Nutrition Assessment

Our Mission

To make it possible for investigators, no matter what their level of training or expertise in dietary assessment, to incorporate the best data collection methods in their studies at reasonable cost.

The Nutrition Assessment shared resource (NASR) provides comprehensive support to investigators who include dietary assessment in their research protocols. Nutritional epidemiologists at Fred Hutch established this resource in 1993, which to date has provided support to hundreds of studies funded by the National Institutes of Health. 

NASR uses the University of Minnesota’s Nutrition Data System for Research (NDSR) software for data entry and nutrient analysis.  This is the most accurate and comprehensive software available for nutrition research.

Dietary Data Collection

NASR uses multiple established methods to collect and process dietary intake data from participants enrolled in observational and intervention studies, including:

Other Services

NASR also offers:

  • Serving Size Tools
  • Individualized Participant Feedback for FFQs
  • Project Staff Training
  • Custom Questionnaire Design
  • Intermediate Datasets (By Request)

Dietary Recalls

The 24-hour dietary recall is an in-depth interview that collects detailed information on all foods and beverages consumed by a participant during the previous 24 hours. These recalls are best administered unannounced (not scheduled on a specific day) so that participants do not change their eating habits in anticipation of the interview.

Recall Procedure

Trained and certified NASR staff conduct recalls over the telephone and enter data directly into the University of Minnesota’s Nutrition Data System for Research (NDSR) software. This interactive software prompts the interviewer to probe for detailed information about specific quantities, brand names and cooking methods for each food. The accuracy of the recall is highly dependent upon participant memory and the communication skills of both the participant and the interviewer. For this reason, NASR interviewers are specially trained to effectively probe for information using neutral and non-leading questions. All participants receive a serving size booklet prior to the call.

NASR's serving size booklet is available for purchase.

Multiple-Day Food Records

A food record or food diary is a detailed description of all foods and beverages consumed over a period of three to seven days. The participant records foods and beverages at the time they are consumed in special booklets obtained from NASR.

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Documented Multiple-Day Food Records

Prior to completing the documented food record, the participant meets with trained study staff to receive detailed instruction on food recording procedures. After completing the food record, the participant meets with study staff again to review and document the information reported in the food record. Study staff then send the reviewed and documented food record to NASR for coding and analysis using the University of Minnesota’s Nutrition Data System for Research (NDSR).

Undocumented Multiple-Day Food Records

For an undocumented food record, the participant receives less instruction on food recording procedures and does not meet with study staff to review and document the completed food record. Study staff send the food record, as completed by the participant, to NASR for coding and analysis using NDSR.

Two studies evaluated a self-administered 3-day food record protocol where the dietary intake data were analyzed both before (undocumented) and after (documented) additional information was obtained from the study participant. Results of these studies suggest that the use of undocumented food records is feasible for use in large cohort studies.

NASR's undocumented multiple-day food record booklet is available for purchase.

For more information:

Kolar AS, Patterson RE, White E, Neuhouser ML, Frank LL, Standley J, Potter JD, Kristal AR. A practical method for collecting 3-day food records in a large cohort. Epidemiology. 2005; 16:579-583.

Kwan ML, Kushi LH, Song J, Timperi AW, Boynton AM, Johnson KM, Standley J, Kristal AR.  A Practical Method for Collecting Food Record Data in a Prospective Cohort Study of Breast Cancer Survivors.  J Am Diet Assoc. 2010; 172 (11): 1315-1323.

Food Record Training

NASR offers training for study staff on the appropriate and accurate completion of the Multiple-Day Food Record. Trainings for study staff include:

  • How to instruct a participant to complete a Multiple-Day Food Record (undocumented)
  • How to instruct a participant to complete a Multiple-Day Food Record (documented)
  • How to document a completed Multiple-Day Food Record (documented)

Trainings can be done individually or in group format. Customized training options are available, pending study needs.

Food Frequency Questionnaires (FFQ)

A food frequency questionnaire (FFQ) is a finite list of foods and beverages with response options to indicate usual frequency of consumption (and, in some cases, portion size) over a specified time period. It is the most common dietary assessment tool used in large epidemiologic studies of diet and health.

