Validation Information: The Maastricht FFQ
Dongen 2019
The Maastricht FFQ: Development and validation of a comprehensive food frequency questionnaire for the Maastricht study
Objective: The aim of this study was to develop and validate a comprehensive food frequency questionnaire (FFQ) for The Maastricht Study, a population-based prospective cohort study in Maastricht, The Netherlands.
Methods: Item selection for the FFQ was based on explained variation and contribution to intake of energy and 24 nutrients. For validation, the FFQ was completed by 135 participants (25–70 y of age) of the Nutrition Questionnaires plus study. Per person, on average 2.8 (range 1–5) telephone-based 24-h dietary recalls (24HRs), two 24-h urinary samples, and one blood sample were available. Validity of 54 nutrients and 22 food groups was assessed by ranking agreement, correlation coefficients, attenuation factors, and ultimately deattenuated correlation coefficients (validity coefficients).
Results: Median correlation coefficients for energy and macronutrients, micronutrients, and food groups were 0.45, 0.36, and 0.38, respectively. Median deattenuated correlation coefficients were 0.53 for energy and macronutrients, 0.45 for micronutrients, and 0.64 for food groups, being >0.50 for 18 of 22 macronutrients, 16 of 30 micronutrients and >0.50 for 17 of 22 food groups. The FFQ underestimated protein and potassium intake compared with 24-h urinary nitrogen and potassium excretion by –18% and –2%, respectively. Correlation coefficients ranged from 0.50 and 0.55 for (fatty) fish intake and plasma eicosapentaenoic acid and docosahexaenoic acid, and from 0.26 to 0.42 between fruit and vegetable intake and plasma carotenoids.
Conclusion: Overall, the validity of the 253-item Maastricht FFQ was satisfactory. The comprehensiveness of this FFQ make it well suited for use in The Maastricht Study and similar populations.
Total number of nutrients validated: 21
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: 10
- Micronutrients: 11
| 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 and Elderly | Both | Energy (kcal) | 44 | 63 | 0.49 (NR) | -81 | 170 | |||
| Protein (g) | 2.40 | 2.41 | 0.48 (NR) | -2.4 | 7.2 | ||||||
| Fat (g) | 2.80 | 3.12 | 0.38 (NR) | -3.5 | 9.1 | ||||||
| Saturated Fat | 0.00 | 1.28 | 0.41 (NR) | -2.6 | 2.6 | ||||||
| MUFA (g) | 1.80 | 1.20 | 0.30 (NR) | -0.6 | 4.2 | ||||||
| PUFA (g) | 0.80 | 0.78 | 0.28 (NR) | -0.8 | 2.4 | ||||||
| Carbohydrates | 13 | 8 | 0.56 (NR) | -3.4 | 29 | ||||||
| Sodium (mg) | 250 | 108 | 0.07 (NR) | 33 | 467 | ||||||
| Calcium (mg) | 81 | 42 | 0.63 (NR) | -2.7 | 165 | ||||||
| Iron (mg) | 0.80 | 0.42 | 0.39 (NR) | -0.05 | 1.7 | ||||||
| Folate | -20 | 12 | 0.37 (NR) | -44.4 | 4.41 | ||||||
| Vitamin C (mg) | 17 | 7 | 0.42 (NR) | -2.9 | 31 | ||||||
| Vegetables | 1.50 | 1.35 | 0.51 (NR) | -1.2 | 4.2 |
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.
van Dongen MC, Wijckmans-Duysens NEG, den Biggelaar LJ, Ocke MC, Meijboom S, Brants HA, et al. The Maastricht FFQ: Development and validation of a comprehensive food frequency questionnaire for the Maastricht study. Nutrition. 2019;62:39-46.