Application of the method of triads to evaluate the performance of food frequency questionnaires and biomarkers as indicators of long-term dietary intake

Am J Epidemiol. 2001 Dec 15;154(12):1126-35. doi: 10.1093/aje/154.12.1126.


Little is documented about the performance of the food frequency questionnaire (FFQ) in US minority groups and in populations in developing countries. The authors applied a novel technique, the method of triads, to assess the validity and reproducibility of the FFQ among Hispanics. The subjects were men (n = 78) and women (n = 42) living in Costa Rica. Seven 24-hour dietary recalls and two FFQ interviews (12 months apart) were conducted between 1995 and 1998 to estimate dietary intake during the past year. Plasma and adipose tissue samples were collected from all subjects. Validity coefficients, which measure the correlation between observed and "true" dietary intake, were also estimated. The median validity coefficients for tocopherols and carotenoids estimated by dietary recall, the average of the two FFQs, and plasma were 0.71, 0.60, and 0.52, respectively. Compared with adipose tissue, plasma was a superior biomarker for carotenoids and tocopherols. Adipose tissue was a poor biomarker for saturated and monounsaturated fatty acids but performed well for polyunsaturated fatty acids (validity coefficients, 0.45-1.01) and lycopene (validity coefficient, 0.51). This study also showed that biomarkers did not perform better than the FFQ and that they should be used to complement the FFQ rather than substitute for it.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Validation Study

MeSH terms

  • Adipose Tissue / chemistry*
  • Biomarkers / analysis
  • Carotenoids / administration & dosage*
  • Carotenoids / analysis
  • Carotenoids / blood
  • Costa Rica
  • Epidemiologic Research Design
  • Factor Analysis, Statistical
  • Fatty Acids / administration & dosage
  • Fatty Acids / analysis
  • Fatty Acids, Unsaturated / administration & dosage
  • Fatty Acids, Unsaturated / analysis
  • Female
  • Humans
  • Lycopene
  • Male
  • Mental Recall
  • Middle Aged
  • Minority Groups
  • Nutrition Surveys
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Surveys and Questionnaires / standards*
  • Time Factors
  • Tocopherols / administration & dosage*
  • Tocopherols / blood


  • Biomarkers
  • Fatty Acids
  • Fatty Acids, Unsaturated
  • Carotenoids
  • Tocopherols
  • Lycopene