Dietary Questionnaire for Epidemiological Studies

(DQES v2)

User Information Guide

2009

Cancer Epidemiology Centre

Nutritional Assessment Office
Cancer Council Victoria
1 Rathdowne Street
Carlton Vic 3053

ffq@cancervic.org.au
Phone: 03 9635-5603
Fax: 03 9635-5330
http://www.cancervic.org.au/dqes

Updated: January 2009

 TABLE OF CONTENTS

1 INTRODUCTION.........................................................................................................................3

2 QUESTIONNAIRE EVALUATION..............................................................................................5

3 SOURCES OF NUTRITIONAL DATA........................................................................................5

4 ADMINISTRATION OF THE QUESTIONNAIRE........................................................................6

5 ALCOHOL CALCULATIONS IN THE FFQ................................................................................8

6 SCANNING ERRORS.................................................................................................................8

7 BARCODE LABELS...................................................................................................................9

8 OUTPUT FROM SCANNED QUESTIONNAIRES .....................................................................10

9 REFERENCING THE FOOD FREQUENCY QUESTIONNAIRE ...............................................18

10 PROCEDURE FOR PROCESSING QUESTIONNAIRES..........................................................18

11 CONTACT US.............................................................................................................................19

12 REFERENCES............................................................................................................................19

13 ORDER/MOU FORM (APPENDIX A).........................................................................................20

14 HOW TO FILL IN A QUESTIONNAIRE (APPENDIX B)............................................................22

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1 Introduction
Food frequency questionnaires have developed as a means of assessing usual diet in large-
scale epidemiological studies (1), and are not intended to replace careful diet histories or
recalls in one-to-one nutritional counselling (2). In most epidemiological applications the aim
of the FFQ is to rank people according to intake, although for translation into public health
recommendations it is necessary to measure absolute intakes. In FFQ’s it is necessary to
compromise between including enough foods to reflect intake accurately and not including so
many that participants do not complete the questionnaire (1).

Because FFQ’s usually ask about intake over the previous 12 months, and may not be
sensitive to small changes in intake, they may not be appropriate for measuring short-term
dietary change in response to interventions. In a study of 397 women, FFQ’s and four 24-
hour recalls were used to measure dietary change from baseline to 1 year post-intervention.
Both instruments were able to detect dietary change in the desired direction, over this period
(3), but the FFQ was modified specifically “to ensure that the food items and dietary
practices associated with the prescribed intervention were adequately represented in the
instrument”, and the reference period was only the last 3 months. If, for example the
intervention is about reducing fat intake by trimming fat from meat and skin from chicken,
these behaviours need to be included on the FFQ.

The original FFQ, developed by Willet for the Nurse’s Health Study, included only 61 items
and accounted for between 60 and 80% of intakes for most nutrients, compared with those
estimated by four 1-week diet records. For an enlarged FFQ with 116-items, over 90% of
most nutrients were accounted for. Other data provided by Willett showed that the mean
energy intakes for 27 men and women for the 116-item FFQ and 1-year diet records were
reasonably similar. However, for each person the agreement is likely to be much less (1).

The Observing Protein and Energy Nutrition (OPEN) study used urinary nitrogen and doubly
labelled water as biomarkers to assess a FFQ, this showed that both protein and energy
intakes were considerably under-estimated by the FFQ, although the percentage of energy
from protein was not under-reported (4). A sub-study of EPIC showed reasonable
correlations of protein (n=134) and energy (n=28) intakes with biomarkers, however, all but
one person under-reported energy intake (5). Correlations with a ‘gold standard’ method are
typically used as the main measure of validity for FFQ’s, reflecting the main purpose of
ranking, rather than absolute nutrient intake measurement.

There are a number of different methods of assessing dietary intake, and the appropriate
method depends on the intended end use of the information. If a FFQ is suitable for your
needs, it is ideal to develop and validate a dietary tool for your specific study and population,
but this is usually not practical (6). If you are using a pre-existing questionnaire, such as the
Cancer Council Victoria Dietary Questionnaire (CCVDQ), it is important to consider its
suitability for your particular study. The CCVDQ is a modification of a FFQ that was
developed in the late 1980’s to measure diet in the Melbourne Collaborative Cohort Study
(MCCS). The MCCS participants are men and women aged 40-69 at recruitment between
1990 to 94, who were born in Australia, Greece and Italy, and the food list on the original
FFQ was based on weighed food records in 810 demographically similar volunteers. The
only validation of the CCVDQ was conducted in a group of women aged 16-48 years (mean
33 yrs), and showed correlation coefficients for nutrient intakes comparable with those
reported for other FFQ’s (7). The CCVDQ is not recommended for children, or younger
people in general, as it does not include soft drinks/electrolyte drinks for example, which
contributed only around 4-5% of energy, but 16-21% of sugar in males and females aged 12-
18 years in the 1995 National Nutrition Survey (8).

We believe that the CCV DQ is a suitable tool for assessing intakes of foods and nutrients
among adults in epidemiological studies, subject to the limitations common to all FFQ’s. For

Page 3 of 22
other uses, where more detail about diet is required, or where a very different population is
being studied, we cannot be confident about the suitability of this instrument.

