Validity of retrospective diet history: assessing recall of midlife diet using food frequency questionnaire in later life.

Objectives: Limited information exists on the validity of dietary information given by elderly people on their past diet. Here we test the relative validity of a food frequency questionnaire asking older persons about their midlife diet.

Design: Retrospective food intake of 56-72-year-old subjects was estimated using a food frequency questionnaire designed for the AGES-Reykjavik Study (AGES-FFQ), an epidemiological study of older individuals. Results were compared with detailed dietary data gathered from the same individuals 18-19 years previously, i.e., in midlife, as part of a national cohort. Spearman correlation and cross-classifications were used to assess the ability of the AGES-FFQ to rank subjects according to their intake.

Setting: Nationwide, Iceland.

Participants: Subjects, born 1937-1952 (n=174), who participated in the 1990 Icelandic National Dietary Survey.

Measurements: Dietary intake, estimated by the AGES-FFQ (2008-2009), and dietary history obtained from the 1990 Icelandic National Dietary Survey as a reference method.

Results: The strongest correlation between the AGES-FFQ and the reference method was found for cod liver oil, r=0.53, p<0.001 and r=0.56, p<0.001, for men and women, respectively. For men the corresponding correlation coefficient for milk and dairy products was r=0.43, p<0.001. The correlation coefficients were lower but within a reasonably acceptable range (r=0.26-0.40) for meat, fish and potatoes for both genders, as well as fresh fruits and milk/dairy products for women and whole-wheat bread, oatmeal/muesli and blood/liver-sausage for men. No correlation was found between the AGES-FFQ and the dietary history for rye bread and vegetable consumption. Subjects were categorized into five groups according to level of consumption by the two methods. Cross-classification showed that 16-59% were classified into same group and 43-91% into same or adjacent group, 0-14% were grossly misclassified into opposite groups.

Conclusion: The AGES-FFQ on midlife diet was found suitable to rank individuals by their intake of several important food groups.