Agreement Between a Food Frequency Questionnaire and the Willett Questionnaire in Overweight or Obese Pregnant Women
DOI:
https://doi.org/10.6000/1929-5634.2013.02.02.4Keywords:
Food frequency questionnaire, Obesity, Overweight, Diet, PregnancyAbstract
Background & Aims: Overweight and obesity during pregnancy is associated with an increased risk of many adverse health outcomes for both women and their infants. There is a need for simple food frequency questionnaires to assess nutritional intake and aid implementation and evaluation of nutritional interventions in these women. The aim of this study was to compare a newly developed food frequency questionnaire with the Willett food frequency questionnaire in Australian pregnant women who were overweight or obese.
Methods: 170 overweight or obese pregnant women (12-20 weeks’ gestation) completed both the Willett and the devised (LIMIT) food frequency questionnaire with n=41 excluded due to unrealistic energy intake or incomplete questionnaires. The mean nutrient intake for each questionnaire and the mean difference in nutrient intake between the questionnaires was assessed. The correlation and agreement between the two questionnaires were assessed by Spearmans correlation coefficients and Bland-Altman method.
Results: There were high correlations for total energy intake, protein, carbohydrates, cholesterol, iron, folate, and caffeine (r>0.50, P<0.01), and moderate correlations for fat, fibre, and calcium (r=0.4-0.5, P<0.01). Correlations were low (r<0.3) for vitamins. There was no significant systematic error between the two food frequency questionnaires with the exception of alcohol, calcium, iron, and folate (P>0.05). The limit of agreement (LOA) was wide (LOA <50% or >200%) for macronutrients, calcium, and folate, but within the acceptable range for iron, vitamins, and caffeine (LOA 133%).
Conclusions: There is good agreement between the Willett and the LIMIT food frequency questionnaires in estimating macronutrient and some key pregnancy-related micronutrients for group-level comparisons.
References
The International Obesity Task Force. The Global Epidemic. 2011 [cited 2011 05/10]; Available from: http://www.iaso.org/ iotf/obesity/obesitytheglobalepidemic/.
Alexandra P, Vassilios B, Alexandra V, George K, Vassiliki L, Chryssa B. Population-based trends of pregnancy outcome in obese mothers: what has changed over 15 years. Obesity (Silver Spring) 2011; 19(9): 1861-5. Epub 2011/01/22. http://dx.doi.org/10.1038/oby.2010.317 DOI: https://doi.org/10.1038/oby.2010.317
The NHS Information Centre LS. Statistics on obesity, physical activity and diet: England, 2010. The NHS Information Centre 2010; 10/02/2010. Report No.
Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999-2004. JAMA 2006; 295(13): 1549-55. Epub 2006/04/06. http://dx.doi.org/10.1001/jama.295.13.1549
Chan A, Scott J, Nguyen A-M, Sage L. Pregnancy Outcome in South Australia 2008. In: Pregnancy Outcome Unit SH, editor. Adelaide: Government of South Australia 2009.