1. Willett W: Nutritional Epidemiology. In Monographs in Epidemiology and Biostatistics, Second ed.

Kelsey JL, Marmot MG, Stolley PD, Vessey MP, Eds. New York, Oxford University Press, 1998, p. 514
2. Gibson RS: Principles of nutritional assessment. New York, Oxford University Press, 1990
3. Thomson CA, Giuliano A, Rock CL, Ritenbaugh CK, Flatt SW, Faerber S, Newman V, Caan B,
Graver E, Hartz V, Whitacre R, Parker F, Pierce JP, Marshall JR: Measuring dietary change in a diet
intervention trial: comparing food frequency questionnaire and dietary recalls. Am J Epidemiol
157:754-762, 2003
4. Subar AF, Kipnis V, Troiano RP, Midthune D, Schoeller DA, Bingham S, Sharbaugh CO, Trabulsi J,
Runswick S, Ballard-Barbash R, Sunshine J, Schatzkin A: Using Intake Biomarkers to Evaluate the
Extent of Dietary Misreporting in a Large Sample of Adults: The OPEN Study. Am. J. Epidemiol.
158:1-13, 2003
5. Kroke A, Klipstein-Grobusch K, Voss S, Möseneder J, Thielecke F, Noack R, Boeing H: Validation
of a self-administered food-frequency questionnaire administered in the European Prospective
Investigation into cancer and Nutrition (EPIC) Study: comparison of energy, protein, and macronutient
intakes estimated with the doubly labeled water, urinary nitrogen, and repeated 24-h dietary recall
methods. Am J Clin Nutr 70:439-447, 1999
6. Cade J, Thompson R, Burley V, Warm D: Development, validation and utilisation of food-frequency
questionnaires - a review. Public Health Nutr 5:567-587, 2002
7. Hodge A, Patterson AJ, Brown WJ, Ireland P, Giles G: The Anti Cancer Council of Victoria FFQ:
relative validity of nutrient intakes compared with weighed food records in young to middle-aged
women in a study of iron supplementation. Aust NZ J Public Health 24:576-583, 2000
8. McLennan W, Podger A: National Nutrition Survey Nutrient Intakes and Physical Measurements
Australia. Canberra, Australian Bureau of Statistics, 1998

The dietary questionnaire was developed specifically for use in Australian adults. It is the
dietary instrument used in the Australian arm of the Breast Cancer CFR, the Melbourne
Collaborative Cohort Study, the Australian Prostate Cancer Family Study, the Australian
Longitudinal Study of Women’s Health and over 20 other smaller epidemiological studies in
Australia.

The original questionnaire was developed for the Melbourne Collaborative Cohort Study,
including foods identified from weighed food records among men and women born in
Australia, Greece and Italy. The current questionnaire was developed from the original, and
now comprises a food list of 74 items with 10 frequency response options ranging from
‘Never’ to ‘3 or more times per day’. It also contains 3 photographs of scaled portions for four
foods (used to calculate a portion size calibrator), questions on the overall frequency of
consumption of fruits and vegetables (used to calibrate the overestimation of these foods in
the food list), and questions on consumption of foods such as bread that do not fit easily into
the frequency format. The 74 food items are grouped into four categories: 1) cereal foods;
sweets and snacks; 2) dairy products, meats and fish; 3) fruit and 4) vegetables. A separate
set of questions covers intake of alcoholic beverages. The food composition data used to
calculate nutrients are from NUTTAB95 [1], supplemented by other data where necessary [2]
[3] [4] [5] The output includes the following: water, kilojoules, fat (total),protein, carbohydrate
(total), sugars, starch and dextrins, dietary fibre, cholesterol, sodium, potassium, calcium,
phosphorus magnesium, iron, zinc, retinol equivalent, retinol, thiamine, beta-carotene
equivalent, riboflavin, niacin niacin equivalent, vitamin c, alcohol, saturated fatty acids (total),
monounsaturated fatty acids(total), polyunsaturated acids (total). We have recently extended
the calculations to include individual fatty acids, carotenoids, glycemic index and glycemic
load.

The dietary questionnaire is the property of the Cancer Council Victoria.

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2 Questionnaire Evaluation

The performance of the current questionnaire is described in the paper below,

and the subsequent erratum:

Hodge A, Giles GG, Patterson A, Brown W, Ireland P. The Anti-Cancer Council of Victoria
FFQ. Relative validity of nutrient intakes compared with diet diaries in young of middle-aged
women in a study of iron supplementation. ANZ J of Public Health 2000;24:576-83.
An erratum to this was published in ANZJPH 2003;27 (4) 468.

The following papers have also evaluated the questionnaire.

Ambrosini GL, van Roosbroeck SA, Mackerras D, Fritschi L, de Klerk NH, Musk AW.The reliability of
ten-year dietary recall: implications for cancer research. J Nutr. 2003 Aug;133(8):2663-8.

Xinying Xie P, Noakes M, Keogh J. Can a food frequency questionnaire be used to capture dietary
intake data in a 4 week clinical intervention trial? Asia Pacific Journal of Clinical Nutrition
2004;1(4):318-23.

Woods RK, Stoney RM, Ireland PD, Bailey MJ, Raven JM, Thien FC, Walters EH, Abramson MJ. A
valid food frequency questionnaire for measuring dietary fish intake. Asia Pac J Clin Nutr.
2002;11(1):56-61.

