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Evaluation of brief dietary questions to estimate vegetable and fruit consumption – using serum carotenoids and red-cell folate

Published online by Cambridge University Press:  02 January 2007

Terry Coyne*
Affiliation:
Nutrition Program, School of Population Health, University of Queensland, Brisbane, Queensland, Australia Epidemiology Services Unit, Health Information Branch, Queensland Health Building, 147–163 Charlotte Street, Brisbane, Queensland 4001, Australia
Torukiri I Ibiebele
Affiliation:
Epidemiology Services Unit, Health Information Branch, Queensland Health Building, 147–163 Charlotte Street, Brisbane, Queensland 4001, Australia
Sarah McNaughton
Affiliation:
Nutrition Program, School of Population Health, University of Queensland, Brisbane, Queensland, Australia
Ingrid HE Rutishauser
Affiliation:
School of Health Sciences, Deakin University, Geelong, Victoria, Australia
Kerin O'Dea
Affiliation:
Menzies School of Health Research, Casuarina, Northern Territory, Australia
Allison M Hodge
Affiliation:
Cancer Epidemiology Centre, Cancer Council of Victoria, Carlton, Victoria, Australia
Christine McClintock
Affiliation:
Epidemiology Services Unit, Health Information Branch, Queensland Health Building, 147–163 Charlotte Street, Brisbane, Queensland 4001, Australia
Michael G Findlay
Affiliation:
Epidemiology Services Unit, Health Information Branch, Queensland Health Building, 147–163 Charlotte Street, Brisbane, Queensland 4001, Australia
Amanda Lee
Affiliation:
Statewide Health Promotion Unit, Public Health Services, Queensland Health, Brisbane, Queensland, Australia
*
*Corresponding author: Email [email protected]
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Abstract

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Objective

To evaluate responses to self-administered brief questions regarding consumption of vegetables and fruit by comparison with blood levels of serum carotenoids and red-cell folate.

Design

A cross-sectional study in which participants reported their usual intake of fruit and vegetables in servings per day, and serum levels of five carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin and lycopene) and red-cell folate were measured. Serum carotenoid levels were determined by high-performance liquid chromatography, and red-cell folate by an automated immunoassay system.

Settings and subjects

Between October and December 2000, a sample of 1598 adults aged 25 years and over, from six randomly selected urban centres in Queensland, Australia, were examined as part of a national study conducted to determine the prevalence of diabetes and associated cardiovascular risk factors.

Results

Statistically significant (P<0.01) associations with vegetable and fruit intake (categorised into groups: ≤1 serving, 2–3 servings and ≥4 servings per day) were observed for α-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin and red-cell folate. The mean level of these carotenoids and of red-cell folate increased with increasing frequency of reported servings of vegetables and fruit, both before and after adjusting for potential confounding factors. A significant association with lycopene was observed only for vegetable intake before adjusting for confounders.

Conclusions

These data indicate that brief questions may be a simple and valuable tool for monitoring vegetable and fruit intake in this population.

