & (Munger et al., 1992).”
MethodInfluentialSucrose Intakes and Incident Colorectal Cancer Risk among Women
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Challenges in Research in Nutritional Epidemiology
Jacobs, D. R. (2023) · Nutrition and health · doi:10.1007/978-3-031-24663-0_2 · Cited by 4
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Metadata
- Authors
- Munger, R. G., Folsom, A. R., Kushi, L. H., Kaye, S. A., & Sellers, T. A.
- Affiliations
- University of Iowa (US)
- University of Minnesota (US)
- Corresponding author
- Munger, Ronald G.
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 1992-07-15
- Volume
- 136
- Issue
- 2
- Pages
- 192-200
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W1894977589
- Cited by
- 353
- References
- 0
- Citations by year
- 2026: 7 · 2025: 1 · 2023: 4 · 2022: 4 · 2021: 33 · 2020: 6 · 2019: 6 · 2018: 8 · 2017: 8 · 2016: 3 · 2015: 5 · 2014: 7 · 2013: 12 · 2012: 12
- FWCI
- 9.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (R01 CA39742, R01CA039742)
- 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, dietary assessment, reproducibility, 24-hour dietary recall, micronutrient intake, macronutrient intake, older women, dietary supplements, iron intake, calcium intake, vitamin intake, questionnaire validation, Iowa women
- MeSH terms
- Energy Intake, Evaluation Studies as Topic, Female, Humans, Interviews as Topic, Iowa, Middle Aged, Nutrition Surveys, Surveys and Questionnaires, Reproducibility of Results
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