With the upsurge in online dietary modification programmes, online dietary assessment tools are needed to capture food intake. Although the DASH (Dietary Approaches to Stop Hypertension) diet is recommended by the US Department of Agriculture, there are no online instruments that capture DASH food servings. Our objective was to assess the validity of a new, short, online dietary questionnaire developed to capture intake of DASH food servings. The DASH Online Questionnaire (OLQ) was validated against the well-known Block Food Frequency Questionnaire (FFQ).

This was a cross-sectional validation of the DASH OLQ, which contained eleven food groups (breakfast cereals; dairy; drinks; fats and oils; fruits; grains and snacks; meat, fish and poultry; mixed dishes; sweets; vegetables; and nuts, seeds and legumes). Each subject completed a DASH OLQ once weekly for four weeks and one 98.2 Block FFQ (110 questions) between weeks 2 and 4. DASH OLQ were averaged and then compared with the Block FFQ for nutrient intakes as well as intakes of DASH food groups.

Boston University Medical Center, Boston, Massachusetts.

One hundred and ninety-one faculty and staff at Boston University Medical Center aged 20–70 years.

There were significant positive correlations between the Block FFQ and the DASH OLQ for all food groups ranging from r = 0·8 for the nuts/seeds/legumes category to r = 0·3 for vegetables and mixed dishes. A comparison of nutrient intakes found strong positive correlations in all nutrient categories. Of particular interest in the DASH diet and the web-based nutrition and physical activity programme were total fat (r = 0·62), total carbohydrate (r = 0·67), total K (r = 0·68), total Ca (r = 0·69), total vitamin C (r = 0·60) and total energy intake (r = 0·68).

The DASH OLQ captures food and nutrient intake well in relation to the more established Block FFQ.

Intake and status of carotenoids have been associated with chronic disease. The objectives of this study were to examine the association between carotenoid intakes as measured by two regional food-frequency questionnaires (FFQs) and their corresponding measures in serum, and to report on dietary food sources of carotenoids in Jackson Heart Study (JHS) participants.

Cross-sectional analysis of data for 402 African American men and women participating in the Diet and Physical Activity Sub-Study (DPASS) of the JHS.

Mean serum carotenoid concentrations and intakes in this population were comparable to those reported for the general US population. After adjustment for covariates, correlations between serum and dietary measures of each carotenoid, for the average of the recalls (deattenuated), the short FFQ and the long FFQ, respectively, were: 0·37, 0·35 and 0·21 for α-carotene; 0·35, 0·26 and 0·28 for total (diet plus supplements) β-carotene; 0·25, 0·17 and 0·20 for dietary β-carotene; 0·42, 0·34 and 0·26 for β-cryptoxanthin; 0·33, 0·15 and 0·17 for lutein plus zeaxanthin; and 0·37, 0·19 and 0·14 for lycopene. Major dietary sources of α-carotene were orange vegetables; of β-carotene and lutein plus zeaxanthin, mustard, turnip and collard greens; of β-cryptoxanthin, orange juice; and of lycopene, tomato juice.

On average, carotenoid intakes and serum concentrations are not lower in this southern African American population than the general US population. The two regional FFQs developed for a southern US population and used as dietary assessment tools in the JHS appear to provide reasonably valid information for most of these carotenoids.

To examine educational differences among people who consume foods containing fat in Finland and the Baltic countries.

Data were collected from cross-sectional postal Finbalt Health Monitor surveys that were carried out in 1998, 2000 and 2002.

Estonia, Finland, Latvia and Lithuania.

For each survey, nationally representative random samples of adults aged 20–64 years were drawn from population registers (Estonia, n = 3656; Finland, n = 9354, Latvia, n = 6015; Lithuania, n = 5944).

Differences were revealed between the countries in the consumption of foods that contain fat. Finnish people consumed butter on bread, high-fat milk, meat and meat products, and vegetable oil for cooking less frequently than people in the Baltic countries. Cheese was most popular in Finland. Educational differences in fat-related food habits were examined by applying logistic regression analysis. A positive association was found between level of education and consumption of vegetable oil used in food preparation. Drinking high-fat milk was associated with low education in all countries. People with higher education tended to consume cheese more often. Educational patterns in the consumption of butter on bread and in the consumption of meat and meat products differed between countries.

The consumption of foods containing fat was related to educational levels in all four countries. The diet of better-educated people was closer to recommendations for the consumption of saturated and unsaturated fats than the diet of people with lower level of education. The educational gradient was more consistent in Finland than in the Baltic countries. These existing educational differences in sources of fat consumed should be taken into account in the development of national cardiovascular disease prevention programmes.

