European Journal of Nutrition

, Volume 53, Issue 2, pp 549–555

Validity of food frequency questionnaire-based estimates of long-term long-chain n-3 polyunsaturated fatty acid intake

  • Alice Wallin
  • Daniela Di Giuseppe
  • Ann Burgaz
  • Niclas Håkansson
  • Tommy Cederholm
  • Karl Michaëlsson
  • Alicja Wolk
Original Contribution



To evaluate how long-term dietary intake of long-chain n-3 polyunsaturated fatty acids (LCn-3 PUFAs), estimated by repeated food frequency questionnaires (FFQs) over 15 years, is correlated with LCn-3 PUFAs in adipose tissue (AT).


Subcutaneous adipose tissue was obtained in 2003–2004 (AT-03) from 239 randomly selected women, aged 55–75 years, after completion of a 96-item FFQ (FFQ-03). All participants had previously returned an identical FFQ in 1997 (FFQ-97) and a 67-item version in 1987–1990 (FFQ-87). Pearson product-moment correlations were used to evaluate associations between intake of total and individual LCn-3 PUFAs as estimated by the three FFQ assessments and AT-03 content (% of total fatty acids).


FFQ-estimated mean relative intake of LCn-3 PUFAs (% of total fat intake) increased between all three assessments (FFQ-87, 0.55 ± 0.34; FFQ-97, 0.74 ± 0.64; FFQ-03, 0.88 ± 0.56). Validity, in terms of Pearson correlations between FFQ-03 estimates and AT-03 content, was 0.41 (95 % CI 0.30–0.51) for total LCn-3 PUFA and ranged from 0.29 to 0.48 for individual fatty acids; lower correlation was observed among participants with higher percentage body fat. With regard to long-term intake estimates, past dietary intake was also correlated with AT-03 content, with correlation coefficients in the range of 0.21–0.33 and 0.21–0.34 for FFQ-97 and FFQ-87, respectively. The correlations were improved by using average estimates from two or more FFQ assessments. Exclusion of fish oil supplement users (14 %) did not alter the correlations.


These data indicate reasonable validity of FFQ-based estimates of long-term (up to 15 years) LCn-3 PUFA intake, justifying their use in studies of diet-disease associations.


Adipose tissue Dietary assessment Food frequency questionnaire Long-chain n-3 fatty acids Validation 


