Non-quantitative Food Frequency Questionnaire Research Articles

Association of Maternal Diet during Pregnancy and Metabolite Profile in Cord Blood.

Cord blood metabolites can be predictive of long-term disease risk, but how levels of different metabolites might vary with respect to maternal diet is not well understood. The aim of this study was to evaluate the associations of different dietary patterns during pregnancy with cord blood metabolites (including glycerophospholipid fatty acids, polar lipids, non-esterified fatty acids, amino acids, and the sum of hexoses). Participants from the German LISA birth cohort study, with available data on targeted cord blood metabolomics and maternal diet, were included (n = 739). Maternal diet during the last 4 weeks of pregnancy was assessed by a non-quantitative food-frequency questionnaire. Using factor analysis, ten dietary patterns were identified, which were used in linear regression models exploring associations with cord blood metabolites. After correction for multiple hypothesis testing and adjustment for basic covariates, “fish and shellfish” was associated with higher glycerophospholipid fatty acid C20:5 n3 and lower C22:5 n6, whereas the “meat and potato” pattern was directly associated with propionylcarnitine (C3:0). The observed associations highlight potential metabolic pathways involved in the early programming of health and disease through maternal diet, as well as the potential for establishing quantitative biomarkers for dietary patterns of pregnant women.

Today's Mediterranean Diet in Greece: Findings from the National Health and Nutrition Survey-HYDRIA (2013-2014).

Background: This study aimed to investigate the food and macronutrient intake of the population in Greece and evaluate its adherence to the Greek traditional Mediterranean diet. Methods: Adults over 18 years old (n = 4011) were included from the 2013–2014 National Health and Nutrition survey—HYDRIA. Dietary intake was collected using two 24-h recall interviews and a nonquantitative food frequency questionnaire. Macronutrient intakes were calculated using an updated version of the Greek FCT. Results: Only 28.3% of the adult population had high adherence to the Greek traditional Mediterranean diet, with a higher percentage (39.7%) observed for participants over 65 years compared to those under 65 years (25.5%). Differences in adherence to the MD were observed among the four geographical regions in Greece. Younger adults had a higher intake of meat, cereals, alcoholic and nonalcoholic beverages, and sugar products than older individuals who consumed more vegetables, fruits, legumes, dairy, fish, and lipids (mainly from olive oil). Adults do not meet the international dietary recommendations for the intake of several foods and macronutrients. Conclusions: The adult Greek population, especially younger people, has headed away from the Greek traditional Mediterranean diet. These observations indicate potential detrimental consequences in terms of morbidity and mortality.

Association between food intake and obesity in pregnant women living with and without HIV in Cape Town, South Africa: a prospective cohort study

BackgroundAlthough global nutrition/dietary transition resulting from industrialisation and urbanisation has been identified as a major contributor to widespread trends of obesity, there is limited data in pregnant women, including those living with HIV in South Africa. We examined food-based dietary intake in pregnant women with and without HIV at first antenatal care (ANC) visit, and associations with maternal overweight/obesity and gestational weight gain (GWG).MethodsIn an urban South African community, consecutive women living with (n = 479) and without (n = 510) HIV were enrolled and prospectively followed to delivery. Interviewer-administered non-quantitative food frequency questionnaire was used to assess dietary intake (starch, protein, dairy, fruits, vegetables, legumes, oils/fats) at enrolment. Associations with maternal body mass index (BMI) and GWG were examined using logistic regression models.ResultsAmong women (median age 29 years, IQR 25–34), the prevalence of obesity (BMI ≥ 30 kg/m2) at first ANC was 43% and that of excessive GWG (per IOM guidelines) was 37% overall; HIV prevalence was 48%. In women without HIV, consumption of potato (any preparation) (aOR 1.98, 95% CI 1.02–3.84) and pumpkin/butternut (aOR 2.13, 95% CI 1.29–3.49) for 1–3 days a week increased the odds of overweight/obesity compared to not consuming any; milk in tea/coffee (aOR 6.04, 95% CI 1.37–26.50) increased the odds of excessive GWG. Consumption of eggs (any) (aOR 0.52, 95% CI 0.32–0.86) for 1–3 days a week reduced the odds of overweight/obesity while peanut and nuts consumption for 4–7 days a week reduced the odds (aOR 0.34, 95% CI 0.14–0.80) of excessive GWG.In women with HIV, consumption of milk/yoghurt/maas to drink/on cereals (aOR 0.35, 95% CI 0.18–0.68), tomato (raw/cooked) (aOR 0.50, 95% CI 0.30–0.84), green beans (aOR 0.41, 95% CI 0.20–0.86), mixed vegetables (aOR 0.49, 95% CI 0.29–0.84) and legumes e.g. baked beans, lentils (aOR 0.50, 95% CI 0.28–0.86) for 4–7 days a week reduced the odds of overweight/obesity; tomato (raw/cooked) (aOR 0.48, 95% CI 0.24–0.96) and mixed vegetables (aOR 0.38, 95% CI 0.18–0.78) also reduced the odds of excessive GWG.ConclusionsDiet modification may promote healthy weight in pregnant women living with and without HIV.