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FFQ Procedure

The NASR FFQ is self-administered. It asks participants to report the frequency of consumption and portion size of approximately 125 line items over a defined period of time (e.g., the last month; the last three months). Each line item is defined by a series of foods or beverages. Additional questions on food type and preparation methods enable the analysis software to further refine nutrient calculations. The database for the NASR FFQ is based on the nutrient strings in the Nutrition Data System for Research (NDSR) developed by the Nutrition Coordinating Center (NCC) at the University of Minnesota. See more about NDSR.

The GNA (General Nutrition Assessment) is the current version of the standard FFQ. It has a counterpart called the MNA, which is intended for use with male participants. The line items on these two questionnaires are identical, but the medium portion sizes are larger on the MNA.

The GNA/MNA is available in English and Spanish. See sample FFQs and the serving size resource.

Using FFQs & Data Analysis

The current version of the standard FFQ is the GNA/MNA. It is a 12-page booklet. The booklets are purchased from NASR. Completed booklets are sent back to NASR to be scanned (i.e., read by an optical scanner) and processed (to generate nutrient output).

Process At A Glance

  • Complete the Study Account Information form to set up your study and purchase FFQ booklets.
  • Designate a "FFQ Quality Assurance (QA) Lead" for your study and perform QA activities before sending completed FFQs to NASR for scanning/processing. See QA Guidelines.
  • Send FFQs to NASR for scanning/processing. Use FedEx/UPS (for tracking). Include FFQ Batch Cover Sheet.
  • Processed FFQ output files are posted to the secure NASR Study Portal. Access Your Data.
  • Review error report for quality considerations after downloading data files. See QA Guidelines.
  • Cite NASR in your publications.

For more information, see the FFQ Technical Documentation (GNA/MNA).

Custom Services

Custom services are available. For example:

  • Customization of FFQ's.
  • Customized datasets (e.g., additional variables on Healthy Eating Index [HEI] scoring).
  • Individualized Participant Feedback (called the Nutrient Analysis Report or NAR) — a printable report giving the estimated dietary intake of specific nutrients for each study participant.
Development History

NASR periodically updates its standard FFQ to reflect U.S. food consumption patterns and major changes in the marketplace.

The previous version of the standard FFQ was the GSEL (and its counterpart, the MSEL). The GSEL/MSEL was designed in 2001 under the direction of Fred Hutch nutritional scientists and epidemiologists and was based on the questionnaires used in two large NIH-funded studies, the Selenium and Vitamin E Cancer Prevention Trial (SELECT) and the VITamins and Lifestyle study (VITAL). The GSEL/MSEL was updated in late 2010 to become the GNA/MNA.

The validation study by Patterson et al, using the WHI FFQ, is an excellent approximation of the inter-method reliability of the standard FFQ. The questionnaires use the same format and analysis algorithms. There are some differences in FFQ items. The nutrient database systems are the same; however, the standard FFQ nutrient database is updated regularly as new nutrients/food components are added to NDSR and improved analytic methods result in updated nutrient composition data.

Reference: Patterson RE, Kristal AR, Carter RA, Fels-Tinker L, Bolton MP, Agurs-Collins T. Measurement characteristics of the Women's Health Initiative food frequency questionnaire. Annals of Epidemiology. 9: 178-187, 1999.

 

Short Food Questionnaires

Short questionnaires to assess the consumption of specific foods and/or specific food-related behaviors have been developed and are available for use in research studies. Please contact us at nasr@fredhutch.org to obtain permission and pricing information.

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Beverage and Snack Questionnaire

BSQ

The Beverage and Snack Questionnaire (BSQ) is a 19-item questionnaire used to assess frequency of consumption of beverages such as soft drinks, energy drinks, juice, fruit drinks and milk, plus consumption of salty and sweet snacks such as cookies and candy. The response options inquire whether the food or beverage was consumed at school or away from school. The questionnaire was developed for use with youth (ages 10-18 years).

Reference: Neuhouser ML, Lilley S, Lund A, and Johnson DB. Development and validation of a beverage and snack questionnaire for use in evaluation of school nutrition policies. J Am Diet Assoc 2009; 109 (9): 1587-1592.