  1. 1.
    Mozaffarian D, Wu JH (2011) Omega-3 fatty acids and cardiovascular disease: effects on risk factors, molecular pathways, and clinical events. J Am Coll Cardiol 58:2047–2067CrossRefGoogle Scholar
  2. 2.
    Whelton SP, He J, Whelton PK, Muntner P (2004) Meta-analysis of observational studies on fish intake and coronary heart disease. Am J Cardiol 93:1119–1123CrossRefGoogle Scholar
  3. 3.
    He K, Song Y, Daviglus ML, Liu K, Van Horn L, Dyer AR, Goldbourt U, Greenland P (2004) Fish consumption and incidence of stroke: a meta-analysis of cohort studies. Stroke 35:1538–1542CrossRefGoogle Scholar
  4. 4.
    Arab L, Akbar J (2002) Biomarkers and the measurement of fatty acids. Public Health Nutr 5:865–871CrossRefGoogle Scholar
  5. 5.
    Beynen AC, Hermus RJ, Hautvast JG (1980) A mathematical relationship between the fatty acid composition of the diet and that of the adipose tissue in man. Am J Clin Nutr 33:81–85Google Scholar
  6. 6.
    Burdge G (2004) Alpha-linolenic acid metabolism in men and women: nutritional and biological implications. Curr Opin Clin Nutr Metab Care 7:137–144CrossRefGoogle Scholar
  7. 7.
    Bergström L, Kylberg E, Hagman U, Erikson H, Bruce A (1991) The food composition database KOST: the National Administration’s information system for nutritive values of food. Vår Föda 43:439–447Google Scholar
  8. 8.
    Beynen AC, Katan MB (1985) Rapid sampling and long-term storage of subcutaneous adipose-tissue biopsies for determination of fatty acid composition. Am J Clin Nutr 42:317–322Google Scholar
  9. 9.
    The Swedish Board of Agriculture Statistics Database. Accessed Mar 2013
  10. 10.
    Becker W (1994) Befolkningens kostvanor och näringsintag i Sverige 1989. Metod-och resultatanalys (Dietary habits and nutrient intake in Sweden 1989. The first national food consumption survey). The Swedish National Food Agency, UppsalaGoogle Scholar
  11. 11.
    Becker W, Pearson M (2002) Riksmaten 1997–98. Befolkningens kostvanor och näringsintag. Metod-och resultatanalys (Dietary habits and nutrient intake 1997–98. The second national food consumption survey). The Swedish National Food Agency, UppsalaGoogle Scholar
  12. 12.
    Amcoff E, Edberg A, Barbieri HE, Lindroos A, Nälsén C, Pearson M, Lemming EW (2012) Riksmaten–vuxna 2010–11. Livsmedels-och näringsintag bland vuxna i Sverige (Dietary habits and nutrient intake in Sweden 2010-11. The third national food consumption survey). The Swedish National Food Agency, UppsalaGoogle Scholar
  13. 13.
    Wolk A, Ljung H, Vessby B, Hunter D, Willett WC (1998) Effect of additional questions about fat on the validity of fat estimates from a food frequency questionnaire. Study Group of MRS SWEA. Eur J Clin Nutr 52:186–192CrossRefGoogle Scholar
  14. 14.
    London SJ, Sacks FM, Caesar J, Stampfer MJ, Siguel E, Willett WC (1991) Fatty acid composition of subcutaneous adipose tissue and diet in postmenopausal US women. Am J Clin Nutr 54:340–345Google Scholar
  15. 15.
    Hunter DJ, Rimm EB, Sacks FM, Stampfer MJ, Colditz GA, Litin LB, Willett WC (1992) Comparison of measures of fatty acid intake by subcutaneous fat aspirate, food frequency questionnaire, and diet records in a free-living population of US men. Am J Epidemiol 135:418–427Google Scholar
  16. 16.
    Tjonneland A, Overvad K, Thorling E, Ewertz M (1993) Adipose tissue fatty acids as biomarkers of dietary exposure in Danish men and women. Am J Clin Nutr 57:629–633Google Scholar
  17. 17.
    Godley PA, Campbell MK, Miller C, Gallagher P, Martinson FE, Mohler JL, Sandler RS (1996) Correlation between biomarkers of omega-3 fatty acid consumption and questionnaire data in African American and Caucasian United States males with and without prostatic carcinoma. Cancer Epidemiol Biomarkers Prev 5:115–119Google Scholar
  18. 18.
    Andersen LF, Solvoll K, Johansson LR, Salminen I, Aro A, Drevon CA (1999) Evaluation of a food frequency questionnaire with weighed records, fatty acids, and alpha-tocopherol in adipose tissue and serum. Am J Epidemiol 150:75–87CrossRefGoogle Scholar
  19. 19.
    Baylin A, Kim MK, Donovan-Palmer A, Siles X, Dougherty L, Tocco P, Campos H (2005) Fasting whole blood as a biomarker of essential fatty acid intake in epidemiologic studies: comparison with adipose tissue and plasma. Am J Epidemiol 162:373–381CrossRefGoogle Scholar
  20. 20.
    Baylin A, Kabagambe EK, Siles X, Campos H (2002) Adipose tissue biomarkers of fatty acid intake. Am J Clin Nutr 76:750–757Google Scholar
  21. 21.
    Holmes MD, Powell IJ, Campos H, Stampfer MJ, Giovannucci EL, Willett WC (2007) Validation of a food frequency questionnaire measurement of selected nutrients using biological markers in African-American men. Eur J Clin Nutr 61:1328–1336CrossRefGoogle Scholar
  22. 22.
    Ascherio A, Rimm EB, Stampfer MJ, Giovannucci EL, Willett WC (1995) Dietary intake of marine n-3 fatty acids, fish intake, and the risk of coronary disease among men. N Engl J Med 332:977–982CrossRefGoogle Scholar
  23. 23.
    Lopes C, Aro A, Azevedo A, Ramos E, Barros H (2007) Intake and adipose tissue composition of fatty acids and risk of myocardial infarction in a male Portuguese community sample. J Am Diet Assoc 107:276–286CrossRefGoogle Scholar
  24. 24.
    Willett WC (1998) Nutritional epidemiology, 2nd edn. Oxford University Press, New YorkCrossRefGoogle Scholar
  25. 25.
    Marckmann P, Lassen A, Haraldsdottir J, Sandstrom B (1995) Biomarkers of habitual fish intake in adipose tissue. Am J Clin Nutr 62:956–959Google Scholar
  26. 26.
    Popp-Snijders C, Blonk MC (1995) Omega-3 fatty acids in adipose tissue of obese patients with non-insulin-dependent diabetes mellitus reflect long-term dietary intake of eicosapentaenoic and docosahexaenoic acid. Am J Clin Nutr 61:360–365Google Scholar
  27. 27.
    Calder PC, Yaqoob P (2009) Understanding omega-3 polyunsaturated fatty acids. Postgrad Med 121:148–157CrossRefGoogle Scholar
  28. 28.
    Overby NC, Serra-Majem L, Andersen LF (2009) Dietary assessment methods on n-3 fatty acid intake: a systematic review. Br J Nutr 102(Suppl 1):S56–S63CrossRefGoogle Scholar
  29. 29.
    Heitmann BL, Lissner L (1995) Dietary underreporting by obese individuals–is it specific or non-specific? BMJ 311:986–989CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Alice Wallin
    • 1
  • Daniela Di Giuseppe
    • 1
  • Ann Burgaz
    • 1
  • Niclas Håkansson
    • 1
  • Tommy Cederholm
    • 2
  • Karl Michaëlsson
    • 3
  • Alicja Wolk
    • 1
  1. 1.Division of Nutritional Epidemiology, Institute of Environmental MedicineKarolinska InstitutetStockholmSweden
  2. 2.Department of Public Health and Caring Sciences, Clinical Nutrition and MetabolismUppsala UniversityUppsalaSweden
  3. 3.Department of Surgical Sciences, Section of OrthopedicsUppsala UniversityUppsalaSweden

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