Validating polyphenol intake estimates from a food-frequency questionnaire by using repeated 24-h dietary recalls and a unique method-of-triads approach with 2 biomarkers

Am J Clin Nutr. 2017 Mar;105(3):685-694. doi: 10.3945/ajcn.116.137174. Epub 2017 Jan 25.

Abstract

Background: The assessment of polyphenol intake in free-living subjects is challenging, mostly because of the difficulty in accurately measuring phenolic content and the wide presence of phenolics in foods.Objective: The aims of this study were to evaluate the validity of polyphenol intake estimated from food-frequency questionnaires (FFQs) by using the mean of 6 measurements of a 24-h dietary recall (24-HR) as a reference and to apply a unique method-of-triads approach to assess validity coefficients (VCs) between latent "true" dietary estimates, total urinary polyphenol (TUP) excretion, and a surrogate biomarker (plasma carotenoids).Design: Dietary intake data from 899 adults of the Adventist Health Study 2 (AHS-2; 43% blacks and 67% women) were obtained. Pearson correlation coefficients (r), corrected for attenuation from within-person variation in the recalls, were calculated between 24-HRs and FFQs and between 24-HRs and TUPs. VCs and 95% CIs between true intake and polyphenol intakes from FFQs, 24-HRs, and the biomarkers TUPs and plasma carotenoids were calculated.Results: Mean ± SD polyphenol intakes were 717 ± 646 mg/d from FFQs and 402 ± 345 mg/d from 24-HRs. The total polyphenol intake from 24-HRs was correlated with FFQs in crude (r = 0.51, P < 0.001) and deattenuated (r = 0.63; 95% CI: 0.61, 0.69) models. In the triad model, the VC between the FFQs and theoretical true intake was 0.46 (95% CI: 0.20, 0.93) and between 24-HRs and true intake was 0.61 (95% CI: 0.38, 1.00).Conclusions: The AHS-2 FFQ is a reasonable indicator of total polyphenol intake in the AHS-2 cohort. Urinary polyphenol excretion is limited by genetic variance, metabolism, and bioavailability and should be used in addition to rather than as a replacement for dietary intake assessment.

Keywords: Adventist Health Study 2; method of triads; phytochemicals; polyphenols; urinary polyphenols.

Publication types

  • Validation Study

MeSH terms

  • Aged
  • Biomarkers / blood
  • Biomarkers / urine
  • Carotenoids / blood
  • Diet Records
  • Diet Surveys
  • Diet*
  • Energy Intake
  • Feeding Behavior*
  • Female
  • Humans
  • Male
  • Mental Recall
  • Middle Aged
  • Polyphenols / administration & dosage*
  • Polyphenols / urine
  • Reference Values
  • Reproducibility of Results
  • Surveys and Questionnaires / standards*

Substances

  • Biomarkers
  • Polyphenols
  • Carotenoids