To compare the effects of disparities in economic development in urban and rural Eastern China on the nutritional status of adolescents.

A cross-sectional survey consisting of self-completion questionnaires, anthropometry and haemoglobin measurement.

Twelve middle schools in an urban and a rural area of Zhejiang Province: Hangzhou, the capital, and Chunan, a poor mountainous area.

Some 4835 young adolescents (predominant age range 13–16 years).

The mean body mass index (BMI) was significantly higher in urban Hangzhou (P=0.01) Overweight affected 3.6% overall; adjusted odds ratios (ORs) showed male sex (OR 2.1, 95% confidence interval (CI) 1.1–3.4) and urban residence (OR 9.1, 95% CI 3.7–22) to be the most important risk factors. The prevalence of underweight was 18%, with no significant urban–rural difference. Predictors of underweight were male sex (OR 1.5, 95% CI 1.1–2.0) and low household income (OR, 1.3, 95% CI 1.1–1.5). Mean haemoglobin was significantly lower in the rural area. Anaemia was more common in girls, 51% compared with 21% of the boys, but rural residence was not an independent risk factor. Rural students exercised more and had a less varied diet than their urban counterparts. Around one-third of the respondents consumed dietary supplements on a regular basis.

These results suggest that in urban areas of Eastern China a dual picture is emerging with the problems of excess (overweight and obesity) coexisting with underweight and anaemia. In rural areas the problems of relative nutritional deprivation predominate, but the long-term consequences of such marginal underweight and anaemia are not clear.

This study sought to evaluate the benefit of utilizing a nutritionist review of a self-administered food frequency questionnaire (FFQ), to determine whether accuracy could be improved beyond that produced by the self-administered questionnaire alone.

Participants randomized into a dietary intervention trial completed both a FFQ and a 4-day food record (FR) at baseline before entry into the intervention. The FFQ was self-administered, photocopied and then reviewed by a nutritionist who used additional probes to help complete the questionnaire. Both the versions – before nutritionist review and after nutritionist review – were individually compared on specific nutrients to the FR by means, correlations and per cent agreement into quintiles.

Three hundred and twenty-four people, a subset of participants from the Polyp Prevention Trial – a randomized controlled trial examining the effect of a low-fat, high-fibre, high fruit and vegetable dietary pattern on the recurrence of adenomatous polyps – were recruited from clinical centres at the University of Utah, University of Buffalo, Memorial Sloan Kettering Cancer Center in New York and Kaiser Permanente Medical Program in Oakland.

Reviewing the FFQ increased correlations with the FR for every nutrient, and per cent agreement into quintiles for all nutrients except calcium. Energy was underestimated in both versions of the FFQ but to a lesser degree in the version with review.

One must further evaluate whether the increases seen with nutritionist review of the FFQ will enhance our ability to predict diet–disease relationships and whether it is cost-effective when participant burden and money spent utilizing trained personnel are considered.

To determine changes in reported food frequency in adults between 1986 and 1999.

Four consecutive cross-sectional surveys.

Counties of Norrbotten and Västerbotten, Northern Sweden.

The Northern Sweden MONICA (Monitoring of Trends and Determinants in Cardiovascular Disease) population, four independent cross-sectional surveys in 1986, 1990, 1994 and 1999. Randomly selected age-stratified samples of the population aged 25–64 years. Analysis is based on 2982 males and 3087 females who completed an 84-item food-frequency questionnaire.

Between 1986 and 1999, average reported consumption of 3%-fat milk decreased from 42 to 7 intakes month-1 in men and from 28 to 4 intakes month-1 in women. Reported use of 1.5%-fat milk increased from 6 to 27 intakes month-1 in men and from 6 to 24 in women. Monthly intakes of potatoes and root vegetables decreased from 38 to 27 in men and from 39 to 32 in women. Consumption of pasta increased from 4 to 7 intakes month-1 in both sexes. Intakes of solid fats with 80% fat content dropped from 92 to 62 per month in men and from 78 to 52 per month in women, whereas use of 40%-fat spread increased from 12 to 22 intakes month-1 in men and from 5 to 26 in women. Monthly intakes of vegetable oil increased from 3 to 12 in men and from 3 to 15 in women. The percentage of overweight or obese individuals (body mass index >25 kg m-2) increased from 52 to 65% in men and from 41 to 52% in women (P for linear trend in all these changes, <0.001).

Our data indicate reduced consumption of foods with a high content of saturated fats. In spite of that, there is an unbroken trend towards increased obesity.