Type
Research Article
Copyright
Copyright © The Authors 2005

References

1World Health Organization (WHO)/Food and Agriculture Organization. Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation. In: Joint WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases. Geneva: WHO, 2002.Google Scholar
2World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR). Vegetables and fruit. In: Food, Nutrition and the Prevention of Cancer: A Global Perspective. Washington, DC: WCRF/AICR, 2000; 436–44.Google Scholar
3Ness, AR, Powles, JW. Fruit and vegetables, and cardiovascular disease: a review. International Journal of Epidemiology 1997; 26 113.CrossRefGoogle ScholarPubMed
4Liu, S, Manson, JE, Lee, IM, Cole, SR, Hennekens, CH, Willett, WC, et al. Fruit and vegetable intake and risk of cardiovascular disease: the Women's Health Study. American Journal of Clinical Nutrition 2000; 72 922–8.CrossRefGoogle ScholarPubMed
5Sargeant, L, Khaw, K, Bingham, S, Day, N, Luben, R, Oakes, S. Fruit and vegetable intake and population glycosylated haemoglobin levels: the EPIC–NORFOLK study. European Journal of Clinical Nutrition 2001; 55 342–8.CrossRefGoogle ScholarPubMed
6National Health and Medical Research Council (NH&MRC). Dietary Guidelines for Australians. Canberra: NH&MRC, 2002.Google Scholar
7US Department of Health and Human Services (DHHS). Healthy People 2000: National Health Promotion and Disease Prevention Objectives. Washington, DC: US DHHS, 1991.Google Scholar
8Strategic Intergovernmental Nutrition Alliance. Eat Well Australia: An Agenda for Action for Public Health Nutrition 2001–2010. Canberra: National Public Health Partnership, 2001.Google Scholar
9Produce for Better Health Foundation/National Cancer Institute. 5 A Day for Better Health: Guidebook: Newark, DE: Produce for Better Health Foundation/National Cancer Institute, 1991.Google Scholar
10Department of Health. 5 A DAY Program. Available at: www.doh.gov.uk/fiveaday.Google Scholar
11CATI Technical Reference Group. SNAP(S) Smoking, Nutrition, Alcohol misuse, Physical inactivity, (Stress). Adelaide: CATI Technical Reference Group, 2001.Google Scholar
12Australian Bureau of Statistics (ABS). National Nutrition Survey: Selected Highlights, Australia. Catalogue No. 4802.0. Canberra: ABS, 2001.Google Scholar
13Australian Bureau of Statistics (ABS). National Health Survey: Summary of Results, Australia. Catalogue No. 4364.0. Canberra: ABS, 2001.Google Scholar
14Riley, M, Rutishauser, I, Webb, K. Comparison of Short Questions with Weighed Food Records. Canberra: Commonwealth Department of Health and Aged Care, 2001.Google Scholar
15Marks, G, Webb, K, Rutishauser, I, Riley, M. Monitoring Food Habits in the Australian Population using Short Questions. Canberra: Commonwealth Department of Health and Aged Care, 2001.Google Scholar
16Serdula, M, Coates, R, Byers, T, Mokdad, A, Jewell, S, Chavez, N. Evaluation of a brief telephone questionnaire to estimate fruit and vegetable consumption in diverse study populations. Epidemiology 1993; 4 455–63.CrossRefGoogle ScholarPubMed
17Murphy, SP, Kaiser, LL, Townsend, MS, Allen, LH. Evaluation of validity of items for a food behaviour checklist. Journal of the American Dietetic Association 2001; 101 751–61.CrossRefGoogle Scholar
18Resnicow, K, Odom, E, Wang, T, Dudley, WN, Mitchell, D, Vaughan, R. Validation of three food frequency questionnaires and 24-hour recalls with serum carotenoid levels in a sample of African-American adults. American Journal of Epidemiology 2000; 152 1072–80.CrossRefGoogle Scholar
