Dietary flavonoids and flavonoid-rich foods: validity and reproducibility of FFQ-derived intake estimates

Yiyang Yue, Joshua Petimar, Walter C. Willett, Stephanie A. Smith-Warner, Changzheng Yuan, Sinara Rosato, Laura Sampson, Bernard Rosner, Aedin Cassidy, Eric B. Rimm, Kerry L. Ivey*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective: To evaluate the validity and reproducibility of a 152-item semi-quantitative FFQ (SFFQ) for estimating flavonoid intakes.

Design: Over a 1-year period, participants completed two SFFQ and two weighed 7-d dietary records (7DDR). Flavonoid intakes from the SFFQ were estimated separately using Harvard (SFFQHarvard) and Phenol-Explorer (SFFQPE) food composition databases. 7DDR flavonoid intakes were derived using the Phenol-Explorer database (7DDRPE). Validity was assessed using Spearman’s rank correlation coefficients deattenuated for random measurement error (r s ), and reproducibility was assessed using rank intraclass correlation coefficients.

Setting: This validation study included primarily participants from two large observational cohort studies.Participants:Six hundred forty-one men and 724 women

Participants: Six hundred forty-one men and 724 women.

Results: When compared with two 7DDRPE, the validity of total flavonoid intake assessed by SFFQPE was high for both men and women (r s = 0·77 and r s = 0·74, respectively). The r s for flavonoid subclasses ranged from 0·47 for flavones to 0·78 for anthocyanins in men and from 0·46 for flavonols to 0·77 for anthocyanins in women. We observed similarly moderate (0·4–0·7) to high (≥0·7) validity when using SFFQHarvard estimates, except for flavonesHarvard (r s = 0·25 for men and r s = 0·19 for women). The SFFQ demonstrated high reproducibility for total flavonoid and flavonoid subclass intake estimates when using either food composition database. The intraclass correlation coefficients ranged from 0·69 (flavonolsPE) to 0·80 (proanthocyanidinsPE) in men and from 0·67 (flavonolsPE) to 0·77 (flavan-3-ol monomersHarvard) in women.

Conclusions: SFFQ-derived intakes of total flavonoids and flavonoid subclasses (except for flavones) are valid and reproducible for both men and women.
Original languageEnglish
Pages (from-to)3295-3303
Number of pages9
JournalPublic health nutrition
Issue number18
Early online date23 Jul 2020
Publication statusPublished - 01 Dec 2020

Bibliographical note

Funding Information:
Acknowledgements: The authors thank the Lifestyle Validation Study staff (Kristie Antonitto, Kirstin Anderson, Stephanie Bostic, Lisa Bowser (deceased), Catherine Clowry, Stefanie Dean, Brenna Murphy, Maria Petkova and Sean Sinnott). Financial support: MLVS and WLVS are supported by National Institutes of Health (grants UM1 CA186107, UM1 CA176726, P01 CA055075-18S1, U01CA152904 and U01CA167552). K.L.I. was supported by a National Health and Medical Research Council fellowship. J.P. is supported by T32HL098048 from National Heart, Lung and Blood Institute. Conflict of interest: There are no conflicts of interest. Authorship: The authors’ responsibilities are as follows: K.L.I., J.P., Y.Y. and E.B.R. designed the analysis and had responsibility for the final content; E.B.R., W.C.W., L.S., K.L.I., J.P., S.A.S.-W. and S.R. collected data and performed computations; Y.Y., J.P. and K.L.I. analysed data and performed statistical analysis; Y.Y. and J.P. wrote the final manuscript; W.C.W., SSW, C.Y., S.A.S.-W., S.R., L.S., B.R. and A.C. provided conceptual advice and assisted in interpreting the data and editing the manuscript; all authors read and approved the manuscript. Ethical standards disclosure: This study was conducted according to the guidelines laid down in the Declaration of Helsinki, and all procedures involving research study participants were approved by the Harvard T.H. Chan School of Public Health and Brigham and Women’s Hospital. Written informed consent was obtained from all subjects.

Publisher Copyright:

Copyright 2021 Elsevier B.V., All rights reserved.


  • Diet record
  • Dietary assessment
  • FFQ
  • Flavonoids
  • Validation study

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Public Health, Environmental and Occupational Health


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