Public Health Nutrition

Research Paper

Performance of a food-frequency questionnaire in the US NIH–AARP (National Institutes of Health–American Association of Retired Persons) Diet and Health Study

Frances E Thompsona1 c1, Victor Kipnisa1, Douglas Midthunea1, Laurence S Freedmana2, Raymond J Carrolla3, Amy F Subara1, Charles C Browna1, Matthew S Butchera4, Traci Mouwa1, Michael Leitzmanna1 and Arthur Schatzkina1

a1 US National Cancer Institute, EPN 4016, 9000 Rockville Pike, Bethesda, MD 20893-7344, USA

a2 Gertner Institute for Epidemiology, Tel Hashomer, Israel

a3 Department of Statistics, Texas A&M University, College Station, TX, USA

a4 Information Management Services, Inc., Silver Spring, MD, USA


Objective We evaluated the performance of the food-frequency questionnaire (FFQ) administered to participants in the US NIH–AARP (National Institutes of Health–American Association of Retired Persons) Diet and Health Study, a cohort of 566 404 persons living in the USA and aged 50–71 years at baseline in 1995.

Design The 124-item FFQ was evaluated within a measurement error model using two non-consecutive 24-hour dietary recalls (24HRs) as the reference.

Setting Participants were from six states (California, Florida, Pennsylvania, New Jersey, North Carolina and Louisiana) and two metropolitan areas (Atlanta, Georgia and Detroit, Michigan).

Subjects A subgroup of the cohort consisting of 2053 individuals.

Results For the 26 nutrient constituents examined, estimated correlations with true intake (not energy-adjusted) ranged from 0.22 to 0.67, and attenuation factors ranged from 0.15 to 0.49. When adjusted for reported energy intake, performance improved; estimated correlations with true intake ranged from 0.36 to 0.76, and attenuation factors ranged from 0.24 to 0.68. These results compare favourably with those from other large prospective studies. However, previous biomarker-based studies suggest that, due to correlation of errors in FFQs and self-report reference instruments such as the 24HR, the correlations and attenuation factors observed in most calibration studies, including ours, tend to overestimate FFQ performance.

Conclusion The performance of the FFQ in the NIH–AARP Diet and Health Study, in conjunction with the study’s large sample size and wide range of dietary intake, is likely to allow detection of moderate (≥1.8) relative risks between many energy-adjusted nutrients and common cancers.

(Received August 02 2006)

(Accepted March 12 2007)


c1 Corresponding author: Email