Download Information Packet 2017

SEMI-QUANTITATIVE FOOD FREQUENCY QUESTIONNAIRES

Three different versions of our semi-quantitative food frequency questionnaire
have been developed at Harvard University and are available for research
purposes. It is the result of over thirty years of continued development,
evaluation, refinement and re-evaluation. It was originally created to be used as a
self-administered, mailed questionnaire. At every step we have attempted to
examine the reproducibility and validity of the questionnaire by comparing its
estimates with those of diet records or multiple 24-hour recalls and with relevant
biochemical indicators of nutrient intakes. Such studies have been conducted
among adults of all ages and both sexes, and among a variety of socio-economic
groups; many of these validation studies have been published. The results of the
validation studies have indicated that the method is remarkably robust; similarly
valid results have been obtained from virtually all the groups that we have
studied. Obviously, the process of continued refinement of the questionnaire can
not stop, in part because the nature of the food supply and the distribution of
dietary intakes is in constant change.

Although the semi-quantitative food frequency questionnaire was developed for
our own research purposes, we are happy to share it with other investigators. This
extended use has obvious advantages in better defining the useful scope and limits
of the methodology, and, sometimes, providing direct information on the degree
of validity in different populations and with various methods of administration.

Although we are not organized as a service group, we have tried to accommodate
the wide variety of requests from different investigators as efficiently as possible
and within the limited constraints of research budgets. For routine questionnaire
processing, this operates quite smoothly at present. We have not always been able
to meet special requests as quickly as desired, but do have a professional team
available to do their best in meeting such requests. Most importantly, we have
strived to maintain the same level of data quality for external users, as we want
for our own research.

We have developed this website for those interested in obtaining copies of the
food frequency questionnaires. There is also a general information file containing
a list of published validation studies, a list of nutrients analyzed, a sample hard
copy output and a pricing list. Due to the volume of investigators interested in
receiving the questionnaires, we ask you to please review the information on
our website to answer general questions.
PLEASE NOTE: ANY SALE OR COMMERCIAL USE OF THE
QUESTIONNAIRE REQUIRES WRITTEN PERMISSION OF OUR
INSTITUTION.
TO: Investigators using the semiquantitative food frequency questionnaires (SFFQ)
FROM: Laura Sampson, Walter Willet
RE: Coding Instructions
An optical scanner is used to read the bar codes and the “skunk marks” along the border
of the SFFQ, as well as the coding bubbles within the body of the SFFQ. Users of the SFFQ must
use only a NO. 2 PENCIL or a NO.1 PENCIL to mark the questionnaire. The scanner will not
recognize ink whether black or blue ink. If the respondent completes the questionnaire in ink, the
responses must be shaded over with pencil.
When the machine reads a page, it reads both sides of the page simultaneously. For this
reason, care must be taken to avoid writing text on top of any bubble or black rectangle on any
page. The scanner sees double responses if writing over bubbles exist. If lead covers the black
rectangles or is present in between the black rectangles, the questionnaire will not scan. Studies
will be responsible for “cleaning up” these errors by transcribing the SFFQ over onto new forms.
To best avoid this possibility, writing, whether in ink or pencil, is only allowed in blank white
margins found on any questionnaire.
Additionally, NEVER WRITE OR PLACE LABELS above the solid bar at the top
of each page. This will interfere with the bar code. If labels must be added onto the
questionnaires, keep them very small and carefully place them only on the top center of
page 1, where it reads “dietary assessment” without covering any coding bubbles (the
box that is shaded blue). If the label is placed too high on the SFFQ, the questionnaire
will eject out of the side of the scanner. IF the label crosses the box outlining question 2
on the SFFQ the scanner will pick up 6+ per day responses on the fruit and vegetable
section on page 2.
Do not add scotch tape, staples, or punch holes to any part of the SFFQ, or submit
questionnaires that are damaged (either wrinkled or torn). All scenarios often cause the
questionnaire to enter the scanner at an incorrect angle or become jammed and torn within the
scanner, further damaging the questionnaire. Again, Studies will be responsible for correcting
these errors which may entail copying SFFQs over to blank forms.