19Cappuccio, F, Rink, E, Perkins-Porras, L, McKay, C, Steptoe, A. Estimation of fruit and vegetable intake using a two-item dietary questionnaire: a potential tool for primary health care workers. Nutrition, Metabolism, and Cardiovascular Diseases 2003; 13 12–9.CrossRefGoogle ScholarPubMed
20Lee, AJ, Bailey, APV, Yarmirr, D, O'Dea, K, Mathews, JD. Survival tucker: improved diet and health indicators in an Aboriginal community. Australian Journal of Public Health 1994; 18 277–85.CrossRefGoogle Scholar
21Broekmans, WM, Klopping-Ketelaars, IA, Schuurman, CR, Verhagen, H, Van den Berg, H, Kok, FJ. Fruits and vegetables increase plasma carotenoids and vitamins and decrease homocysteine in humans. Journal of Nutrition 2000; 130 1578–83.CrossRefGoogle ScholarPubMed
22Block, G, Norkus, E, Hudes, M, Mandel, S, Helzlsouer, K. Which plasma antioxidants are most related to fruit and vegetable consumption?. American Journal of Epidemiology 2001; 154 1113–8.CrossRefGoogle ScholarPubMed
23Martini, MC, Campbell, DR, Gross, MD, Grandits, GA, Potter, JA, Slavin, JL. Plasma carotenoids as biomarkers of vegetable intake: The University of Minnesota Cancer Prevention Research Unit feeding studies. Cancer Epidemiology, Biomarkers & Prevention 1995; 4: 491–6.Google ScholarPubMed
24Van Kappel, AL, Steghens, JP, Zeleniuch-Jacquotte, A, Chajes, V, Toniolo, P, Riboli, E. Serum carotenoids as biomarkers of fruit and vegetable consumption in the New York Women's Health Study. Public Health Nutrition 2001; 4 829–35.CrossRefGoogle ScholarPubMed
25Campbell, DR, Gross, MD, Martini, MC, Grandits, GA, Slavin, JL, Potter, JD. Plasma carotenoids as biomarkers of vegetable and fruit intake. Cancer Epidemiology, Biomarkers & Prevention 1994; 3 493500.Google ScholarPubMed
26Forman, MR, Lanza, E, Yong, LC, Holden, JM, Graubard, BI, Beecher, GR et al. . The correlation between two dietary assessments of carotenoid intake and plasma carotenoid concentrations: application of a carotenoid food-composition database. American Journal of Clinical Nutrition 1993; 58 519–24.CrossRefGoogle ScholarPubMed
27Drewnowski, A, Rock, CL, Henderson, SA, Shore, AB, Fischler, C, Galan, P et al. . Serum β-carotene and vitamin C as biomarkers of vegetable and fruit intakes in a community-based sample of French adults. American Journal of Clinical Nutrition 1997; 65 1796–802.CrossRefGoogle Scholar
28Ford, ES, Bowman, BA. Serum and red blood cell folate concentrations, race, and education: findings from the Third National Health and Nutrition Examination Survey. American Journal of Clinical Nutrition 1999; 69 476–81.CrossRefGoogle ScholarPubMed
29Dunstan, D, Zimmet, P, Welborn, T, Sicree, R, Armstrong, T, Atkins, R, et al. Diabesity and Associated Disorders in Australia–2000. The Accelerating Epidemic. The Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Melbourne: International Diabetes Institute, 2001.Google Scholar
30Dunstan, DW, Zimmet, PZ, Welborn, TA, Cameron, AJ, Shaw, J, de Courten, M. The Australian Diabetes, Obesity and Lifestyle Study (AusDiab) – methods and response rates. Diabetes Research and Clinical Practice 2002; 57 119–29.CrossRefGoogle ScholarPubMed
31Su, Q, Rowley, KG, O'Dea, K. Stability of individual carotenoids, retinol and tocopherols in human plasma during exposure to light and after extraction. Journal of Chromatography. B, Biomedical Sciences and Applications 1999; 729 191–8.CrossRefGoogle ScholarPubMed
32Talwar, D, Ha, TK, Cooney, J, Brownlee, C, O'Reilly, DS. A routine method for the simultaneous measurement of retinol, α-tocopherol and five carotenoids in human plasma by reverse phase HPLC. Clinica Chimica Acta 1998; 270 85100.CrossRefGoogle ScholarPubMed
