Validation Information: German EPIC FFQ1
Kroke 1999
Validation of a self-administered food-frequency questionnaire administered in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study: comparison of energy, protein, and macronutrient intakes estimated with the doubly labeled water, urinary nitrogen, and repeated 24-h dietary recall methods.
Background:The validation of dietary assessment instruments is critical in the evaluation of diet as a chronic disease risk factor.
Objective:The objective was to assess the validity of a self-administered food-frequency questionnaire by comparison with dietary recall, urinary nitrogen excretion, and total energy expenditure data.
Design:Over a 1-y period, data from twelve 24-h dietary recalls, a food-frequency questionnaire, and four 24-h urine samples were obtained from 134 study participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) Study in Potsdam, Germany. In a substudy of 28 participants, total energy expenditure from doubly labeled water measurements was assessed.
Results:Energy-adjusted, deattenuated correlation coefficients between the questionnaire and the recalls ranged from 0.54 for dietary fiber to 0.86 for alcohol. Cross-classification of quintiles of nutrient intakes from the questionnaire and recalls indicated severe misclassification to be <4%. Reported protein intake correlated with estimated protein excretion (r = 0.46). Energy intake and total energy expenditure were also significantly correlated (r = 0.48); however, all but one subject underreported their energy intake. The magnitude of underreporting varied considerably, by 22% on average, and increased slightly with increasing energy intake. A similar pattern of underreporting was observed when energy intakes from the 24-h dietary recalls were compared with total energy expenditure.
Conclusions:These data indicate an acceptable relative validity of the food-frequency questionnaire in this study population. Compared with measurements of total energy expenditure and protein excretion, however, only moderate agreement with both the food-frequency questionnaire and the 24-h dietary recalls was observed.
Total number of nutrients validated: 12
Not all of the nutrients validated in the validation studies are included in the table below, as statistical data was only selected to be displayed for a number of nutrients, this included:
- Energy
- Fat
- Saturated Fat
- Mono-unsaturated Fat
- Poly-unsaturated Fat
- Carbohydrates
- Protein
- Sugar
- Non‐starch polysaccharides(NSP)
- Sodium
- Calcium
- Iron
- Zinc
- Retinol
- Folate
- Folic Acid
- Vitamin B12
- Vitamin C
- Fruit & Vegetables
- Urinary Nitrogen
To find information on the other validated nutrients please read the validation study.
- Energy
- Macronutrients: 11
- Micronutrients: 0
| Comparator | Lifestage | Sex | Nutrient Measured | Mean Difference | Standard Deviation | Correlation Coefficient | Cohen's Kappa Coefficient | Percentage Agreement | Percentage Agreement Categories | Lower Limits of Agreement | Upper Limits of Agreement |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 24hr Recall | Adults | Both | Energy (kcal) | 239 | 478 | 0.61 (P) | -698 | 1176 | |||
| Energy (kJ) | 1000 | 2000 | 0.61 (P) | -2920 | 4920 | ||||||
| Protein (g) | 5 | 18 | 0.51 (P) | 45 | 5 | -30 | 40 | ||||
| Fat (g) | -3 | 21 | 0.59 (P) | 39.6 | 5 | -44 | 38 | ||||
| Saturated Fat (g) | -4 | 9 | 0.62 (P) | 44.8 | 5 | -22 | 14 | ||||
| MUFA (g) | -5 | 8 | 0.59 (P) | 41.8 | 5 | -21 | 11 | ||||
| PUFA (g) | 0.2 | 4 | 0.47 (P) | 36.6 | 5 | -8 | 8 | ||||
| Carbohydrates (g) | 19 | 51 | 0.56 (P) | 38.1 | 5 | -81 | 119 | ||||
| Biomarkers | Adults | Both | Protein (g) | -22 | 21 | 0.41 (P) | -63 | 19 | |||
| Doubly Labelled Water | Adults | Both | Energy (kcal) | -717 | 543 | 0.48 (P) | -1780 | 346 | |||
| Energy (kJ) | -3000 | 2270 | 0.48 (P) | -7449 | 1449 |
Some results have been calculated using statistical techniques based on the published data.
For further information on statistical terms click on Statistical tests used in validation studies
All correlations coefficients in the table are unadjusted unless stated otherwise. For adjusted correlation coefficients and other statistical methods used in the study e.g. paired t-tests, please read the validation articles.
- # Adjusted
- † Energy adjusted.
- ‡ For loge-transformed, energy-adjusted nutrient intakes.
- ^ Adjacent included.
- ᵟ Participants provided identical responses.
- (w) = Weighted.
Kroke A, Klipstein-Grobusch K, Voss S, Moseneder J, Thielecke F, Noack R, et al. Validation of a self-administered food-frequency questionnaire administered in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study: comparison of energy, protein, and macronutrient intakes estimated with the doubly labeled water, urinary nitrogen, and repeated 24-h dietary recall methods. The American journal of clinical nutrition. 1999;70(4):439-47.