Abstract
The study aimed to examine the external validity of the Folate Food Frequency Questionnaire (F-FFQ) designed for assessing the folate intake in Serbian women of reproductive age. The F-FFQ was tested against repeated 24 h dietary recalls and correspondent nutritional biomarkers (red blood cells (RBC) and serum folate concentrations) using the method of triads. In a cross sectional study, 503 women aged 18–49 years completed dietary questionnaires and representative validation subsample (n = 50) provided fasting blood samples for biomarker analyses. Correlation coefficients were calculated between each of the dietary methods and three pair-wise correlations were applied for the calculation of validity coefficients. Correlation coefficients observed between F-FFQ and three 24 h recalls were r = 0.56 (p < 0.001) and r = 0.57 (p < 0.001) for total sample and validation group, respectively. Bland–Altman plot and cross-classification analyses indicated good agreement between methods. High validity coefficients were determined between the true intake (I) and dietary assessment methods, F-FFQ (Q) and 24 h dietary recalls (R) (ρQIrbc = 0.871 and ρQIser = 0.814; ρRIrbc = 0.652 and ρRIser = 0.698), and moderate ones for biomarkers (B) (ρBIrbc = 0.428 and ρBIser = 0.421). The F-FFQ is valid instrument for the assessment of dietary folate intake in women living in Serbia, a country without mandatory folic acid food fortification.
Highlights
Nutritional imbalances during pregnancy can influence gene expression and cause abnormalities of fetal phenotype
We developed the Food Frequency Questionnaire for folate intake assessment (F-FFQ)
Several approaches were used to examine the external validity of the Folate Food Frequency Questionnaire (F-FFQ) and it performed consistently well
Summary
Nutritional imbalances during pregnancy can influence gene expression and cause abnormalities of fetal phenotype. Scientific progress in the comprehension of congenital anomalies has led to the conclusion that optimally balanced maternal diet with adequate intake of macro- and micronutrients can contribute to reducing the incidence of these disorders [1]. For the prevention of adverse pregnancy outcomes and normal fetal development folate, water-soluble B9 vitamin, is recognized as a nutrient of particular importance [2]. The term folate refers to a group of related compounds including folates naturally present in foods and the synthetic, fully oxidized form, folic acid. The biological functions of folate as a co-enzyme are essentially based on single-carbon units transfer in the processes of purine and pyrimidine nucleotides biosynthesis and metabolism of amino acids methionine, serine, glycine and histidine [3]. An element of the folate structure, cannot be synthesized de novo in mammalian body, Nutrients 2017, 9, 128; doi:10.3390/nu9020128 www.mdpi.com/journal/nutrients
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