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Comparison of a web-based food record tool and a food-frequency questionnaire and objective validation using the doubly labelled water technique in a Swedish middle-aged population

Journal article
Authors Sanna Nybacka
Helene Berteus Forslund
E. Wirfalt
Ingrid Larsson
U. Ericson
E. W. Lemming
Göran Bergström
B. Hedblad
Anna Winkvist
Anna-Karin Lindroos
Published in Journal of Nutritional Science
Volume 5
Pages e39
ISSN 2048-6790
Publication year 2016
Published at Wallenberg Laboratory
Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Pages e39
Language en
Keywords Diet assessment: Food records: FFQ: Doubly labelled water: Validation: Web-based methods: Nutrition epidemiology, dietary assessment methods, total-energy-expenditure, measurement error, nutritional epidemiology, relative validity, subject variation, women, recall, cancer, variability, Nutrition & Dietetics, hoeller da, 1988, journal of nutrition, v118, p1278, rasuk v, 1991, american journal of clinical nutrition, v54, p464
Subject categories Health Sciences


Two web-based dietary assessment tools have been developed for use in large-scale studies: the Riksmaten method ( 4-d food record) and MiniMeal-Q ( food-frequency method). The aim of the present study was to examine the ability of these methods to capture energy intake against objectively measured total energy expenditure ( TEE) with the doubly labelled water technique ( TEEDLW), and to compare reported energy and macronutrient intake. This study was conducted within the pilot study of the Swedish CArdioPulmonary bioImage Study ( SCAPIS), which included 1111 randomly selected men and women aged 50-64 years from the Gothenburg general population. Of these, 200 were enrolled in the SCAPIS diet substudy. TEEDLW was measured in a subsample ( n 40). Compared with TEEDLW, both methods underestimated energy intake: -2.5 ( SD 2.9) MJ with the Riksmaten method; -2.3 ( SD 3.6) MJ with MiniMeal-Q. Mean reporting accuracy was 80 and 82 %, respectively. The correlation between reported energy intake and TEEDLW was r 0.4 for the Riksmaten method ( P < 0.05) and r 0.28 ( non-significant) for MiniMeal-Q. Women reported similar average intake of energy and macronutrients in both methods whereas men reported higher intakes with the Riksmaten method. Energy-adjusted correlations ranged from 0.14 ( polyunsaturated fat) to 0.77 ( alcohol). Bland-Altman plots showed acceptable agreement for energy and energy-adjusted protein and carbohydrate intake, whereas the agreement for fat intake was poorer. According to energy intake data, both methods displayed similar precision on energy intake reporting. However, MiniMeal-Q was less successful in ranking individuals than the Riksmaten method. The development of methods to achieve limited under-reporting is a major challenge for future research.

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