Finally, if self-coded, the SFFQ needs to be “scanner ready”. Please separate each
booklet along their perforation before mailing them in for analysis. Also, please bundle the
SFFQs together in an elastic band. Do NOT paper clip individual questionnaires. You may clip
the SFFQ batch depending on the size of the batch.
.
If you have any questions concerning the completion of the SFFQ, please contact Laura
Sampson at [email protected]. We suggest that you send a copy of your
questionnaires to Laura Sampson for approval if you make any written changes or label additions
to the questionnaire before utilizing in your study. If adherence to the above guidelines is not
followed correctly, investigators need to expect addition processing fees.
BILLING FORM
Please use the Billing form for all requests. Please see Billing Form 2017 on the website.
Dominique S. Michaud, Edward L. Giovannucci, Alberto Ascherio, Eric B. Rimm, Michelle
R. Forman, Laura Sampson, and Walter C. Willett
Associations of Plasma Carotenoid Concentrations and Dietary Intake of Specific Carotenoids
in Samples of Two Prospective Cohort Studies Using a New Carotenoid Database. Cancer
Epidemiology, Biomarkers & Prevention. Vol.7, 283-290, April 1998.
Dietary Assessment
Your Average
Recommended Intake
For ID [ID]
Daily Intake
Age
4-8
9-13
14-18
[calor]
See Diet Assessment
Protein
[prot]%
See Diet
Assessment
Fats
[tfat]%
See Diet
Assessment
Total Calories
Adult
Percentage of Total
Calories From:
-Saturated
-Polyunsaturated
-Monounsaturated
Carbohydrates
[satfat]%
[poly]%
[monfat]%
[carbo]%
See Diet
Assessment
-Sucrose
[sucr]%
Total Protein
[prot]GM
Total Carbohydrates
[carbo] GM
See Diet Assessment
Total Fat
[tfat] GM
See Diet Assessment
Total Cholesterol
[chol] MG
Less Than 300 Mg
Dietary Fiber
[aofib] GM
See Diet Assessment
Vitamin A
[vita] mcg
400
400
600
600
Vitamin C
[vitc] MG
25
25
Vitamin B6
[b6] MG
Vitamin D
0.95
0.95
0.95
0.95
0.85
0.85
0.80
0.80
(M)
(F)
900
700
900
700
(M)
(F)
45
45
75
65
90
75
(M)
(F)
0.6
0.6
1.0
1.0
1.3
1.2
1.3-1.7
1.3-1.5
(M)
(F)
[vitd] IU
600
600
600
600
600
600
600-800
600-800
(M)
(F)
Iron
[iron] MG
10
10
8
8
11
15
8
8-18
(M)
(F)
Calcium
[calc] MG
1000
1300
1300
1000-1200
(M)
GM/KG
Of WGT
1000
1300
1300
1000-1200
(F)
Vitamin B1, Thiamin
[b1] MG
0.6
0.6
0.9
0.9
1.2
1.0
1.2
1.1
(M)
(F)
Vitamin B2, Riboflavin
[b2] MG
0.6
0.6
0.9
0.9
1.3
1.0
1.3
1.1
(M)
(F)
Niacin
[niacin]MG
8
8
12
12
16
14
16
14
(M)
(F)
Vitamin B12
[b12] MCG
1.2
1.2
1.8
1.8
2.4
2.4
2.4
2.4
(M)
(F)
Vitamin E
[vite] MG
7
7
11
11
15
15
15
15
(M)
(F)
Dietary Assessment
Your dietary assessment consists of values we obtained from the food frequency
questionnaire you completed. This assessment includes the percentage of total calories
you obtain from protein, various types of fat, carbohydrates, and sucrose. The assessment
also includes your daily intake of protein, carbohydrates, fats, cholesterol, iron, folic acid,
thiamin, riboflavin, niacin, calcium, and vitamins A, C, D, E, B6, and B12. Please keep in
mind that the totals are calculated from the foods reported on your questionnaire and
these are thus estimates of your usual intake rather than exact numbers.
For each of the nutrients that we have reported, we have included a recommended daily
intake. Most of these values are based on the current dietary reference intakes or DRI’s.
These values include the Recommended Dietary Allowance (RDA), the Adequate Intake
(AI), the Tolerable Upper Intake Level (UL), and the Estimated Average Requirement
(EAR). RDA’s are the average daily dietary intake that meets the nutrient requirements of
almost all healthy individuals in a particular gender and age. The EAR is the daily intake
value that is estimated to meet the requirements of half the healthy individuals of a
particular age and gender. However, when there is not enough scientific evidence to
calculate an EAR, an AI is provided. It is a value based on experimentally derived intake
levels from assessing a group of healthy individuals. The UL is the highest level of daily
nutrient intake that is likely to pose no risk of adverse health effects in most individuals
in a specified age group. These values together create the reference values called the
DRI’s. (1)
There are nutrients for which no DRI’s exist. For those nutrients RDA’s will be
provided instead. However, none of these recommendations should be confused with
your own individual requirements, which can vary according to age, body size, state of
health, and lifestyle.
Calories
Calories are derived from the protein, fats, and carbohydrates in food and are
required for everyday bodily activities. Alcohol can also contribute to caloric
consumption. The amount of calories required for an individual varies depending on their
age, gender, height, weight and level of physical activity. The calories consumed will
depend on the need to lose, maintain, or gain weight. (1) A body weight range from
underweight, healthy weight, overweight, to obese can be determined through a tool
called BMI or Body Mass Index. This tool measures weight in kilograms with height in
meters squared and can give a range of high or low from what is considered healthy
weight. Useful charts and BMI tools can be found at mypyramid.gov (1)
The most common form of malnutrition in the US is obesity. It can lead to many health
problems including type-2 diabetes, heart disease, and some forms of cancer. If your
body weight is higher than what is considered healthy weight, you are probably
consuming more calories than your body needs. If you would like to lose weight, it
should be done gradually. Achieving your weight goal depends on acquiring healthy
eating and exercise habits.
To achieve or maintain healthy weight:
- Avoid soda and other sugar-sweetened beverages
- Limit fruit juices.
- limit consumption of trans fatty acids as much as possible, by avoiding
ingredients containing “partially hydrogenated” shortening or oils and limit other
solid fats
- consume smaller portions
- limit intake of potatoes and refined grains, such as white bread and white rice
- increase dietary fiber by consuming foods such as whole grains, bran, vegetables,
fruits, beans and legumes
- limit added sugar and added sodium in foods
- limit red and processed meats
- limit alcohol intake to a moderate amount
- be physically active everyday
Carbohydrates, Protein and Fats
The Harvard School of Public Health maintains a website,
http://www.hsph.harvard.edu/nutritionsource/, designed to provide timely information on
diet and nutrition for clinicians, allied health professionals, and the public. Please refer to
this website for the latest suggestions and information on carbohydrates, protein and fats.
Cholesterol
Cholesterol is not used for energy even though it is grouped with fats.
