Racial differences in misclassification of healthy eating based on food frequency questionnaire and 24-hour dietary recalls

• Published in: The Journal of nutrition, health & aging Vol. 21; no. 7; pp. 787 - 798
• Main Authors: Olendzki, B., Procter-Gray, E., Magee, M. F., Youssef, G., Kane, K., Churchill, L., Ockene, J., Li, Wenjun
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.07.2017; Springer Nature B.V
• Subjects: African Americans; Aged; Aged, 80 and over; Aging; Black or African American; Cross-Sectional Studies; Diet, Healthy - ethnology; District of Columbia; Exercise; Female; Geriatrics/Gerontology; Humans; Independent Living; Medicine; Medicine & Public Health; Mental Recall; Neurosciences; Nutrition; Nutrition Assessment; Primary Care Medicine; Quality of Life Research; Race; Racial differences; Socioeconomic Factors; Surveys and Questionnaires; White People; District of Columbia; FFQ; healthy eating; race; 24-hour dietary recalls; bias; diet quality; Race
• ISSN: 1279-7707; 1760-4788
• DOI: 10.1007/s12603-016-0839-2

Objectives To examine the agreement in nutrient intake and alternate healthy eating indices (AHEI) between a self-administered Food Frequency Questionnaire (FFQ) and 24-hour recall (24HR) measurements of diet by race, among urban older women. Design Cross-sectional observational study Setting Urban neighborhoods in Washington, DC, USA. Participants Community-dwelling White and Black women aged 65 and older. Measurements In 2014 and 2015, 49 White and 44 Black older women were queried on diet using both FFQ and 24-hour recalls. The correlation coefficients of 55 nutrient intake measures and agreements on healthy eating classification between the two instruments were compared overall and by race. Results The mean correlation coefficient (rho) was 0.46 for Whites and 0.23 for Blacks. For 47 measures, rho was lower for Blacks. Whites had a strong correlation of ≥0.5 for 28 items, while Blacks had strong correlations for only 3 items. Based on FFQ, the mean (SD) of AHEI were 54.0 (10.3) for Whites and 45.9 (8.8) for Blacks (P< 0.001). Based on 24HR, the mean (SD) were 43.9 (10.8) for Whites and 33.2 (9.6) for Blacks (P< 0.001). Using 32 as the cutoff (40% of maximum AHEI score), 50% of Blacks and 14% of Whites were classified as eating unhealthy based on the 24HR, versus 2.6% and 0% based on the FFQ. Conclusion The FFQ has limited ability to accurately assess nutrient intake among older Black women, and tends to underestimate racial differences in healthy eating. The FFQ should be further improved for use in racial disparities research of healthy eating in older age, using a larger sample of older women with racial and geographic diversities.