Dodd JM, Grivell RM, Nguyen AM, Chan A, Robinson JS. Maternal and perinatal health outcomes by body mass index category. Aust N Z J Obstet Gynaecol 2011; 51(2): 136-40. Epub 2011/04/07. http://dx.doi.org/10.1111/j.1479-828X.2010.01272.x DOI: https://doi.org/10.1111/j.1479-828X.2010.01272.x
Cade J, Thompson R, Burley V, Warm D. Development, validation and utilisation of food-frequency questionnaires - a review. Public Health Nutr 2002; 5(4): 567-87. Epub 2002/08/21. http://dx.doi.org/10.1079/PHN2001318 DOI: https://doi.org/10.1079/PHN2001318
Willett WC, Reynolds RD, Cottrellhoehner S, Sampson L, Browne ML. Validation of a Semiquantitative Food Frequency Questionnaire - Comparison with a 1-Year Diet Record. J Am Dietetic Assoc 1987; 87(1): 43-7. DOI: https://doi.org/10.1016/S0002-8223(21)03057-1
Suitor CJW, Gardner J, Willett WC. A Comparison of Food Frequency and Diet Recall Methods in Studies of Nutrient Intake of Low-Income Pregnant-Women. J Am Dietetic Assoc 1989; 89(12): 1786-94. DOI: https://doi.org/10.1016/S0002-8223(21)02469-X
Greeley S, Storbakken L, Magel R. Use of a modified food frequency questionnaire during pregnancy. J Am Coll Nutr 1992; 11(6): 728-34. Epub 1992/12/01. DOI: https://doi.org/10.1080/07315724.1992.10718274
Fawzi WW, Rifas-Shiman SL, Rich-Edwards JW, Willett WC, Gillman MW. Calibration of a semi-quantitative food frequency questionnaire in early pregnancy. Ann Epidemiol 2004; 14(10): 754-62. Epub 2004/11/03. http://dx.doi.org/10.1016/j.annepidem.2004.03.001 DOI: https://doi.org/10.1016/j.annepidem.2004.03.001
Rifas-Shiman SL, Rich-Edwards JW, Willett WC, Kleinman KP, Oken E, Gillman MW. Changes in dietary intake from the first to the second trimester of pregnancy. Paediatr Perinat Epidemiol 2006; 20(1): 35-42. Epub 2006/01/20. http://dx.doi.org/10.1111/j.1365-3016.2006.00691.x DOI: https://doi.org/10.1111/j.1365-3016.2006.00691.x
Ambrosini GL, Mackerras D, de Klerk NH, Musk AW. Comparison of an Australian food-frequency questionnaire with diet records: implications for nutrition surveillance. Public Health Nutr 2003; 6(4): 415-22. http://dx.doi.org/10.1079/PHN2002434 DOI: https://doi.org/10.1079/PHN2002434
Keogh JB, Lange K, Syrette J. Comparative analysis of two FFQ. Public Health Nutr 2010; 13(10): 1553-8. Epub 2010/03/02. http://dx.doi.org/10.1017/S1368980010000066 DOI: https://doi.org/10.1017/S1368980010000066
Dietitians Association of Australia. Pregnancy. Canberra2010 [cited 2011 09/08]; Available from: http://daa.asn.au/for-the-public/smart-eating-for-you/nutrition-a-z/pregnancy/.
Dodd JM, Turnbull DA, McPhee AJ, Wittert G, Crowther CA, Robinson JS. Limiting weight gain in overweight and obese women during pregnancy to improve health outcomes: the LIMIT randomised controlled trial. BMC Pregnancy Childbirth 2011; In Press. http://dx.doi.org/10.1186/1471-2393-11-79 DOI: https://doi.org/10.1186/1471-2393-11-79
Riley MD, Blizzard L. Comparative validity of a food frequency questionnaire for adults with IDDM. Diabetes Care 1995; 18(9): 1249-54. Epub 1995/09/01. http://dx.doi.org/10.2337/diacare.18.9.1249 DOI: https://doi.org/10.2337/diacare.18.9.1249
Nath SD, Huffman FG. Validation of a semiquantitative food frequency questionnaire to assess energy and macronutrient intakes of Cuban Americans. Int J Food Sci Nutr 2005; 56(5): 309-14. Epub 2005/10/21. http://dx.doi.org/10.1080/09637480500284993 DOI: https://doi.org/10.1080/09637480500284993
Brown JE, Buzzard IM, Jacobs DR, Jr., Hannan PJ, Kushi LH, Barosso GM, et al. A food frequency questionnaire can detect pregnancy-related changes in diet. J Am Diet Assoc 1996; 96(3): 262-6. Epub 1996/03/01. http://dx.doi.org/10.1016/S0002-8223(96)00078-8 DOI: https://doi.org/10.1016/S0002-8223(96)00078-8
Rumbold AR, Maats FH, Crowther CA. Dietary intake of vitamin C and vitamin E and the development of hypertensive disorders of pregnancy. Eur J Obstet Gynecol Reprod Biol 2005; 119(1): 67-71. Epub 2005/03/01. http://dx.doi.org/10.1016/j.ejogrb.2004.06.027 DOI: https://doi.org/10.1016/j.ejogrb.2004.06.027
Smith A, Kellet E, Schmerlaib Y. The Australian Guide to Healthy Eating. In: Ageing DoHa, editor. Canberra: Australian Government Publishing Service 1998.
