human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Few studies provide correlations between different indicators of the dietary intakes of older ( > or= 65 y ) black and white adults . This study compared the usual intakes of vitamin E , vitamin C , and selected carotenoids estimated by a modified Harvard food frequency question naire ( FFQ ) to those estimated by multiple 24-h recalls , and to blood concentrations of components in a r and omly selected sample of participants in the Chicago Health and Aging Project ( CHAP ) . Subjects ( n = 59 ) were interviewed to complete multiple 24-h recalls over a year 's time , then completed an FFQ and subsequently provided a fasting blood specimen within 2 mo . Dietary estimates were energy-adjusted separately for men and women . Significant ( P < 0.05 ) correlations between total ( diet and supplement ) FFQ estimates and serum measures of vitamin E and vitamin C were as follows : 0.49 and 0.39 for blacks , and 0.42 and 0.29 for whites , respectively . The highest correlations between serum and FFQ indicators were for dietary beta-cryptoxanthin ( 0.46 ) , total alpha-tocopherol ( 0.46 ) and total beta-carotene ( 0.44 ) among whites ; among blacks , the highest correlations were for dietary alpha-carotene ( 0.81 ) , total alpha-tocopherol ( 0.53 ) and total beta-cryptoxanthin ( 0.50 ) ; all were significant ( P < 0.05 ) . Further adjustment for age , gender , BMI , and educational level minimally altered these coefficients . These findings indicate that the modified Harvard FFQ provides reasonable estimates of serum levels of vitamin E , vitamin C and beta-cryptoxanthin among CHAP participants Although many validation studies of FFQ have been reported , only a few addressed the effect of inclusion of dietary supplement use on the validity of micronutrient estimates . The purpose of the present study was to assess reproducibility and validity of a self-administered FFQ , intended to measure total nutrient intake from diet and from  dietary supplements  , in a r and om population -based sample of 248 middle-aged and elderly men ( 40 - 74 y old ) in central Sweden . Fourteen 24-h recall interviews were used as the reference method . Participants were telephoned about once a month for 1 y , covering every day of the week , twice in r and om order . Spearman correlation coefficients increased 13 % ( from 0.49 to 0.62 ) , between FFQ-based micronutrient estimates and the fourteen 24-h recall interviews ( reference method ) when supplement use was included . Correct classification into highest quintiles was also improved by 14 % ( from 37 to 51 % ) . There were no differences in mean intraclass correlation coefficients for 1-y reproducibility between total micronutrient intake and micronutrients from foods only . The increase in the validity of micronutrient estimates due to inclusion of supplements in nutrient intake assessment has important implication s for sample size in epidemiologic studies . Because a dramatic increase in dietary supplement use has occurred in recent decades in many countries , the issue of including supplements in dietary assessment should be of highest priority in nutritional epidemiologic studies of chronic diseases Most of the tools used to assess nutritional intake in large epidemiological studies were originally developed to be used in young and middle-aged subjects and , therefore , their validity and reliability when employed in older subjects remain uncertain . We conducted this study to verify whether the question naire developed in the context of the European Prospect i ve Investigation into Cancer and nutrition ( EPIC ) could be used to assess dietary intake in the participants of InCHIANTI , an epidemiological study of risk factors for disability in late life , performed in 633 men ( 78 % aged , > or = 65 years ) and 802 women ( 81 % aged , > or = 65 years ) r and omly sample d from the general population . In particular , the aim of this project was to collect preliminary information that could support a future study of concurrent validity . Data on food consumption assessed using the EPIC question naire from the InCHIANTI participants were compared with those collected using a 7-day diary in the National Nutritional Investigation into Dietary Behavior ( INN-CA ) , a study conducted in 15 Italian centres aim ed at assessing Italian households ' and individuals ' dietary intake . In spite of different population s and different methods used in data collection , the distributions of dietary intake from the two studies were remarkably similar for most macro- and micro-nutrients , both in men and women and according to age groups . At a population level , a food frequency question naire and a costly and time-consuming objective method provided similar estimates of dietary intake . Future study should attempt to generalize these findings at an individual level by collecting data with both instruments in the same subjects It is not currently known how dietary assessment in older persons is affected by cognition . In a 1997 - 2000 study , the authors assessed the validity and reproducibility of a modified Harvard self-administered food frequency question naire ( SFFQ ) among 118 Black and 114 White r and omly selected participants , aged 68 - 99 years , of the Chicago Health and Aging Project . Participants completed multiple 24-hour dietary recall interviews ( mean=3.6 ) over 12 months and two SFFQs in the first and 12th months . The average energy-adjusted intraclass correlation coefficient for 15 nutrients was 0.59 for 1-year reproducibility in nutrient intake levels assessed by the SFFQ . The average energy-adjusted Pearson correlation coefficient was 0.46 for comparative validity between nutrient intake levels on the SFFQ and the dietary recalls . SFFQ reproducibility was higher among men , and comparative validity with the dietary recalls was higher among women . There were no remarkable differences in the correlations by age , race , educational level , presence of chronic conditions , or cognitive ability . The modified Harvard SFFQ is a reasonable method of dietary assessment even in a population of older persons , some of whom are at advanced age , have chronic health conditions , and have cognitive impairment STUDY OBJECTIVE --The aim of the study was to determine the reliability of a diet history interview with a short self completed question naire of a basic design used in other studies in the United Kingdom . DESIGN --The study used a cohort of elderly people r and omly divided into two groups after stratification for sex . Members of one group completed the question naire first and were interviewed later ; the procedure was reversed for the other group . SETTING -- Participants were drawn from registers of two general practitioners at a Nottingham health centre . PARTICIPANTS --All non-Asian men aged 65 - 74 years and women aged 59 - 65 years registered with the practice s were identified ( n = 152 ) ; 20 could not be traced and two were too ill , leaving 130 possible participants . Of these , 80 took part in the study . MEASUREMENTS AND RESULTS --Ranking of subjects in terms of estimated fat , fibre , and calcium intakes was compared in the history interview and in the self completed question naire . Agreement in tertile ranking was 58 % for fibre , 53 % for fat , and 49 % for calcium . Corresponding correlation coefficients for estimated nutrient intakes were 0.49 , 0.45 , and 0.41 respectively . The differences in nutrient intakes estimated by the two methods were not affected by age , sex , marital status , or smoking patterns . Subjects in the group asked to complete the question naire before being interviewed showed greater percentage concordance for tertile ranking , but this reached significance only for fat intake . CONCLUSIONS --The two methods provide estimates of intakes similar to those found in other studies in the United Kingdom , and the agreement between them in terms of tertile ranking is also similar to previous studies . The incidence of gross misclassification was low OBJECTIVE To compare the validity of a modified Block food-frequency question naire ( FFQ ) , a picture-sort administration of the FFQ ( PSFFQ ) and a meal pattern-based question naire ( MPQ ) in a multi-ethnic population of low socio-economic status ( SES ) . DESIGN Participants completed six 24-hour dietary recalls ( 24HR ) over six months ; the FFQ , PSFFQ and MPQ were completed in r and om order in the subsequent month . Instruments were interviewer-administered . The PSFFQ and MPQ were developed in formative research concerning difficulties for older adults in responding to st and ard food-frequency instruments . SETTING Rural North Carolina , USA . Subjects One hundred and twenty-two African American , Native American and white adults aged > or = 65 years , with approximately one-third in each ethnic group . Inclusion criteria included education < or = 12 years and income < or = 150 % of national poverty level or Medicaid recipient . RESULTS Comparing median intakes from the average of the 24HR with the three diet assessment instruments , the MPQ tended to overestimate intakes compared with the FFQ and PSFFQ . Correlations among nutrients obtained by the 24HR and the other three instruments were generally statistically significant and positive . Across nutrients , the PSFFQ was most highly correlated with the 24HR for women , while the FFQ was most highly correlated with the 24HR for men . CONCLUSIONS Dietary assessment s using 24HR and FFQ were similar to results reported elsewhere , although correlations between 24HR and FFQ were somewhat lower . Interviewer-administered dietary assessment s should be used with caution to evaluate dietary intake among older adults with low SES . Gender differences and the lower correlations should be investigated more thoroughly to assist in choosing dietary assessment instruments for this population OBJECTIVE To evaluate the 137-item  Utah Picture-sort Food-frequency Question naire ( FFQ ) in the measurement of usual dietary intake in older adults . DESIGN The picture-sort FFQ was administered at baseline and again one year later . Three seasonal 24-hour dietary recall interviews were collected during the year between the two FFQs . Mean nutrient intakes were compared between methods and between administrations of the FFQ . SETTING The FFQ interviews were administered in respondents ' homes or care-centres . The 24-hour diet recalls were conducted by telephone interview on r and om days of the week . SUBJECTS Two-hundred- and -eight men and women aged 55 - 84 years were recruited by r and om sample of controls from a case-control study of nutrition and bone health in Utah . RESULTS After adjustment for total energy intake , median Spearman rank correlation coefficients between the two picture-sort FFQs were 0.69 for men aged < or = 69 years , 0.66 for men aged > 69 years ; and 0.68 for women aged < or = 69 years , 0.67 for women aged > 69 years . Median correlation coefficients between methods were 0.50 for men < or = 69 years old , 0.52 for men > 69 years old ; 0.55 for women < or = 69 years old , 0.46 for women > 69 years old . CONCLUSIONS We report intake correlations between methods and administrations comparable to those reported in the literature for traditional paper- and -pencil FFQs and one other picture-sort method of FFQ . This dietary assessment method may improve ease and accuracy of response in this and other population s with low literacy levels , poor memory skill , impaired hearing , or poor vision Objective : The study was conducted to assess the relative validity of a 170-item semiquantitative food frequency question naire ( SFFQ ) adapted for use in the elderly . Design and subjects : The study was carried out in a sample of 80 men and women aged 55–75 y participating in a community based prospect i ve cohort study in Rotterdam , The Netherl and s. The two-step dietary assessment comprised a simple self-administered question naire ( 20 min ) followed by a structured interview with trained dietitians ( 20 min ) based on the completed question naire . Multiple food records ( FR ) collected over a one year period served as reference method . 24 h urine urea was used as indirect marker for protein intake . Results : Compared with FR , the SFFQ generally overestimated nutrient intake as reflected by difference in means and the ratio of SFFQ to FR . Energy adjustment reduced the observed overestimation . Pearson ’s correlation coefficients varied from close to 0.5 to about 0.9 for crude data , and after adjustment for age , sex , total energy intake , and for within-person variability in daily intake for 0.4–0.8 . Cross-classification into quintiles result ed in correct classification into the same or adjacent quintile of 75.8 % for crude and 76.8 % for energy-adjusted data . Validation of protein intake estimated by SFFQ with protein excretion from 24 h urine urea indicated overestimation of protein intake by SFFQ . Spearman correlation coefficient between protein intake estimated from urea excretion and SFFQ was 0.67 . Conclusions : Adaptation of a SFFQ for use in the elderly result ed in a valid and time-efficient dietary assessment instrument . Its ability to adequately rank study subjects according to their dietary intake support its application in epidemiological studies in the elderly . Sponsorship : ROMERES and Akzo Nobel , the Netherl and s ; K. Klipstein-Grobusch was supported by the Ministry of Research , Culture , and Science of the Federal State of Br and enburg , Germany OBJECTIVE The principal aim of this study was to develop a Swiss Food Frequency Question naire ( FFQ ) for the elderly population for use in a study to investigate the influence of nutritional factors on bone health . 