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American Journal of Epidemiology Vol. 154, No. 12 : 1126-1135
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health


NUTRITIONAL EPIDEMIOLOGY

Application of the Method of Triads to Evaluate the Performance of Food Frequency Questionnaires and Biomarkers as Indicators of Long-term Dietary Intake

Edmond K. Kabagambe1, Ana Baylin1, Damon A. Allan1, Xinia Siles2, Donna Spiegelman3,4 and Hannia Campos1,2

1 Department of Nutrition, Harvard School of Public Health, Harvard University, Boston, MA.
2 Salud Coronaria, Instituto de Investigaciones en Salud, Universidad de Costa Rica, San Pedro, Costa Rica.
3 Department of Epidemiology, Harvard School of Public Health, Harvard University, Boston, MA.
4 Department of Biostatistics, Harvard School of Public Health, Harvard University, Boston, MA.

ABSTRACT

Little is documented about the performance of the food frequency questionnaire (FFQ) in US minority groups and in populations in developing countries. The authors applied a novel technique, the method of triads, to assess the validity and reproducibility of the FFQ among Hispanics. The subjects were men (n = 78) and women (n = 42) living in Costa Rica. Seven 24-hour dietary recalls and two FFQ interviews (12 months apart) were conducted between 1995 and 1998 to estimate dietary intake during the past year. Plasma and adipose tissue samples were collected from all subjects. Validity coefficients, which measure the correlation between observed and "true" dietary intake, were also estimated. The median validity coefficients for tocopherols and carotenoids estimated by dietary recall, the average of the two FFQs, and plasma were 0.71, 0.60, and 0.52, respectively. Compared with adipose tissue, plasma was a superior biomarker for carotenoids and tocopherols. Adipose tissue was a poor biomarker for saturated and monounsaturated fatty acids but performed well for polyunsaturated fatty acids (validity coefficients, 0.45–1.01) and lycopene (validity coefficient, 0.51). This study also showed that biomarkers did not perform better than the FFQ and that they should be used to complement the FFQ rather than substitute for it.

biological markers; diet; epidemiologic methods; Hispanic Americans; methods; questionnaires; recall; reproducibility of results

Abbreviations: FFQ, food frequency questionnaire; USDA, US Department of Agriculture; VC, validity coefficient


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