3 Sources of Nutritional Data

3.1 Nutrients computed using Australian NUTTAB 95 database [1]

Water Kilojoules Calories

Protein Carbohydrate (total) Sugars
Starch & Dextrins Dietary Fibre Cholesterol
Sodium Potassium Calcium
Phosphorus Magnesium Iron
Zinc Retinol Equivalent Retinol
Thiamin Beta-Carotene Equivalent Riboflavin
Niacin Niacin Equivalent Vitamin C
Alcohol Saturated Fatty Acids (total) Monounsaturated fatty
Acids (total)
Fat (total) Polyunsaturated Acids (total)

3.2 Additional outputs

Vitamin E, Folate British data [2]

Carotenoids US data [3]
Fatty acids Australian data [5]
Glycaemic Index, Glycemic International tables [4]
load

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4 Administration of the Questionnaire
The dietary questionnaire is designed to be self-administered, but can also be interviewer-
administered. If self-administered it is the responsibility of the study coordinator to ensure
questionnaires are completed correctly and that no pages are left blank, prior to returning
to the Cancer Epidemiology Centre for scanning and analysis.

It is important to instruct the respondents thoroughly on the need to fill in bubbles completely,
not leave questions blank, and except in questions 3, 5, 7, 10 to only give one answer. As
completed questionnaires are collected, they should be checked for completeness and errors
so that mistakes can be corrected on the spot. If questionnaires are to be interviewer-
administered, it is important that all interviewers have been appropriately trained to
administer the questionnaire in a standard manner.

As the completed forms are optically scanned, it is very important that each question is
answered correctly. Answers should be recorded by completely filling the appropriate
bubble as indicated on page 1 of the questionnaire. If ticks, crosses or lines are used, the
scanner will not detect the response. Either pen or pencil can be used but pencil is preferable
as mistakes can be more easily erased. All mistakes must be completely erased, not
crossed out. Every question should be answered, including the date section on the front
page.

The program used to compute nutrients from the dietary questionnaire produces a report of
all errors and inconsistencies in the responses. In some cases, default values will be
assumed and the output will still be calculated, when the assumptions required for
calculations are too great, no output will be produced. This will be detailed in the error report.
It is up to the investigator to decide what to do about the missing or inconsistent data. You
may choose to exclude the individual or recontact them to edit data.

4.1 Questions 1 and 2

The information obtained about fruit in question 15 is necessary to determine the relative
contribution of different types of fruit to the person's total fruit intake. It is often found that
food frequency questionnaires do not provide an accurate estimate of a person's total fruit
intake, so question 1 has been added to scale the responses in question 15. Generally
people find question 1 relatively easy to answer because their total intake of fruit is
reasonably constant over the year, even if the types of fruit they consume varies with the
seasons.

As with fruit, the information obtained about vegetables in question 15 is essential for
determining the relative contribution of different vegetables to a person’s total vegetable
intake. Question 2 asks about how many different vegetables the person usually eats per
day. We chose not to ask about the number of "serves" of vegetables because there is
confusion about what constitutes a "serve" of vegetables. Moreover, we obtain information
about vegetable serving sizes separately in questions 11 and 12. The response to question 2
is used scale the responses about frequency of vegetable consumption in question 15.

Because the program that computes nutrient values from the scanned data uses responses
to questions 1 and 2 to adjust the answers about fruit and vegetable intake in question 15, if
either of these questions is left blank the program will not compute nutrients for that person.
Also if the responses to questions 1 or 2 are completely inconsistent with the responses in
question 15, nutrients will not be computed. It is not expected that answers will match
exactly, but if for example it were indicated in question 1 that the respondent did not eat fruit,
and in question 15 they reported eating fruit, this would be rejected. Similarly, if some fruit
were reported in question 1 and none in question 15, this would lead to rejection. The same
logic applies to vegetables in questions 2 and 15.
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4.2 Number of responses expected for questions 1-10
Only one response is required for most of these questions. However, for questions 3, 5, 7
and 10 more than one answer is acceptable. If more than a single type of milk, bread, spread
or cheese is selected, it will be assumed that each is consumed in equal quantities for the
computation of nutrient intakes. Inconsistencies between questions determining types of
foods and amounts consumed will result in the data for that person being rejected. For
questions 1, 2, 4, 6, 8 and 9, only one response is allowed, if more than one response is
given the lowest response will be recorded and used for the nutritional analysis.

4.3 Portion Size Questions (Questions 11-14)

Responses to the portion size questions are used to calculate a single portion size factor
(PSF) indicating whether on average a person eats median size serves (PSF=1), more than
the median (PSF > 1), or less than the median (PSF < 1). The PSF is used to scale the
standard portion size for different foods up or down.

Instructions are given at the top of the page for these four questions. Exactly one response
should be recorded on each line. If more than one response per line is given, the smallest
portion size will be assumed. If some of the questions are left blank, for example the steak in
a vegetarian respondent, the portion size factor will be calculated as the average of all
portion size responses provided. If all four portion size questions are left unanswered, a
standard portion size will be used and this will be reflected as a serious error in the Error
Report.

4.4 Question 15
The 74 food items are grouped into four categories:

Cereal foods; sweets and snacks

Dairy products, meats and fish
Fruit
Vegetables

Take care that only one response is recorded per line. It is easy to put two marks on one
line and miss the next one.

