Cognitive research enhances accuracy of food frequency questionnaire reports: Results of an experimental validation study

Department of Psychology, Cleveland State University, Cleveland, Ohio, United States
Journal of the American Dietetic Association (Impact Factor: 3.92). 03/2002; 102(2):212-25. DOI: 10.1016/S0002-8223(02)90050-7
Source: PubMed


To test whether changing a food frequency questionnaire (FFQ) on the basis of cognitive theory and testing results in greater accuracy. Accuracy was examined for 4 design issues: a) Grouping: asking about foods in a single vs multiple separate questions; b) different forms of a food: asking consumption frequency of each form of a food (eg, skim, 2%, whole milk) vs a nesting approach--asking frequency of the main food (eg, milk) and proportion of times each form was consumed; c) additions (eg, sugar to coffee): asking independent of the main food vs nested under the main foods; d) units: asking frequency and portion size vs frequency of units (eg, cups of coffee).
Participants in two randomly assigned groups completed 30 consecutive daily food reports (DFRs), followed by 1 of 2 FFQs that asked about foods consumed in the past month. One was a new, cognitively-based National Cancer Institute (NCI) Diet History Questionnaire; the other was the 1992 NCI-Block Health Habits and History Questionnaire.
623 participants, age range 25 to 70 years, from metropolitan Washington, DC. Statistical analyses performed Accuracy was assessed by comparing DFR and FFQ responses using categorical (percent agreement) and continuous (rank order correlation, discrepancy scores) agreement statistics.
Grouping: accuracy was greater using separate questions. Different forms of food: accuracy was greater using nesting. Additions: neither approach was consistently superior; accuracy of the addition report was affected by accuracy of the main food report. Units: both approaches were similarly accurate.
Accuracy of FFQ reporting can be improved by restructuring questions based on cognitive theory and testing.

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    • "Fasting blood samples were collected to measure the lipid profile, and detailed methodology was described previously (Tsai et al., 2005). Dietary intake was estimated using the diet history questionnaire (Subar et al., 2001; Thompson et al., 2002). Physical activity was assessed by a questionnaire containing questions on the number of hours per day dedicated to different levels (heavy, slight, and sedentary) of activity (Corella et al., 2011). "
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    • "The study details and related methodology of GOLDN have been described (19). Dietary intake was collected using a diet history questionnaire, which was developed by the National Cancer Institute and was validated in two studies (20,21). Calculation of dietary glycemic load (GL) and glycemic index (GI) was according to the method described previously (22). "
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    • "Habitual dietary intake was assessed with a validated National Cancer Institute diet history questionnaire (DHQ) [17], [18], [19] while data on physical activity and other lifestyle variables such as smoking and alcohol intake were collected using an interviewer-administered questionnaire. Fasting glucose, insulin and lipid profiles (e.g., triglycerides, HDL-, LDL-, and total cholesterol) were measured following an eight-hour fast. "
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