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Public Health Nutr. 2014 Jan;17(1):131-8. doi: 10.1017/S1368980012004946. Epub 2012 Nov 16.

A proposed method to determine fumonisin exposure from maize consumption in a rural South African population using a culturally appropriate FFQ.

Author information

1 Division of Human Nutrition, Stellenbosch University, PO Box 19063, Tygerberg 7505, Cape Town, South Africa.
2 Population Health, Health Systems and Innovation, Human Sciences Research Council, Cape Town, South Africa.
3 Department of Biochemistry, Stellenbosch University, Cape Town, South Africa.
5 School of Health Sciences, Faculty of Health & Behavioural Sciences, University of Wollongong, Wollongong, Australia.



To develop an FFQ for estimating culture-specific maize intake that can distinguish between home-grown and commercial maize. Home-grown maize is more likely to be contaminated with fumonisins, mycotoxins that are associated with increased risk of oesophageal cancer.


An existing FFQ developed for use in urban Xhosa populations was used as the initial framework for the maize-specific FFQ (M-FFQ). The existing questionnaire contained 126 food items divided into ten food groups (bread, cereals, vegetables, fruit, meat, dairy, snacks, condiments, beverages and fat). The M-FFQ was developed based on additional data obtained from a literature search, 24 h recalls (n 159), in-depth interviews (n 4), focus group discussions (n 56) and expert consultation. Food items available in local shops (n 3) were compared with information obtained from focus group discussions.


Five villages in two rural isiXhosa-speaking areas of the Eastern Cape Province, known to have a high incidence of oesophageal cancer, were randomly selected.


Women aged 18-55 years were recruited by snowball sampling and invited to participate.


The final M-FFQ comprised twenty-one maize-based food items, including traditional Xhosa dishes and beverages. The questionnaire focused on maize-specific dishes and distinguished between home-grown maize and commercial maize consumption.


A culturally specific dietary assessment method was designed to determine maize consumption and therefore fumonisin exposure. The questionnaire will be tested against 24 h recalls and other methods to determine its validity, after which it will be used in various epidemiological studies to determine fumonisin exposure.

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