Certain foods such as sandwiches and salads are not listed because their composition
varies. People should think about the separate ingredients that make up these foods and
answer the questionnaire accordingly. For example, if a person ate a salad that included
tomato once a week and a tomato sandwich once a week, the appropriate answer for tomato
would be "2 times per week".

For all the foods listed, the bubble indicating how often they were eaten on average should
be filled . People should think back over the past year about foods eaten away from home or
when on holidays as well as foods eaten and prepared at home. For seasonal foods, record
frequency as if foods are in season. If a particular food item is never eaten, the bubble in the
column headed “NEVER” should be filled to indicate this.

4.5 Alcohol Questions

4.5.1 Question 16
Asks about average alcohol consumption over the past twelve months. Each alcohol
type is asked about separately. Only one response is permitted per line.

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 If ALL responses to this question are “NEVER”, no further questions need be
answered.

4.5.2 Question 17
This question asks about the total number of glasses of all alcohol types usually
drunk per day. This may require totalling of all alcohol types usually drunk.

4.5.3 Question 18
This question asks for the maximum number of glasses of alcohol drunk in any 24
hours during the past year. Because the response to this question is not used in
calculation of nutrients, missing this question will not stop nutrients being computed,
but a warning will be given in the error report.

5 Alcohol Calculations in the Dietary Questionnaire

Because the dietary questionnaire asks about beverage-specific frequency of consumption
but only about overall quantity of consumption, we have to make some assumptions in the
calculation of nutrients. To estimate beverage-specific (and total) weekly consumption, we
calculate a weighted average from two extreme methods of assigning quantity to
consumption of individual beverages. The first method assumes that people who consume
more than one type of beverage always do so on the same days (subject to the constraints of
the beverage-specific frequencies), while the second method assumes that people separate
their beverages wherever possible. In both methods, on days when people drink more than
one beverage, we apportion the total glasses consumed equally among all types consumed
on that day. From the 3-day diary of the 1995 National Health Survey, we determined that
people who drank more than one beverage were about two times as likely to drink them on
separate days as on the same day. Therefore, the data from the second method are given
two times the weight of the first method when we construct the weighted average.

Due to the assumptions required in the calculation of nutrients from alcoholic beverages, the
results are less reliable than are those for nutrients from food. Therefore, nutrients from
alcoholic beverages are reported separately and it is up to the investigator to decide whether
to include these nutrients in the totals. If you want to include alcohol, all nutrients in the
alcohol file should be added to the nutrients in the main file.

6 Scanning Errors
It has been our experience that a large proportion of completed questionnaires returned for
scanning contain errors that prevent further processing to compute nutrients. As a result, we
have developed a set of editing rules that are applied when missing or multiple responses
are detected in questions 15 to 16. These default rules are provided below, if you would like
alternative rules applied to your data, please contact us to discuss your requirements.

6.1 Edit rules

When a question has not been answered (missing), it is assumed none of that food or drink
item was consumed in the past 12 months.

Cauliflower

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When two responses have been given when only one was expected (multiple response) the
lowest response is taken (based on the assumption that people tend to over estimate food
intake rather than underestimate).

Cauliflower

When two responses have been given to one question and the following question has been
left unanswered, it is assumed that the greater response on the first line actually belongs to
the second line.

Cauliflower

Broccoli

When one question is left unanswered and the following question has two responses the
greater response on the lower line is taken for the missing question

Cauliflower

Broccoli

7 Barcode Labels
A barcode is affixed to the questionnaire prior to scanning. See Appendix B for instructions.
The barcode labels consist of the Barcode Name and Sequential Number. The Barcode
Name is an abbreviation of the study name, unchanging, maximum of ten digits and used as
the reference name in all correspondence. The Sequential Number is changing, maximum of
ten digits and can contain a capital letter if required i.e. H854.

For example:

Barcode Name HTH 2020

Sequential Number.

If barcode labels are not required, please note on order form.

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8 Output from Scanned Questionnaires
You will receive 5 files consisting of:

1. raw data,
2. nutrients computed from food without alcoholic beverages (including carotenoid &
fatty acids, glycaemic index & glycaemic load),
3. nutrients from alcoholic beverages,
4. food intakes, and
5. error messages

The raw data file includes Scan no., ID no, and date, then goes through the answers to all
questions as scanned. For questions on page 1 except those regarding type of bread, milk,
spread and cheese, responses are coded as sequential numbers starting at 1. For example,
if the second response for Q1, ‘less than 1 piece of fruit per day’ was selected, it would be
coded as 2. For the questions about different types foods, where it is possible to choose
more than one type, there are separate variables for each type, which are coded ‘0’ if not
used and ‘1’ if used. Q11-14 regarding serving sizes are coded from 1 ‘never ate’ to 8 ‘more
than C’. For items in Q15, possible responses are from 1-10, corresponding to the frequency
options from ‘Never’ to ‘3 or more times per day’. To analyse food intake in terms of
frequency it is necessary to convert these responses to daily equivalent frequencies using
the values in the table below.