Metabolic Syndrome and Dietary Habits in Hospitalized Patients with Schizophrenia: A Cross-Sectional Study.

Background and Objectives: The true prevalence of metabolic syndrome (MetS) and the reason for it being higher in patients with schizophrenia when compared to general population have not yet been fully determined. Although being considered as one of the major causes, currently there are limited findings regarding differences in dietary patterns of schizophrenic patients with and without MetS. The present study aimed to determine the prevalence of MetS among hospitalized patients with schizophrenia, to investigate the differences in socio-demographic, clinical, and lifestyle characteristics between participants with and without MetS, with the special emphasis being put on their dietary habits, and to ascertain the correlation between dietary habits and MetS components. Materials and Methods: A cross-sectional study included 259 hospitalized patients with schizophrenia aged ≥ 18 years. All participants underwent basic anthropometric measurements, blood sampling and blood pressure assessment, and provided relevant socio-demographic and lifestyle information. The presence of MetS was determined according to the Joint Interim Statement definition and dietary habits were assessed using a non-quantitative food frequency questionnaire. Results: The overall prevalence of MetS was 47.9%. No socio-demographic or lifestyle differences were found between participants with and without MetS. A large number of participants (42.9%) reported consuming carbonated soft drinks on a daily basis. Daily frequency of fruit (11.6%) and vegetables intake (29.3%) was far below recommended. Dietary habits of participants with and without MetS did not significantly differ, while consumption frequencies of some of the studied food and beverage items and groups significantly correlated with certain MetS components (such as statistically significant positive correlation between cured meat products consumption frequency and waist circumference, as well as between red meat consumption frequency and systolic blood pressure). Conclusions: The concept of the present study did not allow us to distinguish to what extent the participants’ dietary habits were influenced by independent procurement of food products, nor has it allowed us to quantify the portion sizes of consumed food and beverage items and groups. Nevertheless, the findings indicate the need for early identification of individuals with high MetS risk and for the incorporation of nutritional support programs into hospital treatment of patients with schizophrenia.

How Can Dietary Habits Effects on Dysmenorrhea among Health Track Students – A Cross Sectional Study

Objective: This study aimed to evaluate whether dietary habits can affect the dysmenorrhea and irregular menstruation.
 Design: A cross sectional study.
 Setting: A total of 655 female students from Imam Abdulrahman Bin Faisal University (IAU). A non-quantitative food frequency questionnaire was used to assess their food habits.
 Participants: Female students in health track in IAU with no health problem, pregnant or even lactating and age from 17 – 26 years were included.
 Results: The severity of dysmenorrhea was significantly associated with the less intake of seafood (P= 0.007) and low consumption of nuts (P= 0.02). High sweet consumption contributed with pain increased significantly during the menstrual days (P= 0.002), as well as elevates the severity of dysmenorrhea (P= 0.04). Drinking less coffee contributes significantly to the undesired effect of dysmenorrhea (P= 0.04). While there were no significant association between dairy products intake and vegetables consumption with the severity of dysmenorrhea as well as irregular menstruation.
 Conclusion: Regular consumption of seafood and nuts can alleviate the severity of dysmenorrhea. Eating too many sweets increased the severity of dysmenorrhea among 17 to 26 year old female.

Reproducibility of A Non-Quantitative Food Frequency Questionnaire (62-Item FFQ-6) and PCA-Driven Dietary Pattern Identification in 13-21-Year-Old Females.