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Few studies provide correlations between different indicators of the dietary intakes of older ( > or= 65 y ) black and white adults . This study compared the usual intakes of vitamin E , vitamin C , and selected carotenoids estimated by a modified Harvard food frequency question naire ( FFQ ) to those estimated by multiple 24-h recalls , and to blood concentrations of components in a r and omly selected sample of participants in the Chicago Health and Aging Project ( CHAP ) . Subjects ( n = 59 ) were interviewed to complete multiple 24-h recalls over a year 's time , then completed an FFQ and subsequently provided a fasting blood specimen within 2 mo . Dietary estimates were energy-adjusted separately for men and women . Significant ( P < 0.05 ) correlations between total ( diet and supplement ) FFQ estimates and serum measures of vitamin E and vitamin C were as follows : 0.49 and 0.39 for blacks , and 0.42 and 0.29 for whites , respectively . The highest correlations between serum and FFQ indicators were for dietary beta-cryptoxanthin ( 0.46 ) , total alpha-tocopherol ( 0.46 ) and total beta-carotene ( 0.44 ) among whites ; among blacks , the highest correlations were for dietary alpha-carotene ( 0.81 ) , total alpha-tocopherol ( 0.53 ) and total beta-cryptoxanthin ( 0.50 ) ; all were significant ( P < 0.05 ) . Further adjustment for age , gender , BMI , and educational level minimally altered these coefficients . These findings indicate that the modified Harvard FFQ provides reasonable estimates of serum levels of vitamin E , vitamin C and beta-cryptoxanthin among CHAP participants Although many validation studies of FFQ have been reported , only a few addressed the effect of inclusion of dietary supplement use on the validity of micronutrient estimates . The purpose of the present study was to assess reproducibility and validity of a self-administered FFQ , intended to measure total nutrient intake from diet and from  dietary supplements  , in a r and om population -based sample of 248 middle-aged and elderly men ( 40 - 74 y old ) in central Sweden . Fourteen 24-h recall interviews were used as the reference method . Participants were telephoned about once a month for 1 y , covering every day of the week , twice in r and om order . Spearman correlation coefficients increased 13 % ( from 0.49 to 0.62 ) , between FFQ-based micronutrient estimates and the fourteen 24-h recall interviews ( reference method ) when supplement use was included . Correct classification into highest quintiles was also improved by 14 % ( from 37 to 51 % ) . There were no differences in mean intraclass correlation coefficients for 1-y reproducibility between total micronutrient intake and micronutrients from foods only . The increase in the validity of micronutrient estimates due to inclusion of supplements in nutrient intake assessment has important implication s for sample size in epidemiologic studies . Because a dramatic increase in dietary supplement use has occurred in recent decades in many countries , the issue of including supplements in dietary assessment should be of highest priority in nutritional epidemiologic studies of chronic diseases Most of the tools used to assess nutritional intake in large epidemiological studies were originally developed to be used in young and middle-aged subjects and , therefore , their validity and reliability when employed in older subjects remain uncertain . We conducted this study to verify whether the question naire developed in the context of the European Prospect i ve Investigation into Cancer and nutrition ( EPIC ) could be used to assess dietary intake in the participants of InCHIANTI , an epidemiological study of risk factors for disability in late life , performed in 633 men ( 78 % aged , > or = 65 years ) and 802 women ( 81 % aged , > or = 65 years ) r and omly sample d from the general population . In particular , the aim of this project was to collect preliminary information that could support a future study of concurrent validity . Data on food consumption assessed using the EPIC question naire from the InCHIANTI participants were compared with those collected using a 7-day diary in the National Nutritional Investigation into Dietary Behavior ( INN-CA ) , a study conducted in 15 Italian centres aim ed at assessing Italian households ' and individuals ' dietary intake . In spite of different population s and different methods used in data collection , the distributions of dietary intake from the two studies were remarkably similar for most macro- and micro-nutrients , both in men and women and according to age groups . At a population level , a food frequency question naire and a costly and time-consuming objective method provided similar estimates of dietary intake . Future study should attempt to generalize these findings at an individual level by collecting data with both instruments in the same subjects It is not currently known how dietary assessment in older persons is affected by cognition . In a 1997 - 2000 study , the authors assessed the validity and reproducibility of a modified Harvard self-administered food frequency question naire ( SFFQ ) among 118 Black and 114 White r and omly selected participants , aged 68 - 99 years , of the Chicago Health and Aging Project . Participants completed multiple 24-hour dietary recall interviews ( mean=3.6 ) over 12 months and two SFFQs in the first and 12th months . The average energy-adjusted intraclass correlation coefficient for 15 nutrients was 0.59 for 1-year reproducibility in nutrient intake levels assessed by the SFFQ . The average energy-adjusted Pearson correlation coefficient was 0.46 for comparative validity between nutrient intake levels on the SFFQ and the dietary recalls . SFFQ reproducibility was higher among men , and comparative validity with the dietary recalls was higher among women . There were no remarkable differences in the correlations by age , race , educational level , presence of chronic conditions , or cognitive ability . The modified Harvard SFFQ is a reasonable method of dietary assessment even in a population of older persons , some of whom are at advanced age , have chronic health conditions , and have cognitive impairment STUDY OBJECTIVE --The aim of the study was to determine the reliability of a diet history interview with a short self completed question naire of a basic design used in other studies in the United Kingdom . DESIGN --The study used a cohort of elderly people r and omly divided into two groups after stratification for sex . Members of one group completed the question naire first and were interviewed later ; the procedure was reversed for the other group . SETTING -- Participants were drawn from registers of two general practitioners at a Nottingham health centre . PARTICIPANTS --All non-Asian men aged 65 - 74 years and women aged 59 - 65 years registered with the practice s were identified ( n = 152 ) ; 20 could not be traced and two were too ill , leaving 130 possible participants . Of these , 80 took part in the study . MEASUREMENTS AND RESULTS --Ranking of subjects in terms of estimated fat , fibre , and calcium intakes was compared in the history interview and in the self completed question naire . Agreement in tertile ranking was 58 % for fibre , 53 % for fat , and 49 % for calcium . Corresponding correlation coefficients for estimated nutrient intakes were 0.49 , 0.45 , and 0.41 respectively . The differences in nutrient intakes estimated by the two methods were not affected by age , sex , marital status , or smoking patterns . Subjects in the group asked to complete the question naire before being interviewed showed greater percentage concordance for tertile ranking , but this reached significance only for fat intake . CONCLUSIONS --The two methods provide estimates of intakes similar to those found in other studies in the United Kingdom , and the agreement between them in terms of tertile ranking is also similar to previous studies . The incidence of gross misclassification was low OBJECTIVE To compare the validity of a modified Block food-frequency question naire ( FFQ ) , a picture-sort administration of the FFQ ( PSFFQ ) and a meal pattern-based question naire ( MPQ ) in a multi-ethnic population of low socio-economic status ( SES ) . DESIGN Participants completed six 24-hour dietary recalls ( 24HR ) over six months ; the FFQ , PSFFQ and MPQ were completed in r and om order in the subsequent month . Instruments were interviewer-administered . The PSFFQ and MPQ were developed in formative research concerning difficulties for older adults in responding to st and ard food-frequency instruments . SETTING Rural North Carolina , USA . Subjects One hundred and twenty-two African American , Native American and white adults aged > or = 65 years , with approximately one-third in each ethnic group . Inclusion criteria included education < or = 12 years and income < or = 150 % of national poverty level or Medicaid recipient . RESULTS Comparing median intakes from the average of the 24HR with the three diet assessment instruments , the MPQ tended to overestimate intakes compared with the FFQ and PSFFQ . Correlations