Recorded response Frequency Daily equivalent frequency

1 never 0
2 less than once per month 0.02
3 1-3 times per month 0.07
4 once per week 0.14
5 twice per week 0.28
6 3-4 times per week 0.5
7 5-6 times per week 0.78
8 once per day 1
9 twice per day 2
10 3 or more times per day 3

Similarly for the questions on alcoholic beverages, the response values correspond to the
response options on the QUESTIONNAIRE.

The second file usually has ‘_nutanalysis’ in the file name, and is the calculated daily intake
of nutrients from foods in the QUESTIONNAIRE. If the file you receive includes Portion
Standard Factor, Fruit Calib and Vegetable Calib, ignore these, they are calculated on the
way to the final nutrient intakes and are not used for anything else. The third file, typically
including ‘_nutanalysis_alc’ in the file name, has identical variables to the standard nutrients
from food, although some variables will have all zero intakes. As discussed in section 5,
these two nutrient intake files can be added to give total nutrient intakes.

The dietary analysis program has recently been updated to compute intakes of carotenoids,
fatty acids, glycemic load and dietary glycemic index, and individual food intakes.

Variable descriptions are given below:

The nutrients from ‘Energy’ through to ‘Zinc’ are the standard output, and values are based
on Australian nutrient composition data from NUTTAB95 [1], excepting folate and vitamin E,
which are not available in NUTTAB, and have been derived from British tables [2]. Outputs
from both food and alcoholic beverages include these standard nutrients. Within this is a

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variable ‘BetaCarotene’, which is ß-carotene equivalents (mcg/d) from NUTTAB. ß-carotene
equivalents is the sum of the ß-carotene and half the amounts of α-carotene and α- and ß-
cryptoxanthins present.

Alpha-Carotene through to Lycopene are individual carotenoid intakes (mcg/d) calculated

from the USDA data base [3]. The value labeled ‘Beta-Carotene’ is total ß-carotene, and is
not directly related to the ‘BetaCarotene’ from NUTTAB. Because these two variables come
from completely separate databases from different times and countries, and may include
different foods, there is no expectation of close agreement.

Variables FD40 to FD226N3N6, are intakes of individual fatty acids, based on a data set we
obtained from Neil Mann at RMIT, and now used in FoodWorks. Some of these will have
very low or zero intakes, all the variable columns from the original database have been
retained, even if intakes are zero.

Code Unit Fatty acid Name

FD40 g/day C4:0 Butyric acid from diet (g/d)
FD60 g/day C6:0 Caproic acid from diet (g/d)
FD80 g/day C8:0 Caprylic acid from diet g/d)
FD100 g/day C10:0 Capric acid from diet (g/d)
FD120 g/day C12:0 Lauric acid from diet (g/d)
FD140 g/day C14:0 Myristic acid from diet (g/d)
FD150 g/day C15:0 Pentadecanoic acid from diet (g/d)
FD160 g/day C16:0 Palmitic acid from diet (g/d)
FD170 g/day C17:0 Margaric acid from diet (g/d)
FD180 g/day C18:0 Stearic acid from diet (g/d)
FD200 g/day C20:0 Arachidic acid from diet (g/d)
FD220 g/day C22:0 Behenic acid from diet (g/d)
FD240 g/day C24:0 Lignoceric acid from diet (g/d)
FD141 g/day C14:1 Myristoleic acid from diet (g/d)
FD151 g/day C15:1 Pentadecenoic acid from diet (g/d)
FD161 g/day C16:1 Palmitoleic acid from diet (g/d)
FD161T g/day C16:1 trans Trans Palmitoleic acid from diet (g/d)
FD171 g/day C17:1 Heptadecenoic acid from diet (g/d)
FD181 g/day C18:1 Oleic acid from diet (g/d)
FD181T g/day c18:1 trans Elaidic/trans Vaccenic acid from diet (g/d)
FD201 g/day C20:1 Eicosenic acid from diet (g/d)
FD221 g/day C22:1 Cetoleic/Erucic acid from diet (g/d)
FD182N6 g/day C18:2 n-6 Linoleic acid from diet (g/d)
FD182N6T g/day C18:2 n-6 trans Trans Linoleic acid from diet (g/d)
FD183N3 g/day C18:3 n-3 Alpha-linolenic acid from diet (g/d)
FD202N6 g/day C20:2 n-6 Eicosadienoic acid from diet (g/d)
FD203N6 g/day C20:3 n-6 Dihomo-gamma-linolenic acid from diet (g/d)
FD204N6 g/day C20:4 n-6 Arachidonic acid from diet (g/d)
FD205N3 g/day C20:5 n-3 Eicosapentaenoic acid (EPA) from diet (g/d)
FD205N6 g/day C20:5 n-6 Fatty acid F205N6 from diet
FD224N6 g/day C22:4 n-6 Adrenic acid from diet (g/d)
FD225N3 g/day C22:5 n-3 Clupanodonic acid from diet (g/d)
FD226N3 g/day C22:6 n-3 Decosahexaenoic acid from diet (DHA) from diet (g/d)

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Individual food intakes are in grams per day.

Glycemic index and glycemic load are based on values from an international table [4]. The
method of their calculation is explained in the publication including the tables, and also in a
paper we published in Diabetes Care [6]. The relevant section from our paper is copied
below.

