Validation of a food-frequency questionnaire for measurement of nutrient intake in a dietary intervention study

Objective: To validate a 171-item semi-quantitative food-frequency questionnaire (FFQ) for measurement of nutrient intake in an intervention trial based on walnut supplementation. Design and setting: Free-living adults from Southern California were randomly assigned to either an intervention (walnut-supplemented) or a control diet. The prescribed 6-month intervention was >= 28g of walnuts per day for the walnut-supplemented group and <= 2 g of walnuts per day for the control group. Participants provided at least six 24-hour dietary recalls and completed a self-administered FFQ. Subjects: Eighty-seven adults aged 30-72 years (48 females, 39 males). Results: Our findings from validation (by correlation with six diet recall measures) of the measurement of 32 nutrients by the FFQ are as follows. We found significant positive correlations (corrected for measurement error) between the FFQ and diet recalls for total energy (r = 0.34), total carbohydrate (r = 0.42), vegetable protein (r = 0.43), total fat (r = 0.51), polyunsaturated fat (r = 0.77), total fibre (r = 0.60), linoleic acid (r = 0.78) and alpha-linolenic acid (r = 0.79) - the last nutrient being an excellent nutrient biomarker of the intervention (walnut supplementation). Significant positive correlations were also found for vitamin C (r = 0.96) and certain minerals (r = 0.46-0.80 for calcium, phosphorus, magnesium, iron and potassium). Uncorrected correlations were also high (r > 0.40) for retinol, beta-carotene, folate and alcohol. Both diet recalls and FFQ showed a similar significant difference in alpha-linolenic acid content between the walnut-supplemented and control diets. Conclusions: The FFQ demonstrated good relative validity in the estimation intake of some of the major nutrients in a dietary intervention trial and was a particularly valid estimate of an important nutrient biomarker of walnut supplementation.