33Friedwald, WT, Levy, RJ, Fredrickson, DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma without use of the preparative ultracentrifuge. Clinical Chemistry 1972; 18 499502.CrossRefGoogle Scholar
34Armstrong, T, Bauman, A, Davies, J. Physical Activity Patterns of Australian Adults. Result of the 1999 National Physical Activity Survey. Canberra: Australian Institute of Health and Welfare, 2000.Google Scholar
35National Heart Foundation/Australia Institute of Health. Risk Factor Prevalence Study No. 3 1989. Canberra: National Heart Foundation/ustralia Institute of Health, 1990.Google Scholar
36Australia Diabetes Society. Diabetic dyslipidemia–Australian Diabetes Society position statement. Medical Journal of Australia 1995; 162 91–3.CrossRefGoogle Scholar
37Hodge, A, Patterson, AJ, Brown, WJ, Ireland, P, Giles, G. The Anti Cancer Council of Victoria FFQ: relative validity of nutrient intakes compared with weighted food records in young to middle-aged women in a study of iron supplementation. Australian and New Zealand Journal of Public Health 2000; 24 576–83.CrossRefGoogle Scholar
38StataCorp. Stata Statistical Software: Release 8.0 College Station, TX: Stata Corporation, 2001.Google Scholar
39Polsinelli, ML, Rock, CL, Henderson, SA, Drewnowski, A. Plasma carotenoids as biomarkers of fruit and vegetable servings in women. Journal of the American Dietetic Association 1998; 98 194–6.CrossRefGoogle ScholarPubMed
40Romieu, I, Parra, S, Hernandez, JF, Madrigal, H, Willett, W, Hernandez, M. Questionnaire assessment of antioxidants and retinol intakes in Mexican women. Archives of Medical Research 1999; 30 224–39.CrossRefGoogle ScholarPubMed
41Sasaki, S, Ushio, F, Amano, K, Morihara, M, Todoriki, T, Uehara, Y. Serum biomarker-based validation of a self-administered diet history questionnaire for Japanese subjects. Journal of Nutritional Science and Vitaminology 2000; 46 285–96.CrossRefGoogle ScholarPubMed
42Tucker, KL, Chen, H, Vogel, S, Wilson, PW, Schaefer, EJ, Lammi-Keefe, CJ. Carotenoid intakes, assessed by dietary questionnaire, are associated with plasma carotenoid concentrations in an elderly population. Journal of Nutrition 1999; 129 438–45.CrossRefGoogle Scholar
43Michaud, DS, Giovannucci, EL, Ascherio, A, Rimm, EB, Forman, MR, Sampson, L. Associations of plasma carotenoid concentrations and dietary intake of specific carotenoids in samples of two prospective cohort studies using a new carotenoid database. Cancer Epidemiology, Biomarkers & Prevention 1998; 7 283–90.Google ScholarPubMed
44Carroll, YL, Corridan, BM, Morrissey, PA. Carotenoids in young and elderly healthy humans: dietary intakes, biochemical status and diet–plasma relationships. European Journal of Clinical Nutrition 1999; 53 644–53.CrossRefGoogle Scholar
45Bodgers, R, Dagnelie, P, Westerterp, KR, Kester, A, van Klaveren, J, Bast, A et al. . Using a correction factor to correct for over-reporting in a food frequency questionnaire does not improve biomarker-assessed validity for estimates for fruit and vegetable consumption. Journal of Nutrition 2003; 133 1213–9.CrossRefGoogle Scholar
46US Department of Agriculture. USDA-NCC Carotenoid Database for US Foods [online], 1998. Available at: http://www.nal.usda.gov/fnic/foodcomp/Data/car98/car98.html.Google Scholar
47Bohm, V, Bitsch, R. Intestinal absorption of lycopene from different matrices and interactions to other carotenoids, the lipid status, and the antioxidant capacity of human plasma. European Journal of Nutrition 1999; 38 118–25.Google ScholarPubMed