The aim of this study was to evaluate the test–retest reproducibility of a non-quantitative food frequency questionnaire (acronym: 62-item FFQ-6) and the possibility of identifying dietary patterns (DPs) in 13–21-year-old females. The study involved 97 females within three age groups: 13–15, 16–18, and 19–21 years, including 31, 38, and 28 subjects, respectively. The questionnaire was completed twice with a two-week interval (test and retest). For the total sample, using a principal component analysis (PCA), two similar PCA-driven DPs (DP1 and DP2) were identified separately from test data and retest data, considering two sets of input variables. 60-item-DP1 and 60-item-DP2 were identified after excluding two items—vegetables and fruits in general—due to including single items of various kinds of vegetables and fruits. After an aggregation of some items of the questionnaire, 25-item-DP1 and 25-item-DP2 were identified. The kappa statistic (test vs. retest) in the total sample averaged at 0.52 (0.32–0.72 for food items), while within age groups, it averaged at 0.41, 0.53, and 0.65, respectively. The percentage of subjects classified into the same food frequency category (test vs. retest) in the total sample averaged at 68% (51%–89% for food items), while within age groups, it averaged at 60%, 68%, and 77%, respectively. The Spearman correlations between dietary pattern scores (test vs. retest) in the total sample were: 0.84 (within age groups 0.83, 0.81, and 0.78, respectively) for 60-item-DP1, 0.68 (within age groups 0.24, 0.79, and 0.76, respectively) for 60-item-DP2, 0.76 (within age groups 0.56, 0.82, and 0.89, respectively) for 25-item-DP1, and 0.48 (within age groups 0.40, 0.57, and 0.53, respectively) for 25-item-DP2 (p < 0.05 for all). In conclusion, the test–retest reproducibility of the 62-item FFQ-6 was good or very good for most food items, with a tendency to be higher in older age groups of females under study. Due to the acceptable-to-good reproducibility of dietary pattern identification, the use of a 62-item FFQ-6 to describe the overall diet of young Polish females can be recommended.

Gaps in food security, food consumption and malnutrition in households residing along the baobab belt in Kenya

PurposeThis paper aims to describe food insecurity status, food consumption patterns of households and nutritional status of families residing along the baobab belt in Kitui and Kilifi counties of Kenya. It also explores associations between these and household socio-demographic characteristics.Design/methodology/approachA cross-sectional study design was performed with a sample of 216 caregiver/child pairs interviewed. Tablet-based semi-structured questions were used to obtain information on socio-demographic characteristics of children (6-13 years) and caregivers. Food insecurity status was assessed using the household food insecurity experience scale. Information on food consumption was obtained from qualitative 24-h recall as a basis for calculating a household dietary diversity score. Data were also obtained from a non-quantitative food frequency questionnaire. Anthropometric measurements of children and caregivers’ height and weight were taken to assess their nutritional status. Data were analyzed using Statistical Package for Social Science version 24 and WHO AnthroPlus 1.0.4.FindingsThe majority (98.2 per cent) of the households were food insecurity despite 81.5 and 57.4 per cent in Kitui and Kilifi counties, respectively, owning baobab trees. About 32.1 per cent of the households had poor dietary diversity scores (< 4). The prevalence of stunting (28.6 per cent), wasting (11.6 per cent) and underweight (25 per cent) rates among children were high. A significant association was observed between the children stunting rates with their age (p = 0.027), and also with household’s food security status (p < 0.001). Of the caregivers, 14.8 per cent were underweight, 18.1 per cent were overweight and 8.8 per cent were obese. There was significant association between the nutrition status of the caregivers and gender of the children (p < 0.001) and also with stunting rates of children (p = 0.047).Originality/valueThe study provides data on the current food security status and food consumption patterns of households and nutritional status of families residing along the baobab belt in Kenya which are mostly areas of marginal agricultural potential. The findings indicate a need for appropriate dietary improvements.

229 - Red meat, white meat and vegetable intakes and circulating nitrates

Background Intervention studies have shown that dietary nitrate supplementation significantly increased circulating nitrates and inhibited platelet aggregation, improved vascular function and lowered blood pressure. Thus, studying factors that may influence circulating nitrates will help us design strategies to prevent or improve these conditions associated with chronic diseases. Nitrate metabolism in humans are significantly influenced by oral and gut microbiome composition. Meat and vegetable intakes can influence human microbiome composition; thus, determine the associations between consumption of these foods and circulating nitrates may shed light on the interrelationship between meat, nitrate and microbiomes. Objective Determine the associations between red, white meat and vegetable consumption and circulating nitrates in two large observational studies. Methods Using a cross-sectional design, we analyzed data collected from 5,058 adults (men and women) in the National Health and Nutrition Examination Survey (NHANES) and from 1,260 men in the Health Professionals Follow-up Study (HPFS). The non-quantitative food frequency questionnaire (NFFQ) was collected, and urinary nitrates were measured in the NHANES. Plasma nitrates were measured, and a semi-quantitative FFQ (SFFQ) was collected in the HPFS. Results We found a similar trend when assessing the associations of vegetables and red meat with circulating (plasma and urinary) nitrate across two studies (NHANES and HPFS). Both urinary and plasma nitrates were positively associated with vegetables (p Conclusion Our results suggest that increased consumption of vegetable intakes are associated with increased circulating nitrates and increased consumption of processed and unprocessed red meat are associated with reduced circulating nitrates. Our study prompts new studies to determine the interrelationship between red meat, white meat, microbiome and circulating

