Reproducibility of an Italian food frequency questionnaire for cancer studies: Results for specific nutrients

doi:10.1016/1047-2797(95)92893-D

Annals of Epidemiology

Volume 5, Issue 1, January 1995, Pages 69-75

https://doi.org/10.1016/1047-2797(95)92893-D Get rights and content

Abstract

The reproducibility of measures of the intake of total energy and 27 selected nutrients from a quantitative food frequency questionnaire (FFQ) used in a case-control study on cancer of the breast, ovary, and digestive tract was evaluated. The results of two FFQ administrations at an interval of 3 to 10 months (median = 5.4 months) to 452 volunteers (144 males and 308 females; median age = 50 years) from three Italian provinces (Pordenone, Genoa, and Forli) were compared. Pearson correlation coefficients (r) between crude nutrient intake (unadjusted for energy) ranged from 0.50 for vegetable fat to 0.80 for alcohol, with most values falling between 0.60 and 0.70 (median r = 0.67). Adjustment of nutrient intakes for total energy slightly decreased most coefficients (median r = 0.60). The agreement between the two measurements did not differ substantially by sex, age, education, and interval between interviews. The contribution of specific FFQ components (i.e., frequency-only questions, open questions, portion size, and fat intake pattern) was also assessed separately with respect to the performance and reproducibility of nutrient measures, yielding, in general, very similar results. The seven questions concerning individual fat intake pattern, which were used to modulate the composition of various recipes, led, however, to a significant increase in mean daily intake of vegetable fat, oleic acid, and vitamin E, but a reduction of estimated daily intake of linoleic acid and polyunsaturated fatty acids.

The present study showed that the reproducibility of this FFQ is very good. In a country like Italy where distinctive dietary patterns exist in different regions and groups of the population, especially with respect to the use of fat for seasoning, specific questions on individual fat intake pattern are worth asking in order to clarify the role of different types of fat and vitamin E in the etiology of cancer of the breast, ovary, and digestive tract.

References (31)

S Franceschi et al.
Reproducibility of an Italian food frequency questionnaire for cancer studies: Results for specific food items
Eur J Cancer
(1993)
A Reshef et al.
Reliability of a dietary questionnaire
Am J Clin Nutr
(1972)
JH Hankin et al.
Reproducibility of a dietary history questionnaire in a case-control study of breast cancer
Am J Clin Nutr
(1983)
WC Willett et al.
Validation of a semi-quantitative food frequency questionnaire: Comparison with a one-year diet record
J Am Diet Assoc
(1987)
W Willett
Nutritional Epidemiology
E Bidoli et al.
Food consumption and cancer of the colon and rectum in north-eastern Italy
Int J Cancer
(1992)
E Buiatti et al.
A case-control study of gastric cancer and diet in Italy: II. Association with nutrients
Int J Cancer
(1990)
S Franceschi et al.
Diet and thyroid cancer: A pooled analysis of four European case-control studies
Int J Cancer
(1991)
C La Vecchia et al.
Dietary factors and the risk of breast cancer
Nutr Cancer
(1987)
E Marubini et al.
The relationship of dietary intake and serum levels of retinol and β-carotene with breast cancer: Results from a case-control study
Cancer
(1988)

E Carnovale et al.

Tabelle di composizione degli alimenti

(1989)

F Fidanza et al.

Tabelle di composizione degli alimenti

SW Souci et al.

Food Composition and Nutrition Tables, 1989/90

(1989/1990)

C Lentner

Ottava edizione

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^☆: This work was conducted within the framework of the CNR (Italian National Research Council) Applied Projects “Clinical Applications of Oncological Research” (contracts 93.02303.PF39, 93.02152.PF39, and 93.02360. PF39) and “Prevention and Control of Disease Factors” (contract 92. 00229.PF41) and with the contribution of the Italian Association for Research on Cancer and the Italian League Against Tumors.

¹: Dr. Salvini is the recipient of a “Paolo Baffi” fellowship awarded by the Oncological Training Foundation, Milan, Italy.

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Original reportReproducibility of an Italian food frequency questionnaire for cancer studies: Results for specific nutrients☆

Abstract

Eur J Cancer

Am J Clin Nutr

Am J Clin Nutr

J Am Diet Assoc

Nutritional Epidemiology

Food consumption and cancer of the colon and rectum in north-eastern Italy

Int J Cancer

A case-control study of gastric cancer and diet in Italy: II. Association with nutrients

Int J Cancer

Diet and thyroid cancer: A pooled analysis of four European case-control studies

Int J Cancer

Dietary factors and the risk of breast cancer

Nutr Cancer

The relationship of dietary intake and serum levels of retinol and β-carotene with breast cancer: Results from a case-control study

Cancer

Tabelle di composizione degli alimenti

Tabelle di composizione degli alimenti

Food Composition and Nutrition Tables, 1989/90

Ottava edizione

Original report
Reproducibility of an Italian food frequency questionnaire for cancer studies: Results for specific nutrients☆