However, cholesterol does have some important uses. Cholesterol is needed to make bile
salts and steroid hormones. It also is needed for the synthesis of hormones. Our bodies
can produce enough cholesterol even if it is not consumed daily. Excessive consumption
of cholesterol is correlated with an increase risk of cardiovascular disease. The American
Heart Association recommends that healthy adults consume less than 300 mg of
cholesterol per day. However, adults living with heart disease should consume no more
then 200 mg of cholesterol per day. (1) To achieve this goal, practice the following
recommendations:
- Pick nuts, fish, poultry, dried beans as your protein sources
- Moderate your intake of eggs and liver (1 egg yolk = 200mg of
cholesterol)
- Limit use of red meat, cheese, butter and cream
--Use liquid vegetable oils as the main source of fat (including
olive, canola, soy, corn, safflower oils)
- Lower your intake of hydrogenated margarine, shortenings, and
coconut oils (These products do not contain cholesterol, but they
tend to raise blood cholesterol levels)
- Trim off excess fat
Important Sources:
organ meats (liver), egg yolks, fish roe, all types of meat, butter,
cheese, other dairy products
Vitamin A
Vitamin A is a fat-soluble vitamin that occurs in two forms. One form is retinol,
which is found in animal sources and the other is carotene, which is found in vegetable
sources. This vitamin is required for maintaining healthy vision, gene expression,
reproduction, embryonic development, growth, immune function, and for maintaining
healthy skin. Vitamin A is also an important antioxidant. An antioxidant prevents cancer
and hardening of the arteries. The RDA for Vitamin A is 900 mcg retinol activity
equivalents (RAE)/day for men and 700 mcg RAE/day for women. Intake of more then
3,000 mcg/day of preformed vitamin A can be toxic to your body.
Important Sources:
retinol: liver, fish liver oils, egg yolk, red meats, and fortified
foods
carotene: deep-yellow and deep-green leafy vegetables, carrots,
cantaloupe, apricots
Vitamin C
Vitamin C is a water-soluble vitamin. It is also referred to as ascorbic acid.
Vitamin C is another important antioxidant that can also enhance iron absorption in the
body. The vitamin is essential for building strong cells and blood vessels, as well as
healing wounds and broken bones. The current DRI for vitamin C is 90mg for men and
75 mg for women. It is recommended that smokers should have an extra 35mg
everyday.(1) Excess vitamin C is excreted in urine and not considered harmful, but large
doses of 600mg or more can result in diarrhea. Please refer to the DRI chart at the end of
the handout for age and gender specific recommendations.
Important Sources:
Vitamin D
fruits (citrus, cantaloupe, strawberries, tomatoes) and vegetables
(fresh potatoes and leafy green vegetables), supplemented cereals
Vitamin D is a fat-soluble vitamin essential for building and maintaining bone
health and increasing evidence shows vitamin D may play a vital role in heart health and
immune support. Studies have reported associations between low levels of vitamin D and
possible increased risk of certain cancers, type 1 diabetes, multiple sclerosis, and the
decreased ability to fight infectious disease such as flu and tuberculosis. (2) Vitamin D
sources are either naturally occurring or supplemented in the foods we eat, as well as
synthesized by the body when the skin is exposed to sunlight, but how much is produced
through the skin depends on many factors. The DRI recommends 600 IU of vitamin D a
day for both men and women. It has been argued by many that this is a very conservative
estimate based on emerging studies. Tolerable Upper Level Intakes have been set at
4,000 IUs for adults. Vitamin D intakes much higher than 10,000 IU per day have caused
toxicity, including neurologic damage.
Important Sources:
fatty fish, liver oils, egg yolk, fortified milk, supplemented cereals
Vitamin E
Vitamin E is a fat-soluble vitamin and an antioxidant. It helps prevent oxidation
of unsaturated fatty acids and cholesterol, as well as prevent damage to cell membranes
and atherosclerosis (hardening of the arties). The DRI recommends 15mg for both men
and women. (1) Please look at the end of the handout for age and gender specific
recommendations. The Tolerable Upper Intake level for adults has been set at
1,000mg/day of any form of supplemental alpha tocopherol based on the adverse effect of
increased tendency to hemorrhage.(1)
Important Sources:
wheat germ, vegetable oils, nuts, whole grains, dark green leafy
vegetables, supplemented cereals
Vitamin B6
Vitamin B6 is a water-soluble vitamin that is also called pyridoxine. This vitamin
is essential for amino acid or protein metabolism and necessary for the conversion of the
amino acid tryptophan to the vitamin called niacin. It is also needed for the formation of
antibodies and hemogloblin and helps maintain a healthy nervous system. The DRI for
both males and females is 1.3mg. Please look at the DRI chart for specific age and gender
recommendations. The Tolerable Upper Level for adults is 100mg/day. An adverse effect
from high intake of Vitamin B6 is sensory neuropathy. (1)
Important Sources:
Vitamin B1
meat, poultry, and fish (less important sources: potatoes, sweet
potatoes, tomatoes, spinach), supplemented cereal
Vitamin B1 is also known as thiamin. This water-soluble vitamin is essential
because it is needed for metabolism of carbohydrates and branch-chain amino acids. The
DRI recommends 1.2 mg for males and 1.1 mg for females. If you would like age and
gender specific values, please refer to the DRI chart at the end of the handout. Data is
insufficient concerning adverse effects and therefore no Tolerable Upper Intake Level has
been set for Vitamin B1. (1)
Important Sources:
lean meats, liver, fish, eggs, whole grains, leafy green vegetables,
legumes, supplemented cereal
Vitamin B2
Vitamin B2 is also called riboflavin. This essential water-soluble vitamin
forms two coenzymes that work together to help metabolize sugars, fats, and proteins.