Adherence to the Qatar dietary guidelines: a cross-sectional study of the gaps, determinants and association with cardiometabolic risk amongst adults

BackgroundThe Qatar Dietary Guidelines (QDGs) were developed as part of the national strategy to prevent chronic diseases. This study aims at characterizing gaps between the QDGs and usual dietary and lifestyle patterns in Qatar, identifying demographic and socioeconomic determinants of adherence to the QDGs and investigating the association between adherence and cardiometabolic risk.MethodsThis study is based on the Qatar National STEPwise cross-sectional survey which was conducted on a nationally representative sample of Qatari adults, aged 18 to 64 years (n = 1109). Data collection included socio-demographic characteristics, lifestyle factors, anthropometric (weight, height and waist circumference (WC)), and blood pressure measurements. The dietary intake of participants was evaluated using a non-quantitative food frequency questionnaire (FFQ). Biochemical assessment was performed to measure the fasting levels of blood sugar, triglycerides (TG) and HDL cholesterol. The metabolic syndrome (MetS) was defined as the presence of three or more cardiometabolic risk factors. To examine adherence to the guidelines, each specifc recommendation was matched to corresponding data drawn from the survey. To investigate the association of sociodemographic, lifestyle and cardiometabolic characteristics with adherence to the QDGs, an adherence score was calculated.ResultsMore than 83% of adults did not meet the recommendations for vegetables, fruits, whole grains, legumes and high fibre intakes, 70% were overweight or obese, 50–72% reported frequent consumption of sweetened beverages and sweets, and 47% reported frequent consumption of fast foods. Younger adults, the unemployed, the least educated and those not married had lower adherence to the QDGs. Adherence was inversely associated with elevated WC (OR: 0.88, 95% CI:0.82–0.95) and the MetS (OR:0.84,95% CI:0.74–0.96).ConclusionsBuilding on the identified gaps and vulnerable population groups, the study findings should provide a road map for the prioritization of interventions and the development of culture- specific programs aiming at promoting adherence to dietary guidelines in Qatar, while serving as a model to other countries in the region.

Intakes of vegetables and red meat in relation to circulating nitrate levels

ObjectiveOur study aimed to determine the associations between intakes of vegetables and red meat (processed and unprocessed) and circulating nitrate levels.DesignUsing a cross‐sectional study design.Setting and ParticipantsA secondary analysis using data from the National Health and Nutrition Examination Survey (NHANES) and from the Health Professionals Follow‐up Study (HPFS). 5,058 adults (men and women) in the 2005–2006 NHANES and 1,260 men from HPFS were analyzed.MeasurementsThe non‐quantitative food frequency questionnaire (NFFQ) and two 24‐hr recalls were collected and urinary nitrate was measured in the NHANES. Plasma nitrate was measured and a semi‐quantitative FFQ (SFFQ) was collected in the HPFS.ResultsUsing three dietary assessment instruments (NFFQ, SFFQ and average 24‐hr recalls), we found a similar trend when assessing the associations of vegetables and red meat with circulating (plasma and urinary) nitrate. Across instruments, circulating nitrate levels were 15–33% higher for participants in the highest, when compared to the lowest, quintile of vegetable intake (p&lt;0.001). Circulating nitrate levels were 8–16% lower for participants in the highest, when compared to the lowest, quintile of red meat intake (p&lt;0.001).ConclusionOur study has demonstrated a positive association between vegetable and circulating nitrate and an inverse association between red meat and circulating nitrate. As nitrate has been demonstrated to be beneficial for preventing several chronic diseases, our results provide valuable information for studying dietary etiologic factors associated with nitrate and chronic diseases.Support or Funding InformationNCI KO7 awardThis abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Abstract P141: Usual Impact of Vegetable and Red Meat Intake on Urinary Nitrate