BSQ2

A second Beverage and Snack Questionnaire (BSQ2) is also available. The BSQ2 was developed in conjunction with the Network for a Healthy California. It differs slightly from the validated version in that a) the milk questions have been changed in order to separate flavored milks from regular milks, for investigators interested in overall sweetened beverage consumption and b) sweetened coffee and tea beverages and plain water have also been added.

Caffeine Questionnaire

The Caffeine Questionnaire (Supplemental Beverage Questions) is a list of 13 caffeine-containing beverages available to supplement the general Food Frequency Questionnaire on the dietary intake of caffeine. It can also be used independently of the general FFQ.

Reference: Song YJ, Kristal AR, Wicklund KG, Cushing-Haugen KL, Rossing MA.  Coffee, tea, colas, and risk of epithelial ovarian cancer. Cancer Epidemiol Biomarkers Prev 2008; 17(3): 712-6.

Fat-Related Diet Habits Questionnaire

The Fat-Related Diet Habits Questionnaire was designed to assess eating behaviors associated with a low-fat diet.

There are five fat-related dietary patterns (factors): substitute specially manufactured low-fat foods; modify meats to be low in fat; avoid frying foods; replace high-fat foods with lower-fat foods such as fruits and vegetables; and avoid fat as a spread or flavoring.

Responses are on a four-point scale (1=usually or always, 2=often, 3=sometimes, 4=rarely or never), which are coded 1 through 4 to correlate positively with fat intake. Scoring the questionnaire will give a general idea about respondents' low-fat eating patterns; the lower the score, the lower the dietary fat intake.

References:

Kristal AR, Shattuck AL, Henry HJ. Patterns of dietary behavior associated with selecting diets low in fat: reliability and validity of a behavioral approach to dietary assessment. J Am Diet Assoc 1990; 90: 214-20.

Shannon J, Kristal AR, Curry SJ, Beresford SA. Application of a behavioral approach to measuring dietary change: the fat- and fiber-related diet behavior questionnaire. Cancer Epidemiol Biomarkers Prev 1997; 6(5): 355-61.

Mindful Eating Questionnaire

The Mindful Eating Questionnaire (MEQ) is a 28-item scale developed to measure the construct of mindful eating, a nonjudgmental awareness of the physical and emotional sensations associated with eating. 

Reference: Framson C, Kristal AR, Schenk JM, Littman AJ, Zeliadt S, Benitez D. Development and validation of the Mindful Eating Questionnaire. J Am Diet Assoc 2009; 109:1439-1444.

Soy Questionnaire

The Soy Questionnaire was developed to assess the patterns and correlates of soy consumption among postmenopausal women in the United States. It asks questions about the consumption of 20 soy foods and supplements.

Reference: Frankenfeld CL, Patterson RE, Horner NK, Neuhouser ML, Skor HE, Kalhorn TF, Howald WN, Lampe JW. Validation of a soy food frequency questionnaire and evaluation of correlates of plasma isoflavone concentrations in postmenopausal women. Am J Clin Nutr 2003; 77:674-80.

Nutrition Data System for Research

NASR uses the Nutrition Data System for Research (NDSR) developed by the Nutrition Coordinating Center (NCC) at the University of Minnesota for the collection of 24-hour dietary recalls and the analysis of food records, menus, and recipes. In addition, the database for the food frequency questionnaires developed by Fred Hutch is based on the nutrient strings in NDSR.

NDSR uses the United States Department of Agriculture Nutrient Database for Standard Reference and its periodic revisions as the primary data source and is supplemented by information from the scientific literature and food manufacturers. The output provides values for 170+ nutrients, nutrient ratios, and other compounds. 

Read or Download Our NASR Fact Sheet

Carolyn Ehret, M.S., R.D.N., C.D.

Carolyn Ehret, M.S., R.D.N., C.D.

Director, NASR

Mailing Address:

Fred Hutchinson Cancer Research Center
1100 Fairview Ave. N.
P.O. Box 19024
M4-B402
Seattle, WA  98109-1024

Work Location: Arnold Building, 4th Floor
photo  of Fred Hutch campus

General NASR Information

Pricing & Custom Services

Please contact us at nasr@fredhutch.org for pricing and custom services information.

Citing NASR

Please cite both NASR and NDSR software in publications describing research which uses our services. Learn more about citing NASR.

Publications Supported by NASR

A list of publications supported by NASR can be found here.