The DRI recommends 1.3 mg of B2 for men and 1.1 mg for women. Specific
recommendations for age and gender can be found on the DRI chart at the end of the
handout. Data is insufficient concerning adverse effects and therefore no Tolerable Upper
Intake Level has been set for Vitamin B2. (1)
Important Sources:
liver, yeast, egg white, whole grains, meat, poultry, fish, legumes;
major source is milk, supplemented cereal
Vitamin B12
Vitamin B12 is a water-soluble vitamin that is also called cyanocobalamin. It acts in the
synthesis of DNA and when absent from the diet red blood cells do not divide properly.
B12 is also essential for synthesis of some amino acids. The DRI recommends that men
and women consume 2.4 ug per day. (1) Look at the end of the handout for the DRI chart
for specific recommendations based on age and gender. Data is insufficient concerning
adverse effects and therefore no Tolerable Upper Intake Level has been set for Vitamin
B12. (1)
Important Sources:
liver, meat, poultry, fish, dairy foods except butter, eggs,
not found in plant foods, supplemented cereal
Niacin
Niacin is a water-soluble vitamin that is involved in glycolosis, oxidative
phosphorylation, and fat breakdown. It also inhibits cholesterol synthesis. The DRI
recommends that men consume 16 mg and women 14 mg per day. (1) Excessive intake of
niacin can lead to hyperglycemia, flushed skin, tingling sensations and possible liver
damage. The Tolerable Upper Intake Level for niacin in adults is 35mg/day. (1) Specific
recommendations for age and gender are on the DRI chart at the end of the handout.
Important Sources:
poultry, meat, fish. Less important sources are liver, yeast, peanuts,
potatoes, leafy green vegetables
Iron
Iron is an essential mineral necessary for healthy red blood cells, synthesis of
collagen, and as a mediator of oxidative processes. It also helps bind oxygen for
transportation in the blood. The DRI for men is 8 mg and women 18 mg a day of iron.
(1)The Tolerable Upper Intake Level for adults is 45mg/day. (1) Excess iron intake can
cause damage to the liver, heart, and pancreas. Look at the DRI chart at the end of the
handout for age and gender specific recommendations.
Important Sources:
meat, liver, shellfish, egg yolk, dried fruit, nuts, legumes,
molasses, supplemented cereals
Calcium
Calcium is a mineral that is essential for bone health. The DRI for calcium varies
considerably depending on age and gender. Look for the recommendation most
appropriate for you on the DRI chart at the end of the handout. However, these levels are
high compared to other review groups; for example the World Health Organization has
concluded that 500 mg per day is adequate intake for adults. An excessive intake of
calcium is not recommended because it can cause depressed neural function, confusion,
weakness, and kidney stones.
Important Sources: Milk, milk products, leafy green vegetables, fortified orange juice,
supplemented cereal
References
1. “Dietary Reference Intakes”. The National Academies. Retrieved April 22,
2011 from the World Wide Web:
http://iom.edu/Activities/Nutrition/SummaryDRIs/~/media/Files/Activity%20File
s/Nutrition/DRIs/RDA%20and%20AIs_Vitamin%20and%20Elements.pdf.