‘Glycemic index is a method of ranking foods on the basis of the blood glucose response to a
given amount of carbohydrate from that food. GI values of individual food items were
obtained from the 2002 International table of GI and GL values [4]. Where there was more
than one value, GI values were averaged, with preference being given to Australian figures.
Dietary GL was computed by summing the product of carbohydrate intake from each food by
the GI for that food. GL was divided by total carbohydrate intake to obtain dietary GI, i.e an
average of individual food GI values, weighted according to their contribution to carbohydrate
intake [4]. Alcoholic beverages were not included in the overall GI.
None of these new values have been tested or validated so we welcome any feedback and
the values should be used with caution.

The fifth output file is the error log. It lists each error and whether that QUESTIONNAIRE
was processed or not. It is quite possible to have fewer subjects in the calculated nutrients
than the raw data due to exclusions.

Examples of each file type are shown overleaf.

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 8.1 Example of Raw Data

Scan.no Id Date Fruit.p.d Veg.p.d Milk.none Milk.full Milk.red Milk.skim Milk.soy Milk.p.d Bread.none Bread.highf Bread.white
73100000100249 6-Mar-01 3 3 0 0 1 0 0 3 0 1 0

Bread.whol Bread.rye Bread.multi Bread.p.d Spread.none Marg Poly.marg Mono.marg Marg blends Butter Sugar.p.d Eggs.p.w Cheese.none Cheese.hard
0 0 0 6 0 0 1 0 0 0 1 2 0 0

Cheese.firm Cheese.soft Ricotta Cream cheese Lowf.cheese Pot.eat Veg.eat Steak.eat Casserole.eat Allbran Other brans Weetbix Cornflakes Porridge
1 0 0 0 0 6 4 4 4 3 1 7 3 7

Muesli Rice Pasta Dry biscuits Sweet biscuits Cakes Pies/pastries Pizza Hamburger Chocolate Flav.milk Nuts Peanut butter Chips
3 3 3 1 4 1 4 1 1 4 1 3 3 1

Jam/honey Vegemite Cheese Icecream Yoghurt Beef Veal Chicken Lamb Pork Bacon Ham Beef/salami Sausages
4 1 5 3 1 3 1 3 3 3 3 3 3 2

Fish.grill Fish.fried Fish.tinned Fruit.tin Fruit juice Oranges Apples Pears Bananas Melons Pineapple Strawberry Apricots Peaches
2 4 3 3 1 4 4 4 4 1 1 3 3 3

Mango Avocado Pot.roast/fried Pot.not fat Tom sauce/paste Tom.tinned Peppers Green salad Cucumber Celery Beetroot Carrots Cabbage Cauliflower
2 1 3 6 4 4 1 4 4 4 4 4 4 4

Broccoli Spinach Peas Green bean Sprouts Bakes beans Soy bean Other bean Pumpkin Onion Garlic.fresh Mushroom Zucchini Beer.low
4 4 4 4 4 4 1 4 4 4 1 5 5 1

Beer.full Red wine White wine Port/sherry Spirits Glass.p.d Max.glass.p.d

1 1 3 3 3 1 1

Page 13 of 22
8.2 Example of Nutrients from food list (including carotenoid & fatty acids, glycaemic index & glycaemic load), full list
Scan Scan Portion Energy All Fat SatFat PolyFat MonoFat Protein CarbohydratSugars Starch Fibre Alcohol
ID Date Standard kJ/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day
Factor
1948 7/03/2005 0.725 6699.821 61.1701 30.63372 7.717802 17.76102 63.03661 203.0659 101.7313 100.3643 19.41932 0

BetaCaroCalcium Cholesterol Folate Iron MagnesiumNiacin Niacin EquivPhosphorusPotassium Retinol Retinol Equ Riboflavin Sodium
ug/day mg/day mg/day ug/day mg/day mg/day mg/day mg/day mg/day mg/day ug/day ug/day mg/day mg/day

2148.3 1061.274 214.5715 243.2412 10.54445 262.4491 14.83017 28.15072 1273.983 2433.896 451.9157 809.9382 2.077933 1948.391

Thiamin VitaminC VitaminE Zinc Alpha-CaroBeta-CaroteBeta-CryptoLutein+ZeaxLycopene FD40 FD60 FD80 FD100 FD120
mg/day mg/day mg/day mg/day ug/day ug/day ug/day ug/day ug/day g/day g/day g/day g/day g/day

1.3519 84.1606 4.772141 8.098256 724.1287 2825.672 163.2716 710.828 1333.864 0.8125666 0.442995 0.521081 0.8767341 2.298161

FD140 FD150 FD160 FD170 FD180 FD200 FD220 FD240 FD141 FD151 FD161 FD161T FD171 FD181
g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day

4.3079 0.3415976 16.05117 0.305939 9.46227 0.286424 0.121433 7.23E-02 0.3307192 4.09E-03 0.891477 0 3.89E-02 21.2029

FD181T FD201 FD221 FD182N6 FD182N6T FD183N3 FD202N6 FD203N6 FD204N6 FD205N3 FD205N6 FD224N6 FD225N3 FD226N3 Glycemic Glycemic
g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day Load Index

0.679 0.1650253 4.26E-02 6.578168 0.0749 0.949695 1.96E-02 1.07E-02 2.56E-02 2.39E-02 0 2.85E-03 9.64E-03 0.061914 110.3033 54.31897

Page 14 of 22 Page 14 of 22
 8.3 Example of Nutrients from alcoholic beverages, full list

Scan Scan Portion Energy All Fat SatFat PolyFat MonoFat Protein Carbohydrate Sugars Starch Fibre Alcohol
ID Date Standard kJ/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day
Factor
249 6/03/2001 0.9375 56.22954 0 0 0 0 2.31E-02 0.4521611 0.4521611 0 0 1.668858

BetaCarotene Calcium Cholesterol Folate Iron Magnesium Niacin Niacin Equiv Phosphorus Potassium Retinol Retinol Equiv Riboflavin Sodium
ug/day mg/day mg/day ug/day mg/day mg/day mg/day mg/day mg/day mg/day ug/day ug/day mg/day mg/day

0 0.7247917 0 0 0.0214375 0.8438889 8.17E-03 8.17E-03 2.079097 6.138611 0 0 0 2.555486

Thiamin VitaminC VitaminE Zinc

mg/day mg/day mg/day mg/day

0 0.245 0 0

Page 15 of 22 Page 15 of 22
 8.4 Example of food intakes, full list

Scan Scan
Portion Full cream milk Reduced fat milk Skim milk Soya milk High fibre white bread White bread Wholemeal bread Rye bread Multi-grain bread Margarine Polyunsaturated margarine

ID Date
Standard g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day
Factor
1948 7/03/2005 0.725 0 0 375 0 0 0 120 0 0 0 0

Monounsaturated margarine Butter and margarine blends Butter Hard cheese Firm cheese Soft cheese Ricotta or cottage cheese Cream cheese Low fat cheese Sugar Eggs All Bran Branflakes Weet Bix
g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day

0 28 0 0 28.7 0 0 0 0 0 12.9 0 0 20.2

Cornflakes Porridge Muesli Rice Pasta Crackers Sweet Biscuits Cakes Meat pies Pizza Hamburger Chocolate Flavoured Milk Drink Nuts
g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day

23.6 0 0 0 18.7 0 0 53.5 0 0 0 22 0 0

Peanut butter Crisps Jam Vegemite Ice-cream Yoghurt Beef Veal Chicken Lamb Pork Bacon Ham Salami
g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day

0 0 10 0 51.7 0 13.4 0 9.3 11.4 0 0 0 0

Sausages Fish Fried fish Tinned fish Tinned fruit Fruit juice Oranges Apples Pears Bananas Melon Pineapple Strawberries Apricots
g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day

0 0 0 3.7 0 100.7 0 70 0 73.6 0 0 0 0

Peaches Mango Avocado Chips Potatoes Tomato sauce Tomatoes Capsicum Lettuce Cucumber Celery Beetroot Carrots Cabbage
g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day

38.9 0 0 0 31.9 0.4 0 0 10.3 9.5 1.6 8.8 10.8 2.7

Cauliflower Broccoli Spinach Peas Green beans Bean sprouts Baked beans Tofu Other beans Pumpkin Onion Garlic Mushrooms Zucchini
g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day g/day

2 0 5.1 5.4 11.4 0 3.5 0 0 17.4 4.2 0 0.7 1.2

Light beer Heavy beer Red wine White wine Fortified wines Spirits
g/day g/day g/day g/day g/day g/day
Page 16 of 22 Page 16 of 22
3.7 0 128.3 2.3 0 0
8.5 Example of an error report
Scan File is : tccv 22-05-06.csv
Processing was commenced at 4/07/2006 9:26:45 AM

No. ID Warning/Rejection reasons

879000003 2335 Trivial warning - portion size factor(Q11-14) is based on only 3 foods.
879000005 2338 Trivial warning - portion size factor(Q11-14) is based on only 3 foods.
879000021 2360 Trivial warning - Milk type selected in (Q3) but 'none' used in (Q4).
879000025 2356 Serious warning - (Q1) 'I don''t eat fruit' and fruit intake reported in (Q15).
879000104 2507 Trivial warning - (Q2) reports eating 1 or more vegetable per day and no vegetables selected in (Q15).
879000114 2410 Trivial warning - Milk type selected in (Q3) but 'none' used in (Q4).
879000116 2422 Serious warning - (Q1) 'I don''t eat fruit' and fruit intake reported in (Q15).
879000124 2378 Serious warning - (Q1) 'I don''t eat fruit' and fruit intake reported in (Q15).
879000130 2420 Trivial warning - portion size factor(Q11-14) is based on only 3 foods.
879000134 2479 Serious warning - (Q1) 'I don''t eat fruit' and fruit intake reported in (Q15).
879000137 2482 Intermediate warning - cheese type (Q10) is missing or 'I don''t eat cheese' but (Q15) indicates cheese consum
879000158 2510 Intermediate warning - portion size factor(Q11-14) is based on only 2 foods.
879000162 2514 Trivial warning - portion size factor(Q11-14) is based on only 3 foods.
879000164 2516 Intermediate warning - cheese type (Q10) is missing or 'I don''t eat cheese' but (Q15) indicates cheese consum
879000166 2413 Trivial warning - portion size factor(Q11-14) is based on only 3 foods.
879000177 2466 Trivial warning - portion size factor(Q11-14) is based on only 3 foods.
879000185 2521 Trivial warning - portion size factor(Q11-14) is based on only 3 foods.
879000190 2527 Trivial warning - portion size factor(Q11-14) is based on only 3 foods.
879000195 2532 Intermediate warning - cheese type (Q10) is missing or 'I don''t eat cheese' but (Q15) indicates cheese consum
879000203 2539 Trivial warning - cheese consumption indicated in (Q10) but frequency 'never' in (Q15).
879000207 2543 Trivial warning - portion size factor(Q11-14) is based on only 3 foods.
879000210 2545 Trivial warning - (Q2) reports eating 1 or more vegetable per day and no vegetables selected in (Q15).
879000212 2547 Trivial warning - portion size factor(Q11-14) is based on only 3 foods.
879000213 2548 Trivial warning - cheese consumption indicated in (Q10) but frequency 'never' in (Q15).
879000229 586 Serious warning - (Q1) 'I don''t eat fruit' and fruit intake reported in (Q15).
879000229 586 Intermediate warning - Milk type (Q3) is missing or 'none' but (Q4) indicates milk consumed.
879000231 665 Trivial warning - portion size factor(Q11-14) is based on only 3 foods.
879000232 678 Trivial warning - portion size factor(Q11-14) is based on only 3 foods.
Processing was completed at 4/07/2006 9:35:04 AM
Number of records processed : 235
Number of records rejected : 0
9 Referencing the Dietary Questionnaire
Researchers referencing the dietary questionnaire should use the following citation:
Giles GG, Ireland PD. Dietary Questionnaire for Epidemiological Studies (Version 2), Melbourne: The
Cancer Council Victoria, 1996.

