F&N Bulletin Vol 23 No 1b - United Nations University

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78 N. Omidvar et al. of sensitivity, than a targeted intake assessment similarly validated among preschool children in rural Thailand [7]. Infection was more likely to influence serum retinol levels among the Thai children than in the present sample, whereas intake per se is more important in the present sample of Iranian women. Discussion The purpose of this pilot study was to design and validate a short food-frequency questionnaire for screening women’s vitamin A status. A 20-item short food-frequency questionnaire was developed. Validity and reliability tests indicate that the questionnaire is relatively valid and reliable for the purpose of identifying women at risk for vitamin A deficiency as indexed by serum retinol level. The correlation between short food-frequency questionnaire estimates of dietary vitamin A intake and serum concentration of retinol is similar to that reported for children [6, 13, 14] and for pregnant and lactating women [17]. These findings stand in contrast to observations in populations of vitamin A-sufficient adults in which no correlations or only weak relationships between serum retinol and intake were found [18–20]. The findings of the present study indicate a lack of correlation between estimates of vitamin A intake by recall over a 48-hour period and serum retinol concentrations. This observation is consistent with previous studies demonstrating higher reliability of intake estimation by food-frequency questionnaire than that by 24-hour recall with respect to vitamin A status. Serum vitamin A levels are a function of longterm intake of vitamin A-containing foods. Therefore, short-term measurement of vitamin A intake is subject to fluctuation and does not reflect the risk of deficiency. Two items rather specific to this population emerged from this analysis. The most striking is the importance of nuts in the diet. Although nuts are relatively low in provitamin A, their regular intake by the study subjects makes their contribution to vitamin A intake significant. The second is the importance of green leaves of the type utilized in other cuisines as herbs (parsley, dill, cilantro, and others). These are eaten regularly and in large quantities, are grown in household gardens to assure a steady supply for the table, and are basic to Iranian dietary habits. A previous study in Ilam Province of Iran showed a lack of correlation between frequency of intake of vitamin A-containing foods, according to the Helen Keller International short food-frequency questionnaire, and serum retinol in preschool children [16]. This questionnaire allows for modification of some of the food items based on the dietary pattern of the population under study. The modified version of the questionnaire applied in the Ilam study demonstrated low internal consistency. The lack of association observed between the food-frequency questionnaire estimates of vitamin A intake and serum retinol in the Ilam study may have arisen from differences in study design, populations, and specific food items included in the questionnaire as compared with the core foods eaten, affecting the overall validity and reliability of the questionnaire. The short food-frequency questionnaire designed for this study represents one of the first attempts to develop standardized dietary tools for the Iranian population. Application of a biochemical indicator provided an independent measurement for assessment of the validity of the questionnaire for screening vitamin A status. Further study is needed to evaluate the accuracy and applicability of the questionnaire in different communities in the area and whether it could be successfully utilized by auxiliary health workers with minimum training. Acknowledgments We thank the Office of Research Affairs in the Ministry of Health and Medical Education, Islamic Republic of Iran, for financial support; the Human Nutrition Laboratory, National Nutrition and Food Technology Research Institute of Iran for measurement of serum retinol; the Faculty of Nutrition and Public Health at Tabriz University of Medical Sciences; the health workers of Marand District; and the women who participated in the study. This paper was presented in part at the International Conference on Dietary Assessment, Tucson, Arizona, USA, September 17, 2001. References 1. Sommer A, Katz J, Tarwotjo I. Increased risk of respiratory disease and diarrhea in children with pre-existing mild vitamin A deficiency. Am J Clin Nutr 1984; 40:1090–5. 2. Suharno D, Muhilal. Vitamin A and nutritional anemia. Food Nutr Bull 1996;17:7–10. 3. Bellamy C. The state of the world’s children, 1998. New York: United Nations Children’s Fund and Oxford University Press, 1998. 4. Kimiagar M, Ghaffarpur M, Noropuzi F, Hormozdyari H, Hooshiar-rad A. Household food consumption in 24 provinces of Iran. Tehran: Department of Agriculture and National Nutrition and Food Technology Research Institute, 1994.