The purpose of this study is twofold: 1) compare the effectiveness of non-quantitative food frequency questionnaire (NFFQ) to one-time or multiple 24-hr recalls on assessing the associations of vegetable and meat intakes with urinary nitrate; 2) to determine the associations of vegetable and meat intakes with urinary nitrate. Nitrate-related metabolic pathways have emerged as a fascinating topic because promising benefits of using nitrate supplement on several cardiovascular related outcomes in animal and small-scaled human intervention studies. In the past, most people consider that processed meat is the main source of nitrate exposure and nitrate is harmful. In fact, the major exogenous nitrate exposure comes from vegetables. Thus, we seek to untangle the mystery vegetable-nitrate and meat-nitrate associations in a large observational study. We conduct a cross-sectional analysis using the National Health and Nutrition Examination Survey (NHANES) during 2005-2006, among 7,683 participants. Urinary nitrate was measured, NFFQ and two-time 24-hr recalls were collected among these participants. We have found a positive association between vegetable intakes and urinary nitrate and an inverse association between red meat and processed meat intakes and urinary nitrate by using either non-quantitative NFFQ or averaged two-time 24-hr recalls. The magnitudes of the results were stronger when using NFFQ. Further, using NFFQ, we found that urinary nitrate intake increased by 26%, and decreased by 16% when comparing persons with the highest to the lowest quintile of vegetable intake and red and processed meat intake, respectively. Lastly, we found that the results from the 24-hr recall collected a few days after urine collection (but not the 24-hr recall on the day of urine collection) are consistent with NFFQ results. The trend of vegetable-urinary nitrate and red meat-urinary nitrate associations from NFFQ and averaged 24-hr recalls were consistent with our previous published findings using plasma nitrate measurement in the Health Professionals Follow-up Study, where only semi-quantitative FFQ (SFFQ) was administered. In summary, we conclude that dietary assessment with NFFQ,SFFQ, or average 24-hr recalls will yield similar results when evaluating red meat-circulating nitrate or vegetable-circulating nitrate associations. Measurement of circulating nitrate using either urine or plasma will yield similar results. Understanding how usual vegetable and red meat intake influences circulating nitrate in observational studies will provide valuable information for studying nitrate related pathways in the etiology of chronic disease and for designing long-term dietary intervention studies targeting circulating nitrate.

Correlation between Obesity, Diet, Physical Activity and Sedentary Behaviour among School-aged Children and Young Adolescents in Macedonia

Diet and physical activity education in school-aged children and young adolescents are in the focus of the modern healthcare and education system. The aims of our cross-section study were to estimate the prevalence of obesity in youth, and the significant correlation between nutrition status, health behavioural and biological markers. The sample size was 400 randomly selected school-aged children and adolescent from 14 to 18 years old. They were divided into two population groups of school-aged children (12-13 years old) and young adolescent (17-18 years). Standardized, non-quantitative Food Frequency Questionnaire (FFQ) and the International Questionnaire for assessment of Physical Activity (IPAQ-short version) were used as well as the anthropometric measurements: body weight and height, body mass index (BMI kg/m2) presented in percentile using the WHO Child Growth Standards. Statistical analysis was included descriptive statistics, Pearson Chi-square test and Logistic regression analysis using SPSS Statistics 17.0. In accordance with the distribution of Pearson Chi-square=16.94 (p<0.001), there was statistical significance between nutritional status of study participants in both, first and second study groups. Also, there was significant difference in high intensity sports activity between two groups (Pearson Chi-square=26.59; p<0.001). Sedentary behaviour had the highest influence on development of childhood obesity (Wald=2.81; p=0.09). Significant correlation was estimated between obesity and sweetness food (pasta, rise and potatoes), soft drinks, but drinking water had a protective effect. Prevention and treatment of pediatric overweight and obesity require systems-level approaches that include the skills of registered dietitians, sports coaches as well as consistent and integrated messages and environmental support across all sectors of society, especially educational sector. The next step is to develop an innovative “Skills for health” model including nutrition and physical activity education program in Macedonia.

