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Br J Nutr. 2013 Feb 28;109(4):736-47. doi: 10.1017/S0007114512002012. Epub 2012 May 23.

Evaluation of food and nutrient intake assessment using concentration biomarkers in European adolescents from the Healthy Lifestyle in Europe by Nutrition in Adolescence study.

Author information

Scientific Institute of Public Health, J. Wytsmanstraat 14, 1050, Brussels, Belgium.
Division of Human Nutrition, Wageningen University, PO Box 8129, 6700 EV Wageningen, The Netherlands.
Institut für Ernährungs- und Lebensmittelwissenschaften-Humanernährung, Rheinische Friedrich-Wilhelms Universität, Bonn, Germany.
Institut Pasteur de Lille, INSERM U744, Université Lille Nord de France, F-59000 Lille, France.
GENUD (Growth, Exercise, Nutrition and Development) Research Group, School of Health Sciences (EUCS), University of Zaragoza, C/ Domingo Miral s/n, 50009 Zaragoza, Spain.
Dutch National Institute of Public Health and the Environment, RIVM, PO Box 1, 3720 BA Bilthoven, The Netherlands.
Division of Biometry and Data Management, Bremen Institute for Prevention Research and Social Medicine, Bremen, Germany.
Dietary Exposure Assessment Group, International Agency for Research on Cancer (IARC), Lyon, France.
Department of Medical Physiology, Faculty of Medicine, Avenida Madrid n/s, 18012, Granada, Spain.
Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 2 Blok A, B-9000 Ghent, Belgium.
CIC-9301-Inserm-CH&U and Inserm U995, IFR114, IMPRT, Centre Hospitalier & Universitaire de Lille, Université Nord de France, France.
Department of Nutrition and Dietetics, Harokopio University, El, Venizelou 70, Athens, 17671, Greece.
INRAN - National Research Institute for Food and Nutrition, Via Ardeatina 546, 00178 Rome, Italy.
Unit of Preventive Nutrition, Karolinska Institute, 14157 Huddinge, Sweden.
Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council, Madrid, Spain.
Department of Pediatrics, Medical Faculty, University of Pécs, József A. u. 7., 7623 Pécs, Hungary.


Accurate food and nutrient intake assessment is essential for investigating diet-disease relationships. In the present study, food and nutrient intake assessment among European adolescents using 24 h recalls (mean of two recalls) and a FFQ (separately and the combination of both) were evaluated using concentration biomarkers. Biomarkers included were vitamin C, β-carotene, DHA+EPA, vitamin B12 (cobalamin and holo-transcobalamin) and folate (erythrocyte folate and plasma folate). For the evaluation of the food intake assessment 390 adolescents were included, while 697 were included for the nutrient intake assessment evaluation. Spearman rank and Pearson correlations, and validity coefficients, which are correlations between intake estimated and habitual true intake, were calculated. Correlations were higher between frequency of food consumption (from the FFQ) and concentration biomarkers than between mean food intake (from the recalls) and concentration biomarkers, especially for DHA+EPA (r 0·35 v. r 0·27). Most correlations were higher among girls than boys. For boys, the highest validity coefficients were found for frequency of fruit consumption (0·88) and for DHA+EPA biomarker (0·71). In girls, the highest validity coefficients were found for fruit consumption frequency (0·76), vegetable consumption frequency (0·74), mean fruit intake (0·90) and DHA+EPA biomarker (0·69). After exclusion of underreporters, correlations slightly improved. Correlations between usual food intakes, adjusted for food consumption frequency, and concentration biomarkers were higher than correlations between mean food intakes and concentration biomarkers. In conclusion, two non-consecutive 24 h recalls in combination with a FFQ seem to be appropriate to rank subjects according to their usual food intake.

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