Assessing the Validity of a Self-administered Food-Frequency Questionnaire ( FFQ ) in the Adult Population of Newfoundland and Labrador Prepared by :

1. Dietary intake and eating patterns of elderly people in Newfoundland and Labrador. Presented by Lin Liu et.al. at Aging Research in Newfoundland & Labrador: Achievements and Prospects, Conner Brook, NL, Canada; September 2012. Background: Wise food choices and a balanced diet are key elements to a healthy lifestyle and can both slow and improve the aging process. Seniors require fewer calories but more nutrients to promote and protect health, and contribute to independence, self-efficacy and quality of life. However, studies reported dietary conditions in elder people across this country are not encouraging. Moreover, no existing literature has been addressed this issue within NL province to our knowledge. Thus, the objectives of the study were to evaluate dietary intake and eating patterns in a representative population sample of elderly people in NL, and to describe demographic factors that relate to the consumption of specific food items. Methods Subjects: A random sample of 400 participants from the general public in NL was already recruited, and 234 people who are aged over 50 were enrolled in the present study. Demographic characteristics: Demographic characteristics were obtained through telephone interviews using questions regarding age, sex, education attainment, marital status, community size, employment, and smoking habits. Dietary assessment: Most of the tools used to assess nutritional intake in large epidemiological studies were originally developed to be used in young and middle-aged subjects and, therefore, their validity and reliability when employed in older subjects remain uncertain. To obtain a more accurate assessment of the dietary intake in elderly participants, both FFQ and 24-hour dietary recall were used to collect corresponding information in this project. Statistical analysis: Exploratory Factor Analysis was conducted to define the dietary patterns in NL seniors. Univariate analyses and Multivariable Linear Regression Models were used to assess the relationship between participants’ food consumption patterns and demographic variables, with factor scores being the dependent variable. Final Report_ Assessing the Validity of a Self-administered Food-Frequency Questionnaire (FFQ) in the Adult Population of Newfoundland and Labrador 45 Abstract 2. Consumption of Foods with Folate, Niacin, and Vitamin B12: Inadequate and Excessive Nutrient Intakes by an Adult Population of Newfoundland and Labrador Presented by Jennifer Colbourne et al. at Primary Health Care Forum, St. John’s, NL, Canada; December 2011. Purpose: To estimate the daily food intakes of folate, niacin, and vitamin B12 by an adult population of Newfoundland and Labrador (NL). Methods: Four hundred randomly selected adult NL residents were surveyed by telephone. Secondary analysis was performed on two 24-hour food recalls for each participant. Mean daily intakes of folate, niacin, and vitamin B12 were estimated. Statistical significance testing was conducted to compare the means of the age-sex groups. The amount of folate consumed through ready-to-eat cereal (RTEC) and bread products was also examined. Results: 18.1% of participants consumed folate within the recommended range, 81.9% consuming less than the recommended amount per day; 73.6% of participants consumed niacin within the recommended range, 21.9% in excess of the recommended amount per day; and 63.7% of participants consumed vitamin B12 within the recommended range, 36.3% consuming less than the recommended amount per day. 41.6 % of males and 15.2% of females consumed an average daily intake of niacin from food above the Tolerable Upper Intake Level (UL). Conclusions: Despite fortification, NL adults may be consuming inadequate amounts of folate from foods. However, one in every five surveyed was consuming niacin at levels above the maximum recommended value. Closer monitoring of food fortification may be warranted. Final Report_ Assessing the Validity of a Self-administered Food-Frequency Questionnaire (FFQ) in the Adult Population of Newfoundland and Labrador 46 Abstract 3. Fibre Consumption in an Adult Population of Newfoundland and Labrador: How much is being consumed and which food groups are contributing to the intake? Presented by Natasha Baker et al. at Primary Health Care Forum, St. John’s, NL, Canada; December 2011. Purpose: To study dietary intakes from a sample of NL adults for: (1) total fibre and (2) contributions of foods in the four food groups of Eating Well with Canada’s Food Guide (CFG) to total fibre. Methods: 24-hour dietary intake data (2 days) were analyzed by Food Processor SQL. Analysis was completed on data collected from 389 participants, 291 females and 98 males. Data from the original data set were organized and coded into CFG groups using Microsoft Excel 2010. All statistical analyses were completed using Stata version 10.1. Results and Conclusions: Mean