Association of adherence to the seventh report of the Joint National Committee guidelines with hypertension in Korean men and women

Whether the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) guidelines can be applied to the Asian population remains unclear. We aim to test the hypothesis that adherence to the JNC-7 guidelines is associated with hypertension in a representative sample of the Korean population in the fourth Korea National Health and Nutrition Examination Survey. Participants completed a non-quantitative food frequency questionnaire and 24-hour diet recall through interviews. Blood pressure, height, and weight were directly measured, and questions about physical activity and other lifestyle factors were administered. A total of 500 hypertensive and 4567 normotensive participants were identified. We estimated the odds ratio and 95% confidence intervals using a multivariate logistic regression. The following components of the JNC-7 guidelines were considered: dietary approaches to stop a hypertension style diet, moderate consumption of alcohol, adequate physical activity, and a normal body mass index. Those individuals who fell in the low-risk category for all 4 lifestyle components had an odds ratio of 0.48 (95% confidence interval, 0.30-0.78) compared with the remainder of the participants. In conclusion, we found an inverse association between adherence to the JNC-7 guidelines and hypertension prevalence among Korean adults, suggesting the importance of lifestyle modification for the prevention and management of hypertension.

The risk of child and adolescent overweight is related to types of food consumed

Background/AimsTo investigate the association between the risk of overweight and the consumption of food groups in children and adolescents.MethodsWe studied 1764 healthy children and adolescents (age 6-19y) attending 16 Seventh-Day Adventist schools and 13 public schools using a 106-item non-quantitative food frequency questionnaire from the late 1980 Child-Adolescent Blood Pressure Study. Logistic regression models were used to compute the risk of overweight according to consumption of grains, nuts, vegetables, fruits, meats/fish/eggs, dairy, and, low nutrient-dense foods (LNDF).ResultsThe frequency of consumption of grains, nuts, vegetables and LNDF were inversely related to the risk of being overweight and dairy increased the risk. Specifically, the odds ratio (95% CI) for children in the highest quartile or tertile of consumption compared with the lowest quartile or tertile were as follows: grains 0.59(0.41-0.83); nuts 0.60(0.43-0.85); vegetables 0.67(0.48-0.94); LNDF 0.43(0.29-0.63); and, dairy 1.36(0.97, 1.92).ConclusionThe regular intake of specific plant foods may prevent overweight among children and adolescents.

Comparison of an Electronic Food Diary with a Nonquantitative Food Frequency Questionnaire in Male and Female Smokers and Nonsmokers

Food frequency questionnaires (FFQs) are the preferred method in epidemiologic studies, as they can be administered easily to large population samples at relatively low costs ( (1) Pietinen P. Hartman A.M. Haapa E. Rasanen L. et al. Reproducibility and validity of dietary assessment instruments II. a qualitative food frequency questionnaire. Am J Epidemiol. 1988; 128: 655-666 Google Scholar , (2) Axelson J.M. Csernus M.M. Reliability and validity of a food frequency checklist. J Am Diet Assoc. 1983; 83: 152-155 Google Scholar ). Problems may arise, however, from reporting or transcription errors. Increased variance results, which necessitates longer observation periods and larger numbers of subjects. When short-term effects of interventions or behavioral changes on current dietary intakes are of interest, food diaries appear to be the appropriate method. In addition, depending on the nature of the intervention, these studies are often limited in terms of the length of the observation period and the number of subjects participating. For example, the longer the period of abstinence from transient smoking, the fewer the number of smokers who will be able to pass this period successfully without relapse.

Reliability of Eight-Year Diet Recall in Cancer Cases and Controls

We addressed three questions concerning diet recall in a population of 181 incident cancer cases diagnosed between 1976 and 1984 in the Adventist Health Study, and 225 controls randomly selected from the same population after removing cancer cases: (1) Are recalls of past dietary habits reliable? (2) Does recall ability differ between cancer cases and controls? and (3) Are current or retrospectively recalled reports the best estimator of past dietary practices? Three sets of dietary data were compared using a 35-item nonquantitative food frequency questionnaire: initial reports in 1976, recalled reports obtained retrospectively in 1984, and current reports for 1984. Recall ability was evaluated for individual foods and for all foods combined by comparing recall error scores summing the absolute differences between initial and recalled frequencies. Means and medians for all three food groups were similar for cases and controls. The Spearman rank-order correlations between pairs of reports (initial/recalled, initial/current, and recalled/current) averaged 0.48, 0.41, and 0.62, respectively. A crude difference of 2.0 between cases and controls (p less than 0.05) in the recall error score indicated that cases on the average recalled two foods one frequency category closer to the initial estimate compared with controls. The case-control difference decreased to a nonsignificant 0.4 (p = 0.07) in multivariate analysis that conditioned on dietary changes. On the average, recalled reports estimated initial reports one frequency category closer than did current reports for three foods (p less than 0.001), primarily because of changes in dietary habits.