The Maastricht-FFQ: Development and Validation of a Comprehensive Food Frequency Questionnaire for The Maastricht Study

Summary

Objective: To develop and validate a comprehensive food frequency questionnaire (FFQ) for The Maastricht Study, a population-based prospective cohort study in Maastricht, The Netherlands. Research Methods & Procedures: Item selection for the FFQ was based on explained variation and contribution to intake of energy and 24 nutrients. For validation, the FFQ was filled out by 135 participants (25-70 years) of the Nutrition Questionnaires plus study. Per person, on average 2.8 (range 1 to 5) telephone-based 24h dietary recalls (24hRs), two 24h urinary samples and one blood sample were available. Validity of 54 nutrients and 22 food groups was assessed by ranking agreement, correlation coefficients, attenuation factors, and ultimately de-attenuated correlation coefficients (validity coefficients). Results: Median correlation coefficients for energy and macronutrients, micronutrients and food groups were 0.45, 0.36 and 0.38, respectively. Median de-attenuated correlation coefficients were 0.53 for energy and macronutrients, 0.45 for micronutrients and 0.64 for food groups, being >0.50 for 18 out of 22 macronutrients and 16 out of 30 micronutrients, and >0.50 for 17 out of 22 food groups. The FFQ underestimated protein and potassium intake compared to 24h urinary nitrogen and potassium excretion by -18% and -2%, respectively. Correlation coefficients ranged from 0.50 and 0.55 for (fatty) fish intake and plasma EPA and DHA, and from 0.26-0.42 between fruit and vegetable intake and plasma carotenoids. Conclusion: Overall, the validity of the 253-item Maastricht-FFQ is good. The comprehensiveness of this FFQ make it well-suited for use in The Maastricht Study and similar populations.