International Journal of Epidemiology, Vol 26, S152-S160, Copyright © 1997 by International Epidemiological Association
P Pisani, F Faggiano, V Krogh, D Palli, P Vineis and F Berrino
A pilot questionnaire was developed for the EPIC centres of northern Italy,
and validated in the feasibility part of the cohort project. The
questionnaire was self-administered and of the food frequency type with
portion size estimated by means of pictures. It was structured by courses
within a meal characteristic of Italian dietary habits. Dietary intake
estimated by the questionnaire was compared to the corresponding estimates
obtained from 8-14 24-hour recall interviews administered over a 1-year
period. The reference method was validated by means of urinary nitrogen in
4-6 repeated 24-hour urine collections. One hundred and ninety-seven
volunteers (47 men and 150 women) were enrolled and completed the study
lasting 1 year. They filled out two questionnaires at the beginning and at
the end of the study, and had a 24-hour recall interview once a month.
Twenty-four-hour urine samples were collected at regular intervals. Usual
intake of energy, the major nutrients and some vitamins were estimated for
the questionnaires and the reference method by means of food composition
tables compiled for this study. The agreement between the questionnaire and
the 24-hour recalls was only good for alcohol consumption: Pearson's
correlation was 0.73 and 0.77 in men and women respectively. Otherwise the
relative validity of the questionnaire ranged between 0.28 for fat to 0.52
for carbohydrates in men and 0.25 and 0.50 in women for the same nutrients.
The validity of the two interview methods in estimating protein intake,
compared to mean urinary nitrogen was 0.24 (M) and 0.18 (W) for the
questionnaire and 0.63 (M) and 0.48 (W) for 24-hour recalls. The main
causes of low performance of the questionnaire were identified to be the
estimated intake of dressing and cooking fats, vegetables and meat.
Remedies were devised and introduced in the final version of the
questionnaire currently in use in the EPIC project.
ARTICLES
Relative validity and reproducibility of a food frequency dietary questionnaire for use in the Italian EPIC centres
Divisione di Epidemiologia, Istituto Nazionale dei Tumori, Milano, Italy.
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