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American Journal of Epidemiology Vol. 148, No. 12: 1148-1156
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health

other

Comparison of Food Frequency Questionnaires: The Reduced Block and Willett Questionnaires Differ in Ranking on Nutrient Intakes

A. K. Elisabet Wirfält1,, Robert W. Jeffery2 and Patricia J. Elmer2

1The Malmö Diet Cancer Study, University of Lund Malmö Sweden
2Division of Epidemiology, School of Public Health, University of Minnesota Minneapolis, MN

Reprint requests to Dr. Elisabet Wirfalt, The Malmo Diet and Cancer Study, University of Lund, Claesgatan 7, SE-205 02 Malmo, Sweden.

Food frequency questionnaires, major tools in epidemiologic studies, are often criticized for biased and imprecise intake estimates. The aim of this study was to compare the performance of two widely used food frequency questionnaires, a reduced 60-item Block questionnaire and a 153-item Willett food frequency questionnaire, relative to three 24-hour recalls administered by telephone. The dietary data were collected in 1991 from a group of healthy women age 25–49 years (n = 101) during the baseline period of a weight-loss intervention study in Minneapolis, Minnesota. Total energy and macro- and micronutrient intakes were compared across methods by using four analytic approaches: comparison of means and correlation coefficients, regression analysis, and estimation of percent agreement between each questionnaire and recalls. The Block instrument showed an overall underestimation bias, but was more successful in categorizing individuals on percent energy from fat and carbohydrate intakes than was the Willett instrument. The Willett instrument showed no overall underestimation bias and was more successful in classifying individuals on vitamin A and calcium intakes. Diverging performance characteristics of diet assessment methods have an implication for the design of studies, interpretation of results, and comparison of findings across studies. Am J Epidemiol 1998; 148: 1148–56.

bias (epidemiology); diet; epidemiologic methods; nutrition assessment; nutrition surveys; questionnaires


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