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Accuracy of Different Reduced Versions of a Validated Food-Frequency Questionnaire in Italian Men and Women

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Abstract

This study aimed to explore how possible it would be to reduce the length of a food-frequency questionnaire (FFQ) while maintaining adequate accuracy. This FFQ was validated in women in a previous study by our group, whereas the validation in men was one of the aims of the present study. A 15-item FFQ was administered to 136 men and 211 women (age range 25–75 years) recruited by proportional age-stratified sampling, who agreed to fill in a 14-day diet diary. For the intermediate version of the FFQ we considered only eight items in women and 10 in men. For the very short version we considered only three items. The positive likelihood ratio was markedly lower for the very short version (men = 1.2 and women = 1.5) with respect to the intermediate version (men = 6 and women = 6.3) and the 15-item version (men = 19.6 and women = 19.9). The specificity of the very short version was low (22.2% for men and 35.2% for women). The area under ROC curve of the three-item FFQ was significantly lower with respect to the other two versions. In conclusion, our study suggests that the shortest version of the FFQ could be usefully employed only in those clinical settings where the main objective is the identification of individuals who do not have a low calcium intake. ROC analysis and posttest probability calculated by positive likelihood ratio may represent an optimal method for assessing the accuracy of FFQs.

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References

  1. Nordin BE (1997) Calcium and osteoporosis. Nutrition 13:664–686

    Article  PubMed  CAS  Google Scholar 

  2. Lau EM, Cooper C (2001) Risk factors for osteoporosis in Europe. J Bone Miner Metab 19:142–145

    Article  PubMed  CAS  Google Scholar 

  3. Heaney RP (2002) The importance of calcium intake for lifelong skeletal health. Calcif Tissue Int 70:70–73

    Article  PubMed  CAS  Google Scholar 

  4. Heaney RP (2007) Bone health. Am J Clin Nutr 85(Suppl 1):S300–S303

    Google Scholar 

  5. Boonen S, Vanderschueren D, Haentjens P, Lips P (2006) Calcium and vitamin D in the prevention and treatment of osteoporosis—a clinical update. J Intern Med 259:539–552

    Article  PubMed  CAS  Google Scholar 

  6. Briefel RR, Johnson CL (2004) Secular trends in dietary intake in the United States. Annu Rev Nutr 24:401–431

    Article  PubMed  CAS  Google Scholar 

  7. US Department of Agriculture, US Department of Health and Human Services (2005) Dietary guidelines for Americans, 6th edn. US Government Printing Office, Washington, DC

  8. Kanis JA, Johansson H, Oden A, De Laet C, Johnell O, Eisman JA (2005) A meta-analysis of milk intake and fracture risk: low utility for case finding. Osteoporos Int 16:799–804

    Article  PubMed  Google Scholar 

  9. Cade J, Thompson R, Burley V, Warm D (2002) Development, validation and utilisation of food-frequency questionnaires—a review. Public Health Nutr 5:567–587

    Article  PubMed  Google Scholar 

  10. Cade JE, Burley VJ, Warm DL, Thompson RL, Margetts BM (2004) Food-frequency questionnaires: a review of their design, validation and utilisation. Nutr Res Rev 17:5–23

    Article  PubMed  CAS  Google Scholar 

  11. Marks GC, Hughes MC, van der Pols JC (2006) The effect of personal characteristics on the validity of nutrient intake estimates using a food-frequency questionnaire. Public Health Nutr 9:394–402

    Article  PubMed  Google Scholar 

  12. Magkos F, Manios Y, Babaroutsi E, Sidossis LS (2006) Development and validation of a food frequency questionnaire for assessing dietary calcium intake in the general population. Osteoporos Int 17:304–312

    Article  PubMed  Google Scholar 

  13. Cummings SR, Block G, McHenry K, Baron RB (1987) Evaluation of two food frequency methods of measuring dietary calcium intake. Am J Epidemiol 126:796–802

    PubMed  CAS  Google Scholar 

  14. Blalock SJ, Currey SS, DeVellis RF, Anderson JJ, Gold DT, Dooley MA (1998) Using a short food frequency questionnaire to estimate dietary calcium consumption: a tool for patient education. Arthritis Care Res 11:479–484

    Article  PubMed  CAS  Google Scholar 

  15. Sebring NG, Denkinger BI, Menzie CM, Yanoff LB, Parikh SJ, Yanovski JA (2007) Validation of three food frequency questionnaires to assess dietary calcium intake in adults. J Am Diet Assoc 107:752–759

    Article  PubMed  Google Scholar 

  16. Severo M, Lopes C, Lucas R, Barros H (2009) Development of a tool for the assessment of calcium and vitamin D intakes in clinical settings. Osteoporos Int 20:231–237

    Article  PubMed  CAS  Google Scholar 

  17. Elliott ME, Meek PD, Kanous NL, Schill GR, Weinswing PA, Bohlman JP (2002) Osteoporosis screening by community pharmacists: use of National Osteoporosis Foundation resources. J Am Pharm Assoc 42:101–111

    Article  Google Scholar 

  18. Blalock SJ, Norton LL, Patel RA, Cabral K, Thomas CL (2003) Development and assessment of a short instrument for assessing dietary intakes of calcium and vitamin D. J Am Pharm Assoc 43:685–693

    Article  Google Scholar 

  19. Montomoli M, Gonnelli S, Giacchi M, Mattei R, Cuda C, Rossi S (2002) Validation of a food frequency questionnaire for nutritional calcium intake assessment in Italian women. Eur J Clin Nutr 56:21–30

    Article  PubMed  CAS  Google Scholar 

  20. Willet WC (1998) Nutritional epidemiology, 2nd edn. Oxford University Press, New York

    Google Scholar 

  21. Carnovale E, Marletta L (eds) (1997) Food composition tables. Istituto Nazionale della Nutrizione. EDRA, Milan

  22. Salvini S, Parpinel M, Gnagnarella P, Maissonneuve P, Turrini A (1998) Banca dati di composizione degli alimenti per studi epidemiologici in Italia. European Institute of Oncology, Milan

  23. Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310

    PubMed  CAS  Google Scholar 

  24. Sackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB (2000) Evidence-based medicine. How to practice and teach EBM, 2nd edn. Churchill Livingstone, London

    Google Scholar 

  25. Hanley JA, McNeil PJ (1982) The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology 143:29–36

    PubMed  CAS  Google Scholar 

  26. Hanley JA, McNeil PJ (1983) A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology 148:839–843

    PubMed  CAS  Google Scholar 

  27. Pewsner D, Battaglia M, Minder C, Marx A, Bucher HC, Egger M (2004) Ruling a diagnosis in or out with “SpPIn” and “SnNOut”: a note of caution. BMJ 329:209–213

    Article  PubMed  Google Scholar 

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Gonnelli, S., Rossi, S., Montomoli, M. et al. Accuracy of Different Reduced Versions of a Validated Food-Frequency Questionnaire in Italian Men and Women. Calcif Tissue Int 85, 221–227 (2009). https://doi.org/10.1007/s00223-009-9264-4

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