Evaluating the Validity of a Food Frequency Questionnaire in Comparison with a 7-Day Dietary Record for Measuring Dietary Intake in a Population of Survivors of Colorectal Cancer

Janna L. Koole*, Martijn J. L. Bours, Jose J. L. Breedveld-Peters, Eline H. van Roekel, Martien C. J. M. van Dongen, Simone J. P. M. Eussen, Moniek van Zutphen, Franzel J. B. van Duijnhoven, Hendriek C. Boshuizen, Matty P. Weijenberg

*Corresponding author for this work

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Background Food frequency questionnaires (FFQs) are a commonly used method to assess dietary intake in epidemiological studies. It is important to evaluate the validity of FFQs in the population of interest.

Objective To evaluate the validity of an FFQ for measuring dietary intake in survivors of colorectal cancer (CRC), relative to a 7-day dietary record.

Design Dietary intake was assessed 1 year after the end of CRC treatment. Participants first completed a 7-day dietary record and 2 weeks later a 253-item FFQ that measured intake in the preceding month.

Participants/setting Data were used from a subsample of participants (n=100) enrolled in an ongoing prospective study (EnCoRe study) in the Netherlands, from 2015 to 2018.

Main outcome measures Estimated intakes of total energy, 19 nutrients, and 20 food groups as well as scoring adherence to the dietary recommendations of the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) were compared between both dietary assessment methods.

Statistical analyses performed Means and standard deviations, Spearman rank correlations corrected for within-person variation and total energy, and kappa agreement between quintiles were assessed.

Results The median Spearman correlation corrected for within-person variation for nutrients and total energy was 0.60. Correlations >0.50 were found for 15 of 19 nutrients, with highest agreement for vitamin B-12 (0.74), polysaccharides (0.75), and alcohol (0.91). On average, 73% (range=60% to 84%) of participants were classified into the exact same or adjacent nutrient quintile. The median Spearman correlation corrected for within-person variation for food groups was 0.62. Correlations >0.50 were found for 17 of 20 food groups, with highest agreement for cereals and cereal products (0.96), fish (0.96), and potatoes (0.99). The Spearman correlation between total scores of the WCRF/AICR dietary recommendations was 0.53.

Conclusions Relative to a 7-day dietary record, the validity of an FFQ for measuring dietary intake among survivors of CRC appeared moderate to good for most nutrients and food groups.

Original languageEnglish
Pages (from-to)245-257
Number of pages13
JournalJournal of the Academy of Nutrition and Dietetics
Issue number2
Publication statusPublished - Feb 2020


  • Food frequency questionnaire
  • Dietary record
  • Validity
  • Nutrients
  • Colorectal cancer

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