Reproducibility and validity of a food frequency questionnaire among pregnant women in a Mediterranean area

Jesús Vioque, Eva-María Navarrete-Muñoz, Daniel Gimenez-Monzó, Manuela García-de-la-Hera, Fernando Granado, Ian S Young, Rosa Ramón, Ferran Ballester, Mario Murcia, Marisa Rebagliato, Carmen Iñiguez, INMA-Valencia Cohort Study, Jesús Vioque, Eva-María Navarrete-Muñoz, Daniel Gimenez-Monzó, Manuela García-de-la-Hera, Fernando Granado, Ian S Young, Rosa Ramón, Ferran Ballester, Mario Murcia, Marisa Rebagliato, Carmen Iñiguez, INMA-Valencia Cohort Study

Abstract

Background: Studies exploring the role of diet during pregnancy are still scarce, in part due to the complexity of measuring diet and to the lack of valid instruments. The aim of this study was to examine the reproducibility and validity (against biochemical biomarkers) of a semi-quantitative food frequency questionnaire (FFQ) in pregnant women.

Methods: Participants were 740 pregnant women from a population-based birth cohort study in Valencia (INMA Study). We compared nutrient and food intakes from FFQs estimated for two periods of pregnancy (reproducibility), and compared energy-adjusted intake of several carotenoids, folate, vitamin B12, vitamin C and α-tocopherol of the FFQ in the first trimester with their concentration in blood specimens (validity).

Results: Significant correlations for reproducibility were found for major food groups and nutrients but not for lycopene (r=0.06); the average correlation coefficients for daily intake were 0.51 for food groups and 0.61 for nutrients. For validity, statistically significant correlations were observed for vitamin C (0.18), α-carotene (0.32), β-carotene (0.22), lutein-zeaxantin (0.29) and β-cryptoxantin(0.26); non-significant correlations were observed for retinol, lycopene, α-tocopherol, vitamin B12 and folate (r≤0.12). When dietary supplement use was considered, correlations were substantially improved for folate (0.53) and to a lesser extent for vitamin B12 (0.12) and vitamin C (0.20).

Conclusion: This study supports that the FFQ has a good reproducibility for nutrient and food intake, and can provide a valid estimate of several important nutrients during pregnancy.