fibre intakes were: for females 13.56g/day (31-50 years) and 15.13g/day (51-70 years), for males 16.28g/day (31-50 years) and 17.25g/day (51-70 years). All mean values were below the recommended Adequate Intake (AI) but 7.14% of females aged 31-50 years, 19.55% of females aged 51-70 years, and 6.45% of males aged 51-70 years met or exceeded the appropriate AI. No conclusions of inadequacy could be made because the AI is not set using the mean/median of a healthy population. Most fibre came from foods of the fruit and vegetables group, followed by grain products. A low percentage of all age-sex groups met the recommended servings of CFG. The greatest intakes were grain products consumed by 51-70 year old females, however only about 11% of this age-sex group consumed at least the minimum number of recommended servings per day. Dietary intake data collected were not normally distributed and showed a high degree of inter-person variability. Final Report_ Assessing the Validity of a Self-administered Food-Frequency Questionnaire (FFQ) in the Adult Population of Newfoundland and Labrador 47 Abstract 4. Food Consumption Patterns in Newfoundland and Labrador, Canada: A Cross-Sectional Telephone Survey. Presented by Lin Liu et al. at the AICR Annual Conference on Food, Nutrition, Physical Activity, and Cancer. Washington, DC, U.S.A.; November 3-4, 2011 Background: The objectives of the study were to evaluate the food consumption pattern in the adult population of NL, and to describe demographic factors that relate to the consumption of specific food items. Methods: A random sample of 400 participants from the general public was recruited. Food intake was assessed using a 24-hour dietary recall method. Results: The mean consumption of food by the study population was estimated to be 3023g per day, providing an energy intake of 1572.87kcal per day. Comparing the nutrient intake with the Canadian Community Health Survey (CCHS 2.2) data, Newfoundland population had higher fat intake but lower intakes of carbohydrates and fiber. The results also suggest a relatively lower consumption of fruits and vegetables. For example, 75.43% of participants consumed less than the recommended servings daily. Conclusion: The results highlight the importance of improving healthy eating in NL adult population. Final Report_ Assessing the Validity of a Self-administered Food-Frequency Questionnaire (FFQ) in the Adult Population of Newfoundland and Labrador 48 Abstract 5. Assessing the validity of a self-administered food-frequency questionnaire (FFQ) in the adult population of Newfoundland and Labrador. Presented by Lin Liu et al. at Cancer Research Symposium 2010, Halifax, Canada; November 8-9, 2010 A Food-Frequency Questionnaire (FFQ) used in NL with the colorectal cancer (CRC) project is a modified version of the well-known Hawaii FFQ with input from NL researchers. However, it has not been appropriately validated which makes some of the questionable findings difficult to interpret. The goal of this study is to develop a NL based FFQ which is valid and can be either self-administrated or completed through telephone interview. Being consistent with the NL CRC project, a randomly digit dialing method will be used to recruit 250 study participants between the ages of 35 and 70. All study participants will be asked to finish two 24-hour recalls by pre-trained interviewers in both winter and summer, as well to complete a FFQ survey at the end of the study. Nutrient intakes for individual nutrients will be calculated using the Canadian Nutrient Database software. This research will provide an important tool that is expected to contribute to future epidemiological and other nutritional studies of the NL population. It will also contribute high quality research which, in turn, will enhance the efficiency and effectiveness of the provincial health system. This study is supported Newfoundland and Labrador Centre for Applied Health Research (NLCAHR) through a research grant. Lin Liu is a graduate student. Final Report_ Assessing the Validity of a Self-administered Food-Frequency Questionnaire (FFQ) in the Adult Population of Newfoundland and Labrador 49 Canadian Study of Diet and Health Memorial University of Newfoundland Who this questionnaire is for and what it asks about: This questionnaire is to be completed by the person taking part in this study: Part I asks about the foods you ate OVER THE PAST 12 MONTHS. Part II asks about vitamins and other dietary supplements that you may have used. If possible, please return this questionnaire within two weeks. The completed questionnaire should be sealed in the pre-paid envelope and mailed back to: Health Research Unit, Room 2801A, Division of Community Health & Humanities, Medicine, Health Science Centre, 300 Prince Phillip Drive, St. John's, NL, Canada, A1B 3V6 If you have any questions about this form or the study, please do not hesitate to contact with us with 709-777-2043; leave your question when the answering machine indicates and someone will get back to you within the