1
|
Sadeghi S, Montazeri V, Zamora-Ros R, Biparva P, Sabour S, Pirouzpanah S. Food frequency questionnaire is a valid assessment tool of quercetin and kaempferol intake in Iranian breast cancer patients according to plasma biomarkers. Nutr Res 2021; 93:1-14. [PMID: 34311274 DOI: 10.1016/j.nutres.2021.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 06/14/2021] [Accepted: 06/19/2021] [Indexed: 10/21/2022]
Abstract
In epidemiological and clinical studies, the most common nutritional tool to assess dietary flavonol intake is the food frequency questionnaire (FFQ), which needs to contain a detailed list of plant-based foods and be previously validated. Our study aimed to assess the accuracy of dietary flavonol (quercetin, kaempferol, and isorhamnetin) intake from a food frequency questionnaire (FFQ) compared to fasting plasma flavonol concentrations, as biomarkers of exposure, in breast cancer patients. In a consecutive case series, newly diagnosed patients with breast cancer (n = 140) were recruited at Nour-Nejat Hospital, Tabriz, Iran. Flavonol intake was assessed using a validated FFQ. Plasma flavonol concentrations were measured using high-performance liquid chromatography-ultraviolet detection. The accuracy of dietary status was evaluated using a receiver operating characteristic (ROC) and area under the ROC curve (AUC). Dietary status was shown in dichotomous using ROC-cutoff point. The plasma concentrations of quercetin were moderately correlated with dietary intake of quercetin (Spearman's correlation coefficient (rs) = 0.188, P < .05; rpartial= 0.330, P < .01) and plasma concentrations of isorhamnetin (rs = 0.337, P < .001). A linear correlation between dietary levels and plasma concentrations of kaempferol was attained (rpartial = 0.240, P < .05). Using a ROC-cutoff of 61.9 nmol/L for plasma quercetin (test reference), we were able to differentiate between lower and higher consumers of quercetin with an AUCROC-based reference =0.65 (P < .01, sensitivity = 61.8%, and specificity = 60.0%). Using a plasma kaempferol concentration of 60.1 nmol/L (ROC-cutoff), it was possible to detect significant differences between higher and lower intakes of kaempferol (AUCROC-based reference = 0.64, P < .05). The correlations and diagnostic performance with plasma concentrations could present a significant accuracy rate (validity), which seems acceptable for a nutritional questionnaire (FFQ) to assess intakes intake levels of quercetin and kaempferol. An improvement in the accuracy of the flavonol exposure can provide more precise relationship with health outcomes, which may increase their clinical significance.
Collapse
Affiliation(s)
- Sara Sadeghi
- Molecular Medicine Research Center, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Biochemistry and Dietetics, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Nanotechnology, Islamic Azad University, Langaroud Branch, Langaroud, Iran
| | - Vahid Montazeri
- Department of Thoracic Surgery, Faculty of Medicine, Tabriz University of Medical Sciences/ and also Surgery Ward, Nour-Nejat Hospital, Tabriz, Iran
| | - Raul Zamora-Ros
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Pourya Biparva
- Department of Nanotechnology, Islamic Azad University, Langaroud Branch, Langaroud, Iran
| | - Siamak Sabour
- Department of Clinical Epidemiology, Faculty of Health and Safety/ and also Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran 198353-5511, Iran
| | - Saeed Pirouzpanah
- Molecular Medicine Research Center, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Biochemistry and Dietetics, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
| |
Collapse
|
2
|
Ganji V, Abu-Dbaa R, Othman H, Zewein M, Al-Abdi T, Shi Z. Validation of Vitamin D-Specific Food Frequency Questionnaire against Food Records for Qatari Women. Foods 2020; 9:foods9020195. [PMID: 32075164 PMCID: PMC7074537 DOI: 10.3390/foods9020195] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 02/07/2023] Open
Abstract
The measurement of vitamin D nutritional status through dietary assessment is cost effective. Food frequency questionnaire (FFQ) is usually validated against food records (FR). There is no vitamin D-specific FFQ for Qatar population. The objective of this study was to develop a vitamin D-centric FFQ and validate FFQ against three-day FR for Qatar population. A quantitative FFQ based on vitamin D containing foods consumed in Qatar was developed. Vitamin D contents of foods were gathered from food labels and food composition tables from the United States Department of Agriculture. A vitamin D content database was developed for this study purpose. Dietary intakes while using FFQ and three-day FR were collected from 62 women. Vitamin D intakes from FFQ and three-day FR were validated with quartile comparison and Bland-Altman (BA) tests. BA plot showed an agreement between FFQ and three-day FR vitamin D intakes. The BA index was 3.23%, which is <5%, a commonly used standard for validation. Quartile correlation showed that ≈73% of subjects were within the same or adjacent quartile. In conclusion, an agreement was found between vitamin D intakes from FFQ and three-day FR in Qatari women. More studies are needed to validate the vitamin D-specific FFQ in Qatari population at large.
Collapse
|
3
|
Lombard MJ, Steyn NP, Charlton KE, Senekal M. Application and interpretation of multiple statistical tests to evaluate validity of dietary intake assessment methods. Nutr J 2015; 14:40. [PMID: 25897837 PMCID: PMC4471918 DOI: 10.1186/s12937-015-0027-y] [Citation(s) in RCA: 133] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 04/10/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Several statistical tests are currently applied to evaluate validity of dietary intake assessment methods. However, they provide information on different facets of validity. There is also no consensus on types and combinations of tests that should be applied to reflect acceptable validity for intakes. We aimed to 1) conduct a review to identify the tests and interpretation criteria used where dietary assessment methods was validated against a reference method and 2) illustrate the value of and challenges that arise in interpretation of outcomes of multiple statistical tests in assessment of validity using a test data set. METHODS An in-depth literature review was undertaken to identify the range of statistical tests used in the validation of quantitative food frequency questionnaires (QFFQs). Four databases were accessed to search for statistical methods and interpretation criteria used in papers focusing on relative validity. The identified tests and interpretation criteria were applied to a data set obtained using a QFFQ and four repeated 24-hour recalls from 47 adults (18-65 years) residing in rural Eastern Cape, South Africa. RESULTS 102 studies were screened and 60 were included. Six statistical tests were identified; five with one set of interpretation criteria and one with two sets of criteria, resulting in seven possible validity interpretation outcomes. Twenty-one different combinations of these tests were identified, with the majority including three or less tests. Coefficient of correlation was the most commonly used (as a single test or in combination with one or more tests). Results of our application and interpretation of multiple statistical tests to assess validity of energy, macronutrients and selected micronutrients estimates illustrate that for most of the nutrients considered, some outcomes support validity, while others do not. CONCLUSIONS One to three statistical tests may not be sufficient to provide comprehensive insights into various facets of validity. Results of our application and interpretation of multiple statistical tests support the value of such an approach in gaining comprehensive insights in different facets of validity. These insights should be considered in the formulation of conclusions regarding validity to answer a particular dietary intake related research question.
Collapse
Affiliation(s)
- Martani J Lombard
- Centre of Excellence for Nutrition (CEN), North-West University, Private Bag X6001, Nutrition, Box 594, Potchefstroom, 2520, South Africa.
| | - Nelia P Steyn
- Division of Human Nutrition, University of Cape Town, Cape Town, South Africa.
| | - Karen E Charlton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia.
| | - Marjanne Senekal
- Division of Human Nutrition, University of Cape Town, Cape Town, South Africa.
| |
Collapse
|