EPIC-Germany FFQ Jakob Linseisen Nutritional Epidemiology Division of Cancer Epidemiology German...

EPIC-Germany FFQ

Jakob LinseisenNutritional EpidemiologyDivision of Cancer EpidemiologyGerman Cancer Research Centre, Heidelberg

(food frequency questionnaire)

Long-term reproducibility of the

| Nutritional Epidemiology Cancer Epidemiology

Follow-up of the EPIC-Heidelberg cohort

Recruitment 1994-1998

2. Follow-up (FFQ* and lifestyle questionnaIre) 4. Follow-up

1. Follow-up (lifestyle questionnaire) 3. Follow-up (lifestyle quest:)

5/2000 1/2001 1/2002 1/2003 1/2004 1/2005 1/2006 1/2007 1/2008

Active follow –up of the cohort in order to collect end-point data (cancer, death, chronic diseases,)

with high response rates: – 1. Follow-up 93% – 2. Follow-up 90% – 3. Follow-up 91%

[*self administered semi-quantitative FFQ (148 items), extended for questions on food preparation methods to estimate heterocyclic aromatic amines (HAA) intake]


Information collected during 2nd follow-up (EPIC-HD)

Second FUP: Lifestyle questionnaire

Sociodemograhic variables Occupation, Marital status, Smoking status

Physical activity Physical activity

Medical history Current medication incl. hormones,

family cancer history, incident diseases

Dietary supplements Vitamins, minerals, supplements, naturopathy

Food frequency questionnaire

Diet and alcohol consumption Food and nutrient intake, alcoholic beverages,food preparation methods

For women

Reproductive factors year of menopause,oral contraceptives and hormone use, ovarectomy, hysterectomy


2nd FFQ in EPIC-Heidelberg


2nd FFQ in EPIC-HD:Questions on food preparation methods and preferred degree of browning


EPIC-HD, FFQ2: Participation rate

No. participants1 24.956

Deceased 332

Address uncorrect 49 24.575

No reply for FUP2 1.413

Refused (permanent) 607

Short questionnaire 1.017

Lifestyle quest. only 76

Questionnaires back 21.462

87.3 %

1 Cohort size: previous cohort – deceased – refused (permanent) – unknown address


EPIC-HD, FFQ2:Re-contacting of participants by telephone

5,166 out of 21,462 participants were re-contacted 24 %

Duration of phone calls: roughly 10-15 min (5-30 min) 1,100 hours or 135 working days

Re-contacting if - an entire page was empty;- no answer within an entire food group;- missing answer to “overview”questions;

[This overlapped with phone calls for missing data in life-style questionnaires]


EPIC-HD, follow-up 2:Re-contacting of participants by telephone

Consequence of modification of conditions for re-contacting participants Re-contact because of after 9000 quest. overall missings in …

(% praticipants re-contacted)

life-style quest. 18 % 10 %

FFQ 17 % 19 %

both questionnaires 9 % 5 %

Total 43% 34 %

24 %


Characteristics of the study cohort (n=20,733) at baseline (1994-98) and 2nd FUP (2001-03; mean follow-up time of 5.75 years)

Men (9530) Women (11203)

Baseline FUP2 Baseline FUP2

(%)

AGE (YEARS)

<40 18.1 - 0.0 -

40-49 34.4 34.6 39.0 17.7

50-59 32.4 32.3 42.4 38.8

60-69 15.1 31.5 18.6 41.6

70+ - 1.6 - 1.9

BODY MASS INDEX (BMI)

<18.5 1.4 1.4 0.2 0.2

18.5-25 54.5 53.5 30.8 30.3

25-30 30.0 31.0 51.9 52.4

30-35 10.2 10.1 14.6 14.4

>=35 3.9 3.7 2.5 2.5

CURRENT EMPLOYMENT

Full time 27.8 24.3 77.0 55.0

Part time 38.1 32.4 2.5 3.8

Retired 9.8 20.3 16.5 36.5

Jobless 3.2 2.1 3.4 2.6

Not employed (household, parental leave, education)

21.0 19.2 0.6 0.9

(Nagel et al., Br. J. Nutr. 98:194-200, 2007)


EPIC-HD, FFQ2: … some results

The long-term correlation coefficients ranged from 0.41 (vegetables in men) to 0.77 (alcoholic beverage consumption in women).

Consistently for food groups, 60% to 70% of the participants in both genders were re-classified to the same or adjacent quintile of intake (weighted kappa statistics).

The median intake of potatoes, added fats, sugar/confectionary, cakes and alcoholic beverages was lower in the second than in the first FFQ,

whereas the median intake of fruits, vegetables, cereals/cereal products and non-alcoholic beverages were higher.

(Nagel et al., Br. J. Nutr. 98:194-200, 2007)

EPIC-Germany FFQ Jakob Linseisen Nutritional Epidemiology Division of Cancer Epidemiology German...

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