Validation of dietary vitamin D intake from two food frequency questionnaires, using food records and the biomarker 25-Hydroxyvitamin D among pregnant women

Abstract

Our objective was to validate vitamin D intake from a short vitamin D questionnaire (VDQ) and a longer online food frequency questionnaire (FFQ) against a food record and 25-hydroxyvitamin D (25OHD) as a biomarker of vitamin D status, among pregnant women in Sweden. The number of women included was 1125 with VDQ, FFQ and 25OHD, and of those, 64 also completed the food record. Median vitamin D intakes were 3.9 µg by VDQ (p < 0.001), and 5.3 µg by FFQ (p = 0.89), compared to 5.0 µg by food record. Correlations between vitamin D intake from food record and VDQ (rho = 0.51, p < 0.001) or FFQ (rho = 0.49, p < 0.001) were similar. The VDQ and FFQ also had a similar ability to rank the individuals according to vitamin D intake. However, only vitamin D intake from the VDQ was significantly associated with vitamin D status as assessed by 25OHD. The validation coefficient for the VDQ was 0.68 and 0.75 for the FFQ. In conclusion, assessing dietary vitamin D intake is challenging, regardless of the dietary assessment method. The VDQ, that includes only four food items, is a valid, simple and useful tool in assessing vitamin D intake of pregnant women in Sweden, while imposing a minimal burden on women and researchers.