2. Nutrition Source. Harvard School of Public Health. Retrieved May 11, 2011
from the World Wide Web:
http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vitamind/index.html#vitamin-d-references
DRI Chart
Category
Age
Vit C
Vit D
Vit E
Vit B1
Vit B2
Niacin
Vit B6
Vit A
Calicum
Infants
0-6 mo
40 mg
400 IU
4 mg
.2 mg
.3 mg
2 mg
.1 mg
400 mcg
200 mg
Infants
7-12 mo
50mg
400 IU
5 mg
.3 mg
.4 mg
4 mg
.3 mg
500 mcg
260 mg
Children
1-3 yr
15 mg
600 IU
6 mg
.5 mg
.5 mg
6 mg
.5 mg
300 mcg
700 mg
Children
4-8 yr
25 mg
600 IU
7 mg
.6 mg
.6 mg
8 mg
.6 mg
400 mcg
1,000 mg
Males
9-13 yr
45 mg
600 IU
11 mg
.9 mg
.9 mg
12 mg
1.0 mg
600 mcg
1,300 mg
Males
14-18 yr
75 mg
600 IU
15 mg
1.2 mg
1.3 mg
16 mg
1.3 mg
900 mcg
1,300 mg
Males
19-30 yr
90 mg
600 IU
15 mg
1.2 mg
1.3 mg
16 mg
1.3 mg
900 mcg
1,000 mg
Males
31-50 yr
90 mg
600 IU
15 mg
1.2 mg
1.3 mg
16 mg
1.3 mg
900 mcg
1,000 mg
Males
51-70 yr
90 mg
600 IU
15 mg
1.2 mg
1.3 mg
16 mg
1.7 mg
900 mcg
1,000 mg
Males
> 70 yr
90 mg
800 IU
15 mg
1.2 mg
1.3 mg
16 mg
1.7 mg
900 mcg
1,200 mg
Females
9-13 yr
45 mg
600 IU
11 mg
.9 mg
.9 mg
12 mg
1.0 mg
600 mcg
1,300 mg
Females
14-18 yr
65 mg
600 IU
15 mg
1.0 mg
1.0 mg
14 mg
1.2 mg
700 mcg
1,300 mg
Females
19-30 yr
75 mg
600 IU
15 mg
1.1 mg
1.1 mg
14 mg
1.3 mg
700 mcg
1,000 mg
Females
31-50 yr
75 mg
600 IU
15 mg
1.1 mg
1.1 mg
14 mg
1.3 mg
700 mcg
1,000 mg
Females
51-70 yr
75 mg
600 IU
15 mg
1.1 mg
1.1 mg
14 mg
1.5 mg
700 mcg
1,200 mg
Females
> 70 yr
75 mg
800 IU
15 mg
1.1 mg
1.1 mg
14 mg
1.5 mg
700 mcg
1,200 mg
(8)
RDA
Chart
Category
Age
Iron
Protein
Carbohydrate
Infants
0-6 mo
.27 mg
9.1 g
60 g
Infants
7-12 mo
11 mg
11.0g
95 g
Children
1-3 yr
7 mg
13 g
130 g
Children
4-8 yr
10 mg
19 g
130 g
Male
9-13 yr
8 mg
34 g
130 g
Male
14-19 yr
11 mg
52 g
130 g
Male
19-30 yr
8 mg
56 g
130 g
Male
31-50 yr
8 mg
56 g
130 g
Male
50-70 yr
8 mg
56 g
130 g
Male
>70 yr
8 mg
56 g
130 g
Female
9-13 yr
8 mg
34 g
130 g
Female
14-19 yr
15 mg
46 g
130 g
Female
19-30 yr
18 mg
46 g
130 g
Female
31-50 yr
18 mg
46 g
130 g
Female
50-70 yr
8 mg
46 g
130 g
Female
>70 yr
8 mg
46 g
130 g
(8)