References

    1. Godfrey K, Barker D. Fetal programming and adult health. Public Health Nutr. 2001;4:611–624.
    1. Harding JE. The nutritional basis of the fetal origins of adult disease. Int J Epidemiol. 2001;30:15–23. doi: 10.1093/ije/30.1.15.
    1. Willett W. Nutritional Epidemiology. 2. New York: Oxford University Press; 1998.
    1. Henríquez-Sánchez P, Sánchez-Villegas A, Doreste-Alonso J, Ortiz-Andrellucchi A, Pfrimer K, Serra-Majem L. Dietary assessment methods for micronutrient intake: a systematic review on vitamins. Br J Nutr. 2009;102(Suppl 1):S10–37.
    1. Ortiz-Andrellucchi A, Doreste-Alonso J, Henríquez-Sánchez P, Cetin I, Serra-Majem L. Dietary assessment methods for micronutrient intake in pregnant women: a systematic review. Br J Nutr. 2009;102(Suppl 1):S64–86.
    1. Cade J, Thompson R, Burley V, Warm D. Development, validation and utilisation of food-frequency questionnaires - a review. Public Health Nutr. 2002;5:567–587. doi: 10.1079/PHN2001318.
    1. Hunter D. In: Nutritional Epidemiology. 2. Willet W, editor. New York: Oxford University Press; 1998. Biochemical indicators of dietary intake; pp. 174–243.
    1. Bingham S. Biomarkers in nutritional epidemiology. Public Health Nutr. 2002;5:821–827. doi: 10.1079/PHN2002368.
    1. Ribas-Fitó N, Ramón R, Ballester F, Grimalt J, Marco A, Olea N, Posada M, Rebagliato M, Tardón A, Torrent M, Sunyer J. Child health and the environment: the INMA Spanish Study. Paediatr Perinat Epidemiol. 2006;20:403–410. doi: 10.1111/j.1365-3016.2006.00745.x.
    1. Guxens M, Ballester F, Espada M, Fernández MF, Grimalt JO, Ibarluzea J, Olea N, Rebagliato M, Tardón A, Torrent M, Vioque J, Vrijheid M, Sunyer J. INMA Project. Cohort profile: the INMA–INfancia y medio ambiente–(environment and childhood) Project. Int J Epidemiol. 2012;41:930–940. doi: 10.1093/ije/dyr054.
    1. Ramón R, Ballester F, Iñiguez C, Rebagliato M, Murcia M, Esplugues A, Marco A, García de la Hera M, Vioque J. Vegetable but not fruit intake during pregnancy is associated with newborn anthropometric measures. J Nutr. 2009;139:561–567. doi: 10.3945/jn.108.095596.
    1. Rodríguez-Bernal CL, Rebagliato M, Iñiguez C, Vioque J, Navarrete-Muñoz EM, Murcia M, Bolumar F, Marco A, Ballester F. Diet quality in early pregnancy and its effects on fetal growth outcomes: the infancia y medio ambiente (childhood and environment) mother and child cohort study in Spain. Am J Clin Nutr. 2010;91:1659–1666. doi: 10.3945/ajcn.2009.28866.
    1. Domingo-Salvany A, Regidor E, Alonso J, Alvarez-Dardet C. Proposal for a social class measure. Working group of the Spanish society of epidemiology and the Spanish society of family and community medicine. Aten Primaria. 2000;25:350–363.
    1. Commitee to Reexamine IOM Pregnancy Weight Guidelines IOM, National Research Council. Weight gain during pregnancy: reexamining the guidelines. Washington: National Academy Press; 2009.
    1. Willett W, Sampson L, Stampfer M, Rosner B, Bain C, Witschi J, Hennekens C, Speizer F. Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol. 1985;122:51–65.
    1. Vioque J, Gonzalez L. Validity of a food frequency questionnaire (preliminary results) Eur J Cancer Prev. 1991;1:19–20.
    1. Vioque J, Weinbrenner T, Asensio L, Castelló A, Young I, Fletcher A. Plasma concentrations of carotenoids and vitamin C are better correlated with dietary intake in normal weight than overweight and obese elderly subjects. Br J Nutr. 2007;97:977–986. doi: 10.1017/S0007114507659017.
    1. U.S. Department of Agriculture. Agricultural Research Service. (USDA National Nutrient Database for Standard Reference, Release 25). Accessed Feb 2013: .
    1. Palma I, Farran P, Cervera P. Tablas de composición de Alimentos por medidas caseras de consumo habitual en España. Mc Graw Hill Interamericana: CESNID. Madrid; 2008.
    1. Eichholzer M, Tönz O, Zimmermann R. Folic acid: a public-health challenge. Lancet. 2006;367:1352–1361. doi: 10.1016/S0140-6736(06)68582-6.
    1. Craft NE. Carotenoid reversed-phase high-performance liquid chromatography methods: reference compendium. Methods Enzymol. 1992;213:185–205.
    1. Vuillemier J, Keck E. Fluorometric assay of vitamin C in biological materials using a centrifugal analyser with fluorescence attachment. J Micronutrient Anal. 1989;5:25–34.
    1. Loy SL, Marhazlina M, Nor AY, Hamid JJ. Development, validity and reproducibility of a food frequency questionnaire in pregnancy for the Universiti Sains Malaysia birth cohort study. Malays J Nutr. 2011;17:1–18.
    1. Pinto E, Severo M, Correia S, dos Santos Silva I, Lopes C, Barros H. Validity and reproducibility of a semi-quantitative food frequency questionnaire for use among Portuguese pregnant women. Matern Child Nutr. 2010;6:105–119.
    1. Baer H, Blum R, Rockett H, Leppert J, Gardner J, Suitor C, Colditz G. Use of a food frequency questionnaire in American Indian and Caucasian pregnant women: a validation study. BMC Public Health. 2005;5:135. doi: 10.1186/1471-2458-5-135.
    1. Erkkola M, Karppinen M, Javanainen J, Räsänen L, Knip M, Virtanen S. Validity and reproducibility of a food frequency questionnaire for pregnant Finnish women. Am J Epidemiol. 2001;154:466–476. doi: 10.1093/aje/154.5.466.
    1. Suitor CJ, Gardner J, Willett WC. A comparison of food frequency and diet recall methods in studies of nutrient intake of low-income pregnant women. J Am Diet Assoc. 1989;89:1786–1794.
    1. Brantsaeter AL, Haugen M, Hagve TA, Aksnes L, Rasmussen SE, Julshamn K, Alexander J, Meltzer HM. Self-reported dietary supplement use is confirmed by biological markers in the Norwegian mother and child cohort study (MoBa) Ann Nutr Metab. 2007;51:146–154. doi: 10.1159/000103275.
    1. Brantsaeter A, Haugen M, Alexander J, Meltzer H. Validity of a new food frequency questionnaire for pregnant women in the Norwegian mother and child cohort study (MoBa) Matern Child Nutr. 2008;4:28–43.
    1. Mikkelsen T, Osler M, Olsen S. Validity of protein, retinol, folic acid and n-3 fatty acid intakes estimated from the food-frequency questionnaire used in the Danish National Birth Cohort. Public Health Nutr. 2006;9:771–778.
    1. Scaife AR, McNeill G, Campbell DM, Martindale S, Devereux G, Seaton A. Maternal intake of antioxidant vitamins in pregnancy in relation to maternal and fetal plasma levels at delivery. Br J Nutr. 2006;95:771–778. doi: 10.1079/BJN20051718.
    1. Willett WC, Stampfer MJ, Underwood BA, Speizer FE, Rosner B, Hennekens CH. Validation of a dietary questionnaire with plasma carotenoid and alpha-tocopherol levels. Am J Clin Nutr. 1983;38:631–639.
    1. Willett WC. Foreword. The validity of dietary assessment methods for use in epidemiologic studies. Br J Nutr. 2009;102(Suppl 1):S1–S2.
    1. Navarrete-Muñoz EM, Giménez Monzó D, García de La Hera M, Climent MD, Rebagliato M, Murcia M, Iñiguez C, Ballester F, Ramón R, Vioque J. Folic acid intake from diet and supplements in a population of pregnant women in Valencia, Spain. Med Clin (Barc) 2010;135:637–643. doi: 10.1016/j.medcli.2010.03.033.
    1. Pastor-Valero M, Navarrete-Muñoz EM, Rebagliato M, Iñiguez C, Murcia M, Marco A, Ballester F, Vioque J. Periconceptional folic acid supplementation and anthropometric measures at birth in a cohort of pregnant women in Valencia, Spain. Br J Nutr. 2011;105:1352–1360. doi: 10.1017/S0007114510005143.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren