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      Validity of a Self-administered Food Frequency Questionnaire Used in the 5-year Follow-up Survey of the JPHC Study Cohort I: Comparison with Dietary Records for Food Groups

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          Abstract

          We examined the validity of food intake measurements from a self-administered food frequency questionnaire (FFQ) used in the 5-year follow-up survey of the JPHC study using 28- or 14-day dietary records (DR) as the gold standard. The median (range) correlation coefficients between a 19-food group measured by FFQ and DR were 0.42 (0.13-0.76) for men and 0.41 (0.02-0.75) for women. The median (range) for energy-adjusted correlation coefficients was 0.38 (0.08-0.76) for men and 0.32 (0.06-0.66) for women. The mean percentage of classification into the same categories between the two methods was 30% in men and 31% in women. Only 2% in men and 3% in women of subjects were classified into the extreme opposite categories. When we adjusted for area, the median correlation coefficients were decreased in crude intakes (0.34 in men and 0.28 in women), whereas no remarkable change was observed in energy-adjusted intakes (0.33 in men and 0.29 in women). In conclusion, the results suggest that the FFQ can be used in the JPHC study cohort I to rank individuals according to the intakes for most of the food groups examined. But intake levels both at population and individual levels were difficult to estimate.

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          Total energy intake: implications for epidemiologic analyses.

          Associations between intake of specific nutrients and disease cannot be considered primary effects of diet if they are simply the result of differences between cases and noncases in body size, physical activity, and metabolic efficiency. Epidemiologic studies of diet and disease should therefore be directed at the effect of nutrient intakes independent of total caloric intake in most instances. This is not accomplished with nutrient density measures of dietary intake but can be achieved by employing nutrient intakes adjusted for caloric intake by regression analysis. While pitfalls in the manipulation and interpretation of energy intake data in epidemiologic studies have been emphasized, these considerations also highlight the usefulness of obtaining a measurement of total caloric intake. For instance, if a questionnaire obtained information on only cholesterol intake in a study of coronary heart disease, it is possible that no association with disease would be found even if a real positive effect of a high cholesterol diet existed, since the caloric intake of cases is likely to be less than that of noncases. Such a finding could be appropriately interpreted if an estimate of total caloric intake were available. The relationships between dietary factors and disease are complex. Even with carefully collected measures of intake, consideration of the biologic implications of various analytic approaches is needed to avoid misleading conclusions.
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            Reproducibility and validity of food intake measurements from a semiquantitative food frequency questionnaire.

            Few food frequency questionnaires have been evaluated for their ability to assess intakes of individual foods that may be related to disease independently of their nutrient content. The reproducibility and validity of food intake measurements by a 131-item semiquantitative food frequency questionnaire were evaluated in a sample of 127 men from the Health Professionals Follow-up Study, a large longitudinal study of diet and disease. Each subject completed two questionnaires 1 year apart and two 1-week diet records 6 months apart during the intervening year. Pearson correlations assessing reproducibility between food intakes from the two questionnaires ranged from .31 for pie to .92 for coffee (mean = .59). Validity was measured by comparing food intakes from the second questionnaire with those from the diet records. Pearson correlations corrected for within-person weekly variation in diet record data ranged from .17 for other nuts to .95 for bananas (mean = .63). Large within-person variation precluded the calculation of accurate validity correlations for 29 foods. As we previously observed in women, the foods most often overreported were fruits and vegetables, and meats and dairy products were most often underreported. With few exceptions, reasonable levels of reproducibility and validity were observed for intake of individual foods in this extensive food frequency questionnaire.
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              Social desirability bias in dietary self-report may compromise the validity of dietary intake measures.

              Self-report of dietary intake could be biased by social desirability or social approval thus affecting risk estimates in epidemiological studies. These constructs produce response set biases, which are evident when testing in domains characterized by easily recognizable correct or desirable responses. Given the social and psychological value ascribed to diet, assessment methodologies used most commonly in epidemiological studies are particularly vulnerable to these biases. Social desirability and social approval biases were tested by comparing nutrient scores derived from multiple 24-hour diet recalls (24HR) on seven randomly assigned days with those from two 7-day diet recalls (7DDR) (similar in some respects to commonly used food frequency questionnaires), one administered at the beginning of the test period (pre) and one at the end (post). Statistical analysis included correlation and multiple linear regression. Cross-sectionally, no relationships between social approval score and the nutritional variables existed. Social desirability score was negatively correlated with most nutritional variables. In linear regression analysis, social desirability score produced a large downward bias in nutrient estimation in the 7DDR relative to the 24HR. For total energy, this bias equalled about 50 kcal/point on the social desirability scale or about 450 kcal over its interquartile range. The bias was approximately twice as large for women as for men and only about half as large in the post measures. Individuals having the highest 24HR-derived fat and total energy intake scores had the largest downward bias due to social desirability. We observed a large downward bias in reporting food intake related to social desirability score. These results are consistent with the theoretical constructs on which the hypothesis is based. The effect of social desirability bias is discussed in terms of its influence on epidemiological estimates of effect. Suggestions are made for future work aimed at improving dietary assessment methodologies and adjusting risk estimates for this bias.
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                Author and article information

                Journal
                J Epidemiol
                J Epidemiol
                JE
                Journal of Epidemiology
                Japan Epidemiological Association
                0917-5040
                1349-9092
                30 November 2007
                2003
                : 13
                : 1 Suppl
                : S57-S63
                Affiliations
                [01]Epidemiology and Biostatistics Division, National Cancer Center Research Institute East.
                Author notes

                Address for correspondence : Shoichiro Tsugane, Epidemiology and Biostatistics Division, National Cancer Center Research Institute East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.

                Article
                13.S57
                10.2188/jea.13.1sup_57
                9767694
                12701632
                4d7fb8ac-a423-4233-a951-af615d458b18
                © 2003 Japan Epidemiological Association.

                This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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                validity,food group,food frequency questionnaire,dietaryrecord

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