The following is the reference, which validates the dietary questionnaire:

Hodge A, Patterson AJ, Brown WJ, Ireland P, Giles G. The Anti Cancer Council of Victoria FFQ: relative
validity of nutrient intakes compared with weighed food records in young to middle-aged women in a
study of iron supplementation. Aust N Z J Public Health. 2000 Dec;24(6):576-83.

An erratum to this was published in ANZJPH 2003;27 (4) 468.

10 Procedure for Processing Questionnaires

10.1 Fees
• Price per unit includes questionnaires, barcodes, scanning, analysis, postage and GST.
• Minimum of 100 units per order.

Quantity Cost per unit

100-499 $14.85
500-999 $12.65
1000+ $11.00

10.2 Purchasing
Order/MOU form (Appendix A) is required, before questionnaires can be dispatched. Please submit a
signed copy via email, fax or post to the Nutritional Assessment Office, details above.
Questionnaires, barcode labels and Dispatch & Receipt Agreement from are dispatched within a week of
receiving an authorised Order/MOU form. Barcodes ordered independent of the questionnaires will be
subjected to a minimum additional cost of $55.00.
Invoices are mailed following the questionnaires unless credit card option is selected.

10.3 Scanning and Analysis

Questionnaire’s are scanned and analysed in order lot.. It is imperative that questionnaires are
completed correctly as re-scanning will be subjected to a minimum additional cost of $55.00.
Questionnaires and the Dispatch & Receipt Agreement form should be sent to the Nutritional
Assessment Office, details above. Two week is required to process <200 and four weeks for 200+.

10.4 Output- Nutrient Analysis

You will receive five output files. These files will be emailed to you and consist of

• raw data,
• nutrients computed from food without alcoholic beverages (including carotenoid & fatty acids,
glycaemic index & glycaemic load),
• nutrients from alcoholic beverages,
• food intakes, and
• error messages

Questionnaires are returned to you by mail.

Page 18 of 22
11 Contact Us
Nutritional Assessment Office 1 Rathdowne Street
Cancer Epidemiology Centre Carlton South Victoria 3053
The Cancer Council Victoria Phone: +61 3 9635 5603
Fax: +61 3 9635 5330
E-mail: ffq@cancervic.org.au

12 References
1. Lewis J, Milligan G, and Hunt A. NUTTAB95 Nutrient Data Table for Use in Australia. 1995, Australian
Government Publishing Service: Canberra.

2. Holland B, Welch AA, Unwin ID, Buss DH, Paul AA, and Southgate DAT. McCance and Widdowson's The
Composition of Foods. 5th ed. 1993, Cambridge: Royal Society of Chemistry.

3. USDA-NCC. USDA-NCC Carotenoid Database for U.S.Foods. 1998. Retrieved.

4. Foster-Powell K, Holt HA, and Brand-Miller JC. International tables of glycemic index and glycemic load
values: 2002. Am J Clin Nutr. 2002; 76: 5-56.

5. RMIT. RMIT Fatty Acid database of Australian foods. Xyris software, Brisbane. Retrieved from
http://www.xyris.com.au.

6. Hodge AM, English DR, O'Dea K, and Giles GG. Glycemic index and dietary fiber and the risk of type 2
diabetes. Diabetes Care. 2004; 27:(11): 2701-6.

Page 19 of 22
13 Order/MOU Form (Appendix A)

Page 20 of 22
Page 21 of 22
14 How to fill in a Questionnaire (Appendix B)

Every question MUST be completed. Please check each question is completed. Any question that is not
completed will default to the first answer.

Use a soft pencil only, preferably 2B. Ensure the oval is completely covered.

Place barcode correctly in orange box. It is preferred that numbers start from the bottom of the page
going up, as shown in example below.

BARCODE DIRECTION

Page 22 of 22