To assess the relative validity of the second version of a quantitative food-frequency questionnaire (QFFQ), designed to measure the habitual food and nutrient intake in one season in rural populations in Western Mali, West Africa.

The dietary intake during the previous week was assessed with the 164-item QFFQ administered by interview. This was compared with the intake from a 2-day weighed record (WR) with weighed recipes.

The village of Ouassala in the Kayes region, Western Mali.

Thirty-four women and 36 men aged 15–45 years, from 29 households.

The QFFQ gave a lower intake of lunch and dinner and a higher intake of snacks than the WR. The discrepancies were larger for women than for men. The median proportion of subjects classified in the same quartile of intake was 29% for food groups and 36% for energy and nutrients. For classification into extreme opposite quartiles, the median proportion was 6% for food groups and 7% for energy and nutrients. Spearman's rank correlation for energy and nutrients ranged from 0.16 (% energy from protein) to 0.62 (retinol equivalents).

The second version of the QFFQ tends to underestimate total food weight. The methods used for estimating food portion size should therefore be applied with caution. The changes made from the first version had little effect. The ability to rank subjects according to dietary intake is similar with both versions. The improved layout of the new QFFQ makes it a more user-friendly tool for comparing dietary intake between population groups and for measuring changes over time.

Diet validation research was conducted to compare the respondents' reporting of dietary intake in a food frequency questionnaire (FFQ) with intake reported in food recalls. Because the population received annual salary increments that could modify food intake, diet validation studies (DVSs) were conducted during two time intervals.

A 99-item FFQ was administered by an interviewer twice in a 1-year interval, and responses to each FFQ item were compared with 28 days of interviewer-administered food recalls that were collected in four 1-week intervals during each season of 1992/93. The second validation study in 1995/96 had a similar design to the earlier one.

A prospective cohort study of lung cancer among tin miners in China was initiated in 1992, with dietary and other risk factors updated annually.

Among a cohort of high risk tin miners for lung cancer, two different samples (n = 141 in 1992/93, and n = 113 in 1995/96) for each diet validation study were randomly selected from four mine units, that were representative of all worker units.

Miners reported a significantly higher average frequency of intake of foods in the food recalls than the FFQ, with few exceptions. Deattenuated Pearson correlation coefficients of the frequency of food intake between the FFQ and food recalls were in the range of –0.40 to 0.72 in both studies, with higher positive correlations for beverages and cereal staples than for animal protein sources, vegetables, fruits and legumes. The percentage of individuals with exact agreement in the extreme quartiles of intake in the food recalls and FFQ ranged from 0 to 100% in both studies.

Among Chinese miners, the range in correlations between the food recalls and the FFQ were due to: (i) market availability of foods during the food recall weeks compared to their annual reported intake in the FFQ; (ii) cultural perception of time; and (iii) differences in how the intake of mixed dishes and their multi-ingredient foods were reported in the recalls vs. the FFQ. The range in the percentage of agreement in the same quartiles and the changes in food intake over time may have implications for the analysis of the diet-disease relationship in this cohort.

The purpose of the study was to assess the validity of a 52-item semiquantitative food-frequency questionnaire (FFQ) by comparing it with multiple 24-hour dietary recalls.

Three non-consecutive 24-hour dietary recalls and one FFQ were administered over a one-month period.

Four communities of El Progreso, Guatemala.

Seventy-three individuals aged 22–55 years.

Intakes of energy and other nutrients as measured by the FFQ were higher than intakes measured by 24-hour recalls. Energy was overestimated by 361 kcal, and nutrient overestimates were particularly great for vitamin C and iron. Pearson correlation coefficients for crude energy and nutrients intakes ranged from 0.64 for energy to 0.12 for vitamin C. Exact agreement for both methods (measured by the concordance correlation coefficient) ranged from 0.59 (fat) to 0.06 (vitamin C). Pearson correlation coefficients for energy-adjusted nutrients ranged from 0.59 (carbohydrates) to 0.11 (thiamin). Pearson correlation coefficients for the proportion of total energy derived from specific foods ranged from 0.59 (tortillas) to 0.01 (sugared beverages). Cross-classification of quartiles of crude nutrient intakes for both methods indicated that <11% were grossly misclassified; after adjusting for energy intake, <13% were grossly misclassified.

This FFQ provides good measures of energy and macronutrient intakes and a reasonably reliable measure of micronutrient intake, indicating its suitability for comparing exposures within a study population in reference to heath-related endpoints. Our results highlight the need to adapt any FFQ to specific cultural needs – in this case, the Guatemalan ‘core foods’ (tortilla, bread and beans), for which inter-individual variability in intake is high.