Cade J, Thompson R, Burley V, Warm D. Development, validation and utilization of food-frequency questionnaires-a review. Public Health Nutr 5, 567-587

Nutrition Epidemiology Group, Division of Public Health, Nuffield Institute for Health, 71-75 Clarendon Road, University of Leeds, UK.
Public Health Nutrition (Impact Factor: 2.68). 09/2002; 5(4):567-87. DOI: 10.1079/PHN2001318
Source: PubMed


The purpose of this review is to provide guidance on the development, validation and use of food-frequency questionnaires (FFQs) for different study designs. It does not include any recommendations about the most appropriate method for dietary assessment (e.g. food-frequency questionnaire versus weighed record).
A comprehensive search of electronic databases was carried out for publications from 1980 to 1999. Findings from the review were then commented upon and added to by a group of international experts.
Recommendations have been developed to aid in the design, validation and use of FFQs. Specific details of each of these areas are discussed in the text.
FFQs are being used in a variety of ways and different study designs. There is no gold standard for directly assessing the validity of FFQs. Nevertheless, the outcome of this review should help those wishing to develop or adapt an FFQ to validate it for its intended use.

Download full-text


Available from: Janet Elizabeth Cade, Dec 17, 2013
794 Reads
  • Source
    • "Although not felt to be malnourished, all subjects were given nutritional guidance from a certified nutritionist by way of best clinical practice and also so as to be able to offer some benefit to those subjects randomized to the control group. The nutritional counseling was based on a Food Frequency Questionnaire [21] administered every two months to assess diet and specifically to ascertain the habitual protein intake of the subject. Detailed, written recommendations were then given on an individualized basis with the goal of achieving a daily protein intake of 1.5 g per kilogram of body weight plus a daily energy intake of 35 kilocalories per kilogram of body weight. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The effectiveness of clinic-based pulmonary rehabilitation in advanced COPD is well established, but few data exist for less severe patients treated in alternative settings. The purpose of this study was to investigate whether a novel, community-based exercise program (CBE) was feasible and effective for patients with moderate COPD. Nineteen patients with moderate COPD (mean FEV1 62%) and self-reported exercise impairment were randomized to 12-weeks of progressive endurance and strength training at a local health club under the guidance of a certified personal trainer, or to continuation of unsupervised habitual physical activity. Outcomes assessed at baseline and 12 weeks included session compliance, intensity adherence, treadmill endurance time, muscle strength, dyspnea, and health status. Compliance was 94% and adherence was 83%. Comparisons between CBE and control groups yielded the following mean (SEM) differences in favor of CBE: endurance time 134 (74) seconds versus -59 (49) seconds (P = 0.041) and TDI 5.1 (0.8) versus -0.2 (0.5) (P < 0.001). The CBE group increased muscle strength (weight lifted) by 11.8 kilograms per subject per week of training (P < 0.001). SGRQ was not significantly changed. We demonstrated the feasibility and effectiveness of a novel community-based exercise program involving health clubs and personal trainers for patients with moderate COPD. Trial registration Identifier NCT01985529.
    BMC Pulmonary Medicine 08/2014; 14(1):125. DOI:10.1186/1471-2466-14-125 · 2.40 Impact Factor
  • Source
    • "Use of the 24-hour recall was an important step in obtaining an accurate list of commonly consumed foods relevant to the population of interest, which is considered the most crucial step in QFFQ development [34]–[36]. The use of food models assisted participants in estimating usual amounts consumed, as recommended by Cade et al. [35]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Alaska Native populations are experiencing a nutrition transition and a resulting decrease in diet quality. The present study aimed to develop a quantitative food frequency questionnaire to assess the diet of the Yup'ik people of Western Alaska. A cross-sectional survey was conducted using 24-hour recalls and the information collected served as a basis for developing a quantitative food frequency questionnaire. A total of 177 males and females, aged 13-88, in six western Alaska communities, completed up to three 24-hour recalls as part of the Alaska Native Dietary and Subsistence Food Assessment Project. The frequency of the foods reported in the 24-hour recalls was tabulated and used to create a draft quantitative food frequency questionnaire, which was pilot tested and finalized with input from community members. Store-bought foods high in fat and sugar were reported more frequently than traditional foods. Seven of the top 26 foods most frequently reported were traditional foods. A 150-item quantitative food frequency questionnaire was developed that included 14 breads and crackers; 3 cereals; 11 dairy products; 69 meats, poultry and fish; 13 fruit; 22 vegetables; 9 desserts and snacks; and 9 beverages. The quantitative food frequency questionnaire contains 39 traditional food items. This quantitative food frequency questionnaire can be used to assess the unique diet of the Alaska Native people of Western Alaska. This tool will allow for monitoring of dietary changes over time as well as the identification of foods and nutrients that could be promoted in a nutrition intervention program intended to reduce chronic disease.
    PLoS ONE 06/2014; 9(6):e100412. DOI:10.1371/journal.pone.0100412 · 3.23 Impact Factor
  • Source
    • "They are easy to implement, demanding little resources or analytical power. It is however important to validate FFQs against accepted methods of dietary exposure, for a specific population and setting, in order to be able to draw conclusions from the use of the FFQ (Cade et al., 2002). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Widespread subclinical iodine insufficiency has recently been reported in Europe, based on urinary iodine using World Health Organization/Food and Agriculture Organization criteria, in particular among young women. Although urinary iodine concentration (UIC) is a useful measurement of the iodine status in a population, it does not provide an insight into the habitual iodine intake of this population. This is compounded by the fact that very few iodine-specific food frequency questionnaires (FFQ) have been validated so far. The present study aimed to develop and validate a new, simple, rapid survey tool to assess dietary iodine exposure in females of childbearing age. Methods Iodine was measured in a duplicate 24-h urine collection. Iodine intake was measured with duplicate 4-day semi-quantitative food diaries and the FFQ. Correlation, cross-classification and Bland–Altman analyses were used to estimate agreement, bias and the reliability of the method. The triangular (triad) method was used to calculate validity coefficients. Results Forty-three women, aged 19–49 years, took part in the validation of the 17-items FFQ. Median (interquartile range) UIC was 74 (47–92) μg L−1, which is indicative of mild iodine insufficiency. The FFQ showed good agreement with food diaries with respect to classifying iodine intake (82% of subjects were classified in the same or adjacent quartile). The FFQ was moderately correlated with the food diaries (rs = 0.45, P = 0.002) and urinary excretion in μg L−1 (rs = 0.34, P = 0.025) but not in μg day−1 (P = 0.316). The validity coefficients were 0.69, 0.66 and 0.52 for the food diaries, FFQ and urinary iodine excretion, respectively. Conclusions The FFQ provides a rapid and reliable estimate of dietary iodine exposure to identify those population subgroups at risk of iodine deficiency.
    Journal of Human Nutrition and Dietetics 03/2014; DOI:10.1111/jhn.12219 · 1.99 Impact Factor
Show more