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Validation Information: FFQ (Netherlands)

Visser 2020

Relative Validity of the HELIUS Food Frequency Questionnaire for Measuring Dietary Intake in Older Adult Participants of the Longitudinal Aging Study Amsterdam

The aim of this study was to determine the relative validity of the HEalthy LIfe in an Urban Setting (HELIUS) food frequency questionnaire (FFQ) in assessing the dietary intake of energy, nutrients, and food groups of Dutch older men and women. In 2014–2015, 88 participants of the Longitudinal Aging Study Amsterdam aged 71.9 (SD 8.6) years completed the 238-item HELIUS FFQ and three 24-hour dietary recalls. The mean group-level bias in the intakes of energy, nutrients, and food groups between the two methods was assessed, as well as Pearson’s correlation coefficients and level of agreement using quintile distribution. For the intakes of energy and macronutrients, the group-level bias was ≤5%, Pearson’s correlation coefficients were moderate to good (ranging from 0.26 for total fat to 0.72 for alcohol), and agreement was moderate to high (classification in same or adjacent quintile ranging from 63% for energy, protein, and carbohydrate to 91% for alcohol). For most micronutrients and food groups, the relative validity was moderate (Pearson’s correlation coefficients between 0.3 and 0.5), with the lowest correlations for β-carotene (0.08), vitamin B1 (0.19), fish (0.14), and grains (0.24). In conclusion, for energy and macronutrients, most micronutrients, and most food groups, the relative validity of the HELIUS FFQ to assess dietary intake in Dutch older adults was acceptable to good.

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Validation Information

Year of Publication

Tool Information

Dietary Exposure Measured
Full Nutrient, Food Groups
Tool Type
Food Frequency Questionnaire
Timeframe Tool Measures info
4 Weeks
Portion Size Measures info
The estimation of portion sizes was facilitated by using relevant units (e.g., slice of bread) or household measures (e.g., tablespoons) and by using 11 sets of 5 or 6 pictures of a standard plate indicating different portion sizes.
Reporting Method info
Format info
Online or Paper
Supplements Measured
Not Reported
Administration Method info

Study Information

Study Location
Amsterdam, the Netherlands
Associated Nutrient Database
the Dutch Food Composition Table 2011
Comparator Validated Against
24hr Recall


Sample Size
Adults and Elderly
Age of Population

Range:20-70 years

Other Notable Characteristics

Total number of nutrients validated: 28 info

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: 14
  • Micronutrients: 14
Comparator Lifestage Sex Nutrient Measured info Mean Difference Standard Deviation info Correlation Coefficient info Cohen's Kappa Coefficient Percentage Agreement Percentage Agreement Categories info Lower Limits of Agreement Upper Limits of Agreement
24hr Recall Adults and Elderly Both Energy (kcal) 76 556 0.32 (P) -1036 1188
Protein (g) 3.6 23 0.39 (P) -42.4 49.6
Fat (g) 4.9 28 0.26 (P) -51.1 60.9
Saturated Fat (g) -0.1 13 0.43 (P) -26.1 25.9
MUFA (g) -10.6 19 0.20 (P) -48.6 27.4
PUFA (g) 15.7 9 0.26 (P) -2.3 33.7
Carbohydrate (g) 4.7 66 0.41 (P) -127.3 136.7
Calcium (mg) 103.2 377 0.45 (P) -650.8 857.2
Iron (mg) 0.2 3.2 0.43 (P) -6.2 6.6
Zinc (mg) 0.6 3.3 0.36 (P) -6 7.2
Retinol (µg) 142.6 718 0.42 (P) -1293.4 1578.6
Folate (µg) 30.5 81 0.34 (P) -131.5 192.5
Vitamin B12 (µg) 1.1 3.7 0.50 (P) -6.3 8.5
Vitamin C (mg) 37.6 65 0.44 (P) -92.4 167.6

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.

Visser M, Elstgeest LEM, Winkens LHH, Brouwer IA, Nicolaou M. Relative Validity of the HELIUS Food Frequency Questionnaire for Measuring Dietary Intake in Older Adult Participants of the Longitudinal Aging Study Amsterdam. Nutrients. 2020;12(7):05.