06.02.2015

Pregnancy food frequency questionnaire

The dietary information was converted from frequency and amount to daily intake in grams per day using a standardized measurement table (Blaker's Norwegian Weight and Measurement Table) (15).
The main feature and strength of the MISA study is the wide range of biological specimens collected from mothers during pregnancy, just after delivery, and 6 weeks postpartum; and from the newborns at birth. No woman had diagnosed hypertension prior to pregnancy, whereas 9.0% had elevated blood pressure (BP) at delivery.
Even though only few women describe themselves as teetotallers, alcohol consumption during pregnancy was minimal. To date, studies of changes in the maternal concentrations during pregnancy and postpartum of organochlorines and of toxic and essential elements have been initiated (22, 36).
Comparison of diet measures from a food-frequency questionnaire with measures from repeated 24-hour dietary recalls. Methodological challenges when monitoring the diet of pregnant women in a large study: experiences from the Norwegian Mother and Child Cohort Study (MoBa).
Changes in maternal blood concentrations of selected essential and toxic elements during and after pregnancy. Associations between marine food consumption and plasma concentrations of POPs in a Norwegian costal population.
Levels of organochlorines and lipids across pregnancy, delivery and postpartum periods in women from Northern Norway. Background: A 50-item self-administered food frequency questionnaire (FFQ) was developed for French adults, to assess the intake of energy, 10 macronutrients, 11 vitamins, and 11 minerals, and to be used in the context of a medical consultation.
The questionnaire used in this study was developed to evaluate daily energy, macronutrient, and micronutrient intake during a medical consultation. There were 50 items in the questionnaire of which 27 were food group items (Table 1) and the others individual foodstuffs, for example, olive oil.
First, the food groups consisted of foodstuff homogenous in terms of energy and their macronutrient content, for example, all fruits were combined into one group. The final list of items was ultimately validated by checking that all food groups contributing to at least 5% of the mean energy, macronutrient, vitamin, or mineral intake of the French population were represented in the 50 items of the FFQ, using data from the second national study of the individual food intake of French adults (14). Nutrient profiles of the 50 items were derived from the French food composition database (FFCD), drawn up by the French Data Centre on Food Quality (CIQUAL, last updated in 2008). The amount of each food item consumed was estimated by multiplying the usual portion size by the mean consumption frequency.
The mean daily energy and nutrient intakes were calculated using Nutrilog software (v2.10d) and the CIQUAL food composition database.


Five hundred and fifteen eligible women were enrolled in early pregnancy, with 391 completing the study protocol that included a self-administrated food frequency questionnaire (FFQ) and donation of biological samples for contaminant analysis in the 2nd trimester, just after delivery, and 6 weeks postpartum. Detailed information on food intake (past and present), lifetime residency, education, income, obstetrical history and pregnancy outcome was obtained on enrolment and subsequently through questionnaires. Details are provided on recruitment, data collection, forms and questionnaires used, the database, the study cohort, and quality control measures taken.
Daily energy and nutrient intakes were calculated using The Norwegian Food Composition Database 2006 (16). This database consists of 200 variables including maternal medical history, previous gestational history and present pregnancy and delivery, as well as medical conditions of the newborn.
This is supplemented by the construction of a database that also includes maternal food-frequency questionnaire information and sociodemographic characteristics, as well as clinical information for both the mother and child. From the feedback received from the field workers and participants, another frequent reason was complications at delivery or postpartum.
In order for it to be completed quickly, many items in the questionnaire were not specific foodstuffs, but food groups, thus reducing the number of items. Second, the intake of a food group needed to be easily evaluated by the subject and hence subgroups were created, if needed.
Every individual food listed in the FFCD that corresponded to an item on the questionnaire (single food or food group) was included with the only exception being foods that are never consumed.
Nutrient intake of subjects was calculated by summing the product of each food item nutrient profile with the corresponding amount of food item consumed. It included information regarding the equivalence between portion size and weight in grams for each main food group and a table for recording food intake. Many contaminants are transferred from mother to the foetus via the placenta during pregnancy (11), and from mother's milk postpartum (12).
After making a pregnancy ultrasound appointment at 1 of 8 selected delivering units and 2 antenatal centres in Northern Norway, pregnant women were invited by mail to participate in this project. Once the available data is fully analyzed, the understanding gained should enhance our knowledge of the interplay between maternal diet, the physiological changes that occur in mothers during pregnancy and postpartum, and contaminant pharmacokinetics (including transfer to the infant before and after birth). In this national report, on average 85% gave information about smoking habits, whereas in the current study 88% did so at the onset of pregnancy and 78% at the end. Several methods have been developed to evaluate individual dietary intake, for example, 24-h dietary recalls (24-HRs), diet records (DRs), or food frequency questionnaires (FFQ).
For each of the 50 items, subjects were asked about the portion size they usually consumed and the mean consumption frequency.


For 7 consecutive days, the subject had to write down what and wherever possible the weight of all food and drink consumed both during meals (breakfast, lunch, and dinner) and between meals. Each subject was asked to first complete the FFQ based on the previous week, then, during the following 7 days, the food record.
The energy, macronutrient (including fiber and cholesterol), and micronutrient (11 vitamins and 11 minerals, see Table 3 for details) content per 100 g of each of the 50 items was calculated as the average of the nutrient composition of each individual foodstuff included in the food group item, using Nutrilog software (v2.10d) on the latest CIQUAL food composition database. Pollutant levels in maternal blood during pregnancy and in mother's milk provide an indication of the exposure risk experienced by the unborn child. A minor adjustment to the NOWAC questionnaire involved the expansion of the fish intake section to obtain more details on this topic. Even though the study subjects consumed wine and beer prior to conception (data not shown), alcohol intake during pregnancy is reported to be low – 8% declared themselves to be teetotallers.
In addition, since they first appeared, FFQs have been improved greatly to become semiquantitative, taking into account not only consumption frequency but also the portion size of a list of food items (generally between 100 and 200 items). A data manager reviewed the completed questionnaires and contacted the subjects if necessary to provide missing information or clarify their responses.
Since in our study no information is available for 22% at the end of pregnancy, the actual prevalence might be higher.
To adequately estimate the intake of polyunsaturated fatty acids, the most frequently consumed oils were listed individually and the fish group was divided into three subgroups, according to their polyunsaturated fatty acid content.
In terms of current use, close to 50% of the respondents stated they used fish oil products regularly (2–7 times a week), and more frequently during the winter season (65%). Four FFQs have been developed and validated for the French population based on lists of 124 (10), 134 (11), 238 (12), and 240 (13) food items. At this stage, six subjects were excluded from the study: four because they did not estimate the quantity of their food intake in the 7-DR and two because too much information was missing in either the 7-DR or the FFQ. Of the 557 women who received a blood sample collection package and questionnaire, 15 did not donate blood; the latter constituted the criterion for participation. Although the time required to complete these questionnaires is less than for a DR, it is still excessive, which limits their use among general practitioners. Daily dietary intake among Norwegian and Sami women was comparable for most food items (22).



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