Meltzer HM, Brantsaeter AL, Ydersbond TA, Alexander J, Haugen M. Methodological challenges when monitoring the diet of pregnant women in a large study: experiences from the Norwegian Mother and Child Cohort Study (MoBa). Matern Child Nutr 2008; 4(1): 14-27. Epub 2008/01/04. http://dx.doi.org/10.1111/j.1740-8709.2007.00104.x DOI: https://doi.org/10.1111/j.1740-8709.2007.00104.x
Thompson FE, Byers T. Dietary assessment resource manual. J Nutr 1994; 124(11 Suppl): 2245S-317S. Epub 1994/11/01.
Krebssmith SM, Heimendinger J, Subar AF, Patterson BH, Pivonka E. Using Food Frequency Questionnaires to Estimate Fruit and Vegetable Intake - Association between the Number of Questions and Total Intakes. J Nutr Educ 1995; 27(2): 80-5. http://dx.doi.org/10.1016/S0022-3182(12)80346-3 DOI: https://doi.org/10.1016/S0022-3182(12)80346-3
Hernandez-Avila M, Romieu I, Parra S, Hernandez-Avila J, Madrigal H, Willett W. Validity and reproducibility of a food frequency questionnaire to assess dietary intake of women living in Mexico City. Salud Publica Mex 1998; 40(2): 133-40. Epub 1998/06/09. http://dx.doi.org/10.1590/S0036-36341998000200005 DOI: https://doi.org/10.1590/S0036-36341998000200005
Barclay AW, Flood VM, Brand-Miller JC, Mitchell P. Validity of carbohydrate, glycaemic index and glycaemic load data obtained using a semi-quantitative food-frequency questionnaire. Public Health Nutr 2008; 11(6): 573-80. Epub 2007/10/25. http://dx.doi.org/10.1017/S1368980007001103 DOI: https://doi.org/10.1017/S1368980007001103
Longnecker MP, Lissner L, Holden JM, Flack VF, Taylor PR, Stampfer MJ, et al. The reproducibility and validity of a self-administered semiquantitative food frequency questionnaire in subjects from South Dakota and Wyoming. Epidemiology 1993; 4(4): 356-65. Epub 1993/07/01. http://dx.doi.org/10.1097/00001648-199307000-00012 DOI: https://doi.org/10.1097/00001648-199307000-00012
Giovannucci E, Rimm EB, Stampfer MJ, Colditz GA, Ascherio A, Willett WC. Intake of fat, meat, and fiber in relation to risk of colon cancer in men. Cancer Res 1994; 54(9): 2390-7. Epub 1994/05/01.
Willett WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, et al. Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 1985; 122(1): 51-65. Epub 1985/07/01. DOI: https://doi.org/10.1093/oxfordjournals.aje.a114086
Aldoori WH, Giovannucci EL, Rimm EB, Wing AL, Trichopoulos DV, Willett WC. A prospective study of diet and the risk of symptomatic diverticular disease in men. Am J Clin Nutr 1994; 60(5): 757-64. Epub 1994/11/01. DOI: https://doi.org/10.1093/ajcn/60.5.757
Ascherio A, Rimm EB, Giovannucci EL, Spiegelman D, Stampfer M, Willett WC. Dietary fat and risk of coronary heart disease in men: cohort follow up study in the United States. BMJ 1996; 313(7049): 84-90. Epub 1996/07/13. http://dx.doi.org/10.1136/bmj.313.7049.84 DOI: https://doi.org/10.1136/bmj.313.7049.84
Ascherio A, Willett WC, Rimm EB, Giovannucci EL, Stampfer MJ. Dietary iron intake and risk of coronary disease among men. Circulation 1994; 89(3): 969-74. Epub 1994/03/01. http://dx.doi.org/10.1161/01.CIR.89.3.969 DOI: https://doi.org/10.1161/01.CIR.89.3.969
Nowicki E, Siega-Riz AM, Herring A, He K, Stuebe A, Olshan A. Predictors of measurement error in energy intake during pregnancy. Am J Epidemiol 2011; 173(5): 560-8. Epub 2011/01/29. http://dx.doi.org/10.1093/aje/kwq402 DOI: https://doi.org/10.1093/aje/kwq402
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