Validation of a Revised Food Frequency Questionnaire in a Population of Elderly Men and Women With Fragility Fractures and Correlation With Bone Mineral Density and Biochemical Markers

Assessing food intake is important to estimate nutrient intake and counsel patients regarding their diet patterns and supplement use. The purpose of this study was to revise a validated Block Calcium/Vitamin D Screener to include protein for use in elderly patients with a history of fragility fracture. The Block Calcium/Vitamin D Screener food list was refined by adding protein foods and culling the calcium and vitamin D food items based on 2003-2006 NHANES survey. A nutrient database for the revised FFQ was developed from the United States Department of Agriculture Agricultural Research Service National Nutrient Database. Validation of the revised FFQ was attempted in a population of elderly persons. Thirty-one subjects were recruited. After signing informed consent, a Mini Mental State exam, history and physical exam were completed. Nutrient intake measured by the revised FFQ and the Block 2014 FFQ was assessed in a randomized, sequential crossover design. A biochemical workup and DXA scan for bone mineral density measurement was done. Descriptive statistics were generated and all values were expressed as median (interquartile range) as the values were not normally distributed. The subjects’ biochemical and bone mass values were reported with nonparametric values. The agreement between the two methods of measurement of nutrient values were compared using the Bland-Altman method. A significant difference between methods was found. The mean difference between the FFQs measurement of dietary protein intake was 19.7 g (SD 21.6) which is significantly different from 0 ( p