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Lack of efficacy of a food-frequency questionnaire in assessing dietary macronutrient intakes in subjects consuming diets of known composition^1,2,3

¹ From the Lipid Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, and the Frances Stern Nutrition Center, New England Medical Center, Boston.

Background: We compared the validity of a semiquantitative food-frequency questionnaire in assessing intakes of macronutrients (absolute amounts and percentages of energy) by 19 subjects fed natural-food diets of known composition. In small subsets (n = 5 or 6), we also tested 3-d diet records.

Objective: The objective of this study was to investigate the efficacy of food-frequency questionnaires and diet records in subjects fed natural-food diets of known composition.

Design: Each subject consumed 3 different diets for 6 wk and self-reported his or her food intake by using a food-frequency questionnaire and a diet record. The diets varied in their chemically analyzed contents of fat (15–35% energy), saturated fat (5–14%), monounsaturated fat (5–14.5%), polyunsaturated fat (2.5–10.5%), carbohydrate (49–68%), and cholesterol (108–348 mg/d).

Results: The food-frequency questionnaire significantly underestimated fat, saturated fat, monounsaturated fat, and protein intakes and significantly overestimated carbohydrate intake with the high-fat diet. The percentage of energy from fat was significantly underestimated for the high-fat diet and significantly overestimated for the very-low-fat diet. Estimates from the food-frequency questionnaire differed significantly from actual intakes for fat (absolute and percentage), saturated fat (absolute and percentage), monounsaturated fat (absolute and percentage), and protein (percentage) in the high-fat diet and for polyunsaturated fat (absolute and percentage), saturated fat (percentage), fiber (absolute), and cholesterol (daily absolute; in mg/d) in the lower-fat diet. Estimates from the diet records better agreed with actual intakes than did estimates from the food-frequency questionnaire except for monounsaturated fat (absolute and percentage) in the high-fat diet and polyunsaturated fat (percentage) in the lower-fat diet and the very-low-fat diet.

Conclusion: Our data indicated that the food-frequency questionnaire did not provide reliable estimates of absolute amounts of dietary fats or cholesterol.

Key Words: Food-frequency questionnaire • dietary assessment • diet records • dietary assessment • macronutrient intake • protein • polyunsaturated fat • saturated fat • monounsaturated fat • cholesterol

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