The validation of a vegetable and fruit food frequency questionnaire
used to survey trends in Ontario
presented to the Annual RRFSS Workshop – June 19, 2003 Toronto, Ontario
Katherine Gray-Donald PhD, Principal Investigator – Dr. Gray-Donald is currently the Director of the
School of Dietetics and Human Nutrition at McGill University. Her career started in the 1970’s in the
community trying to improve the nutritional status of disadvantaged Canadian individuals and groups. In
1980-84 she obtained her doctorate in Epidemiology and Biostatistics from McGill. She has worked as a
researcher in the areas of gestational diabetes, nutrition of the frail elderly and the food habits of
Canadians. Her most recent work is focused on the identification and prevention of anemia-related
problems, issues related to dietary assessment methods and increasing knowledge and understanding of
nutritional declines through aging. This last focus will be through a newly funded cohort study in Quebec Dr.
Gray-Donald has been extensively involved in the training of both MSc and PhD students who are
continuing their careers in academia and the health field in Canada and abroad. Her fluency in both English
and French allows her current work as a member of Quebec’s Provincial Ethics Committee and
participation, past and present, in many provincial and federal health initiatives.
Marie Traynor RD – Marie Traynor is a member in good standing of the College of Dietitians of Ontario
and, under the supervision of Dr. Gray-Donald, is a Master’s Candidate in the School of Dietetics and
Human Nutrition at McGill University. She received her Honours BSc from Brescia College University at the
University of Western Ontario in1992. She completed a Dietetic Internship at the KFL&A Health Unit,
Kingston, Ontario in 1994 with a focus on community nutrition and worked in Community Health Centres
and in Public Health in Ontario from 1994-2001. She has been involved in the Ontario Society of Nutrition
Professionals in Public Health, acting as Chair in 2000-2001. Marie has also volunteered as a literacy tutor.
This validation study is the basis for her Master’s research thesis.
Partners:
 Durham Region Health Department
 Food Habits of Canadians, McGill University
 Institute for Social Research, York University
 Regional Municipality of Peel Health Department
 Toronto Public Health
Funding:
 The Rapid Risk Factor Surveillance System Working Group
 Fonds de la recherche en santé du Québec
 Canadian Institutes of Health Research
1
Vegetable and Fruit Food Frequency Module Serves as a Proxy for Quantified
Intake
Introduction: In their work towards chronic disease prevention public health practitioners need
valid tools to survey trends in dietary intake. Currently the Rapid Risk Factor Surveillance Survey
includes an optional six-item vegetable and fruit intake frequency module. Our objectives are 1)
to evaluate the potential for the frequency or occasions of consumption from the module to stand
as a reasonable proxy for quantity collected through a reference method and, 2) to compare the
proportions of respondents who meet national recommendations as classified by each method.
Methods: Dietitians administered the reference method, three 24-hour recalls, to each of 174
adult respondents who had completed the food frequency module as part of the Rapid Risk Factor
Surveillance Survey. Recalls were conducted over the phone using the Multiple Pass Method.
Tools were mailed to respondents to aid with portion estimation. Results: The daily average of
total vegetable and fruit intake for the group was 4.8 servings/day from the recalls and not
significantly different from the 4.6 occasions/day from the questionnaire. Thirty five percent of
respondents were classified as consuming at least five servings/day by the recall method and 37
% were classified as consuming vegetables and fruit on at least five occasions/day by the
questionnaire. Discussion: Results indicate this brief questionnaire can be used as a proxy for
quantified intake. The classification of those meeting national recommendations appeared close.
Conclusion: Given the limited funding available for nutrition promotion, the surveillance data
collected using this type of food frequency questionnaire can contribute to decisions regarding the
distribution of funds for program planning.
Acknowledgements:
Philippa Holowaty, PhD, Academic Advisor & RRFSS Working Group Liaison, McMaster University
and Social & Public Health Services Dept., City of Hamilton
Debra Reid, PhD, RD, Academic Advisor, University of Ottawa and the Dept. of National Defence,
DCOS Force Health Protection
Louise Johnson-Down, MSc, RD - Staff and data management and statistical advice, Food Habits
of Canadians Research Group, McGill University
Sarah Blunden, Grace Su-Jing Chang, Sarah Howe RD, Karine Levy P.Dt.,
Uma Palaniappan PhD, Karen Parsons RD, Serena Strulovitch, Florence Sydney P.Dt.,
Emma Yiin, MSc.
2