among nutrients obtained by the 24HR and the other three instruments were generally statistically significant and positive . Across nutrients , the PSFFQ was most highly correlated with the 24HR for women , while the FFQ was most highly correlated with the 24HR for men . CONCLUSIONS Dietary assessment s using 24HR and FFQ were similar to results reported elsewhere , although correlations between 24HR and FFQ were somewhat lower . Interviewer-administered dietary assessment s should be used with caution to evaluate dietary intake among older adults with low SES . Gender differences and the lower correlations should be investigated more thoroughly to assist in choosing dietary assessment instruments for this population OBJECTIVE To evaluate the 137-item  Utah Picture-sort Food-frequency Question naire ( FFQ ) in the measurement of usual dietary intake in older adults . DESIGN The picture-sort FFQ was administered at baseline and again one year later . Three seasonal 24-hour dietary recall interviews were collected during the year between the two FFQs . Mean nutrient intakes were compared between methods and between administrations of the FFQ . SETTING The FFQ interviews were administered in respondents ' homes or care-centres . The 24-hour diet recalls were conducted by telephone interview on r and om days of the week . SUBJECTS Two-hundred- and -eight men and women aged 55 - 84 years were recruited by r and om sample of controls from a case-control study of nutrition and bone health in Utah . RESULTS After adjustment for total energy intake , median Spearman rank correlation coefficients between the two picture-sort FFQs were 0.69 for men aged < or = 69 years , 0.66 for men aged > 69 years ; and 0.68 for women aged < or = 69 years , 0.67 for women aged > 69 years . Median correlation coefficients between methods were 0.50 for men < or = 69 years old , 0.52 for men > 69 years old ; 0.55 for women < or = 69 years old , 0.46 for women > 69 years old . CONCLUSIONS We report intake correlations between methods and administrations comparable to those reported in the literature for traditional paper- and -pencil FFQs and one other picture-sort method of FFQ . This dietary assessment method may improve ease and accuracy of response in this and other population s with low literacy levels , poor memory skill , impaired hearing , or poor vision Objective : The study was conducted to assess the relative validity of a 170-item semiquantitative food frequency question naire ( SFFQ ) adapted for use in the elderly . Design and subjects : The study was carried out in a sample of 80 men and women aged 55–75 y participating in a community based prospect i ve cohort study in Rotterdam , The Netherl and s. The two-step dietary assessment comprised a simple self-administered question naire ( 20 min ) followed by a structured interview with trained dietitians ( 20 min ) based on the completed question naire . Multiple food records ( FR ) collected over a one year period served as reference method . 24 h urine urea was used as indirect marker for protein intake . Results : Compared with FR , the SFFQ generally overestimated nutrient intake as reflected by difference in means and the ratio of SFFQ to FR . Energy adjustment reduced the observed overestimation . Pearson ’s correlation coefficients varied from close to 0.5 to about 0.9 for crude data , and after adjustment for age , sex , total energy intake , and for within-person variability in daily intake for 0.4–0.8 . Cross-classification into quintiles result ed in correct classification into the same or adjacent quintile of 75.8 % for crude and 76.8 % for energy-adjusted data . Validation of protein intake estimated by SFFQ with protein excretion from 24 h urine urea indicated overestimation of protein intake by SFFQ . Spearman correlation coefficient between protein intake estimated from urea excretion and SFFQ was 0.67 . Conclusions : Adaptation of a SFFQ for use in the elderly result ed in a valid and time-efficient dietary assessment instrument . Its ability to adequately rank study subjects according to their dietary intake support its application in epidemiological studies in the elderly . Sponsorship : ROMERES and Akzo Nobel , the Netherl and s ; K. Klipstein-Grobusch was supported by the Ministry of Research , Culture , and Science of the Federal State of Br and enburg , Germany OBJECTIVE The principal aim of this study was to develop a Swiss Food Frequency Question naire ( FFQ ) for the elderly population for use in a study to investigate the influence of nutritional factors on bone health . 
    Output:
    