48van het Hof, KH, de Boer, BC, Tijburg, LB, Lucius, BR, Zijp, I, West, CE. Carotenoid bioavailability in humans from tomatoes processed in different ways determined from the carotenoid response in the triglyceride-rich lipoprotein fraction of plasma after a single consumption and in plasma after four days of consumption. Journal of Nutrition 2000; 130 1189–96.Google ScholarPubMed
49Brown, MJ, Ferruzzi, MG, Nguyen, ML, Cooper, DA, Eldridge, AL, Schwartz, SJ. Carotenoid bioavailability is higher from salads ingested with full-fat than with reduced-fat dressing as measured by electrochemical detection. American Journal of Clinical Nutrition 2004; 80 396403.CrossRefGoogle ScholarPubMed
50McEligot, AJ, Rock, CL, Flatt, SW, Newman, V, Faerber, S, Pierce, JP. Plasma carotenoids are biomarkers of long-term high vegetable intake in women with breast cancer. Journal of Nutrition 1999; 129 2258–63.CrossRefGoogle ScholarPubMed
51Bernstein, A, Nelson, ME, Tucker, KL, Layne, J, Johnson, E, Nuernberger, A et al. . A home-based nutrition intervention to increase consumption of fruits, vegetables, and calcium-rich foods in community dwelling elders. Journal of the American Dietetic Association 2002; 102 1421–7.CrossRefGoogle ScholarPubMed
52Freese, R, Alfthan, G, Jauhiainen, M, Basu, S, Erlund, I, Salminen, I, et al. High intakes of vegetables, berries, and apples combined with a high intake of linoleic or oleic acid only slightly affect markers of lipid peroxidation and lipoprotein metabolism in healthy subjects. American Journal of Clinical Nutrition 2002; 76 950–60.CrossRefGoogle ScholarPubMed
53Silaste, M, Rantala, M, Alfthan, G, Aro, A, Kesaniemi, Y. Plasma homocysteine concentration is decreased by dietary intervention. British Journal of Nutrition 2003; 89 295301.CrossRefGoogle ScholarPubMed
54Kerver, JM, Yang, EJ, Bianchi, L, Song, W. Dietary patterns associated with risk factors for cardiovascular disease in healthy US adults. American Journal of Clinical Nutrition 2003; 78 1103–10.CrossRefGoogle ScholarPubMed
55Cuskelly, GJ, McNulty, H, Scott, JM. Effect of increasing dietary folate on red-cell folate: implications for prevention of neural tube defects. Lancet 1996; 347 657–9.CrossRefGoogle ScholarPubMed
56Jarvinen, R, Knekt, P, Seppanen, R, Heinonen, M, Aaran, RK. Dietary determinants of serum β-carotene and serum retinol. European Journal of Nutrition 1993; 47 3141.Google ScholarPubMed
57Nierenberg, DW, Stukel, TA, Baron, JA, Dain, BJ, Greenberg, ER. Determinants of plasma levels of β-carotene and retinol. Skin Cancer Prevention Study Group. American Journal of Epidemiology 1989; 130 511–21.CrossRefGoogle ScholarPubMed
58Kaaks, R, Riboli, E, Sinha, R, eds. Biochemical Markers of Dietary Intake. Lyon: International Agency for Research on Cancer Scientific Publications, 1997.Google ScholarPubMed
59Ocke, MC, Kaaks, R. Biochemical markers as additional measurements in dietary validity studies: application of the method of triads with examples from the European Prospective Investigation into Cancer and Nutrition. American Journal of Clinical Nutrition 1997; 65 1240S–5S.CrossRefGoogle ScholarPubMed
60Jensen, C, Spiller, G. Acute effects of dietary carotenes on serum α and β-carotene in humans. Nutrition Reports International 1986; 33 117s–22s.Google Scholar
61Johnson, E, Suter, P, Sahyoun, N, Ribaya-Mercado, JD, Russell, RM. Relation between β-carotene intake and plasma and adipose tissue concentrations of carotenoids and retinoids. American Journal of Clinical Nutrition 1995; 62 598603.CrossRefGoogle ScholarPubMed
62Gibson, RS. Principles of Nutritional Assessment. New York: Oxford University Press, 1990.Google Scholar