Development and validation of a short food-frequency questionnaire 79 5. Underwood BA. Methods for assessment of vitamin A status. J Nutr 1990;120:1459–63. 6. Sloan NL, Rosen D, de la Paz T, Arita M, Temalilwa C, Solomons NW. Identifying areas with vitamin A deficiency: the validity of a semi qualitative food frequency method. Am J Public Health 1997;87:186–91. 7. Nimsakul S, Collumbien M, Likit-Ekaraj V, Suwanarach C, Tansuhaj A, Fuchs GJ. Simplified dietary assessment to detect vitamin A deficiency. Nutr Res 1994;14:325–36. 8. Ross AC. Vitamin A and retinoids. In: Shils ME, Olson JA, Shike M, Ross AC, eds. Modern nutrition in health and disease. 9th ed. Baltimore, Md, USA: Williams & Wilkins, 1999:305–27. 9. Humble CG, Samet JM, Skipper BE. Use of quantified and frequency indices of vitamin A intake in a case control study of lung cancer. Int J Epidemiol 1987;16:341–6. 10. Robinson S, Godfrey K, Osmond C, Cox V, Barker D. Evaluation of a food frequency questionnaire used to assess nutrient intakes in pregnant women. Eur J Clin Nutr 1996;50:302–8. 11. Romieu I, Parra S, Hernandez JF, Madrigal H, Willett W, Hernandez M. Questionnaire assessment of antioxidant and retinol intake in Mexican women. Arch Intern Med 1999;30:224-39. 12. Romieu I, Stampfer MJ, Stryker WS, Hernandez M, Kaplan L, Sober A, Rosner B, Willett WC. Food predictors of plasma beta-carotene and alpha-validation of a food frequency questionnaire. Am J Epidemiol 1990;131:864–76. 13. Tarwatjo I, Sommer A, Soegiharto T. Dietary practices and xerophthalmia among Indonesian children. Am J Clin Nutr 1982;35:574–81. 14. Chavez MM, Martinez H, Chavez A. A simplified tool for assessing vitamin A deficiency risk at the community level. Food Nutr Bull 1989;11:37–40. 15. Rosen DS, Haselow NJ, Sloan NL. How to use the HKI food frequency method to assess community risk of vitamin A deficiency. New York: Helen Keller International Vitamin A Technical Assistance Program, 1993. 16. Omidvar N, Ghazi-Tabatabie M, Djazayeri A, Abbassi S, Zoghi T. Validity and reliability of a short food frequency questionnaire in screening vitamin A status of preschool children, Ilam, Iran. Arnham, Netherlands: Third International Conference on dietary assessment methods, 1998, Abstract No. 47:s25. 17. Alam DS, Van Raaji JMA, Hautvast JGAG, Yanus M, Wahed MA, Fuchs GJ. Validity of IVACG simplified dietary assessment (SDA) in identifying pregnant and lactating women at risk for vitamin A deficiency in rural Bangladesh. San Diego, Calif, USA: Experimental Biology 2000, Abstract No. 525.17:A761. 18. Willet W, Stampfer MJ, Underwood BA, Spezer FE, Rosner B, Hennekens CH. Validation of a dietary questionnaire with carotenoids and alpha-tocopherol levels. Am J Clin Nutr 1983;128:631–9. 19. Roidt L, White E, Goodman GE, Wahl PW, Omenn GS, Rollins B, Karkeck JM. Association of food frequency questionnaire estimates of vitamin A intake with serum vitamin A levels. Am J Epidemiol 1988;128:645–54. 20. Boeing H, Bohlscheid-Thomas S, Voss S, Schneeweiss S, Wahrendorf J. The relative validity of vitamin A intakes derived from a food frequency questionnaire compared to 24-hour recalls and biological measurement: results from the EPIC pilot study in Germany. Int J Epidemiol 1997;26(suppl 1):S82–S90. 21. Sarkissian NT, Rahmanian M, Azar M, Mayourian H, Khalili S. Food composition table of Iran. Vol 1. Raw materials. Baghdad: Institute of Nutrition Science and Food Technology, 1980, Publication No. 131. 22. Underwood BA, Chavez M, Hankin J, Kusin JA, Omololu A, Ronchi-Proja F, Butrum R, Ohata S. Guidelines for the development of a simplified dietary assessment to identify groups at risk for inadequate intake of vitamin A. Washington, DC, USA: International Vitamin A Consultative Group, 1989. 23. Holland B. McCance and Widdowson. The composition of foods. 5th ed. London: Royal society of Chemistry and Ministry of Agriculture, Fisheries, and Food, 1991. 24. Bieri JG, Tolliver TJ, Catignani GL. Simultaneous determination of alpha tocopherol and retinol in plasma or red cells by HPLC. Am J Clin Nutr 1979;32:2143–9.
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Contents Review articles Nuclear an
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Special Article Nuclear and isotopi
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Nuclear and isotopic techniques 5 T
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Nuclear and isotopic techniques 7 T
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Nuclear and isotopic techniques the
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Palm oil: A healthful and cost-effe
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Palm oil will be less absorbed and
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Palm oil oil at the present time is
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Palm oil crystal forms for the requ
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Palm oil myristic acid (14:0) is hi
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Palm oil 13. Kritchevsky D. Influen
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Introduction to three regional stud
Page 25 and 26:
Nutritional status of urban primary
Page 27 and 28: Nutritional status of urban primary
Page 31 and 32: Regional study of nutritional statu
Page 41 and 42: Regional study of nutritional statu
Page 49 and 50: Street food vendors their consumers
Page 51 and 52: Street food vendors whereas roasted
Page 53 and 54: Street food vendors Reardon [28] co
Page 55 and 56: Street food vendors so that bad pre
Page 57 and 58: Iron and energy supplementation imp
Page 59 and 60: Iron and energy supplementation the
Page 61 and 62: Iron and energy supplementation The
Page 63 and 64: Iron and energy supplementation 63
Page 65 and 66: Toward better compliance with iron-
Page 73 and 74: Development and validation of a sho
Page 77: Development and validation of a sho
Page 83 and 84: Factors associated with successful
Page 89 and 90: Difference in goiter rates between
Page 91 and 92: Difference in goiter rates Methods
Page 93 and 94: Difference in goiter rates iodized
Page 95 and 96: Iron-deficiency anemia in young wor
Page 107 and 108: Discussion paper What care practice
Page 109 and 110: Letter to the Editor 109 iodized sa
Page 111 and 112: News and notes 2001 World Food Priz
Page 113 and 114: UNU Food and Nutrition Programme NU
Page 115: Note for contributors The editors o
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F&N Bulletin Vol 23 No 1b - United Nations University

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