Self-Reported Dietary Supplement Use Is Reproducible and Relatively Valid in the Cancer Prevention Study-3 Diet Assessment Substudy

Terryl J. Hartman, Ying Wang, Rebecca A. Hodge, Diane C. Mitchell, W. Dana Flanders, Chengchen Li, Laura Sampson, Alyssa N. Troeschel, Alpa V. Patel, Marjorie L. McCullough

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Dietary supplement use is common, particularly among cancer survivors and those at increased risk for cancer. Objective: The objectives of this study were to assess 1-year test–retest reproducibility of dietary supplement use reported via food frequency questionnaire (FFQ-1 vs FFQ-2) and relative validity in comparison to repeated 24-hour dietary recalls (FFQ-2 vs DRs). Design: This ancillary study was conducted within a large prospective cohort, the American Cancer Society's Cancer Prevention Study-3. Participants/setting: Between 2015 and 2016, 684 participants in the United States (64% women; 62% non-Hispanic White, 23% non-Hispanic Black, and 15% Hispanic) completed two FFQs and up to six unannounced telephone interviewer-administered DRs over 1 year as part of the Cancer Prevention Study-3 Diet Assessment Substudy. Primary outcome measures: FFQs queried current multivitamin-mineral supplement (≥10 components) use, frequency and dose (range) for seven supplements taken individually or as part of a complex (individual/complex) including calcium, vitamins D, C, and E, folic acid, fish oil, and glucosamine. DRs allowed exact reporting of supplement frequency and dose. Statistical analyses: Weighted κ statistics were used to evaluate reproducibility between FFQ-1 and FFQ-2 and Spearman correlation coefficients assessed agreement between supplemental nutrient amounts assessed by FFQ-2 and the average of DRs. Results: Just more than half of the participants reported taking multivitamin-mineral supplements on the baseline FFQ. Kappa statistics for the comparison of categorical responses between FFQ-1 and FFQ-2 were 0.67 for multivitamin-mineral supplements. Kappas for individual/complex supplements ranged from 0.47 for folic acid to 0.74 for vitamin D, with a mean of 0.64. Results were similar between men and women. Spearman correlation coefficients comparing FFQ-2 with the average of DRs (validity) for nutrient intakes from all sources ranged from 0.65 (fish oil for women) to 0.77 (vitamin D for men and calcium for women); results were similar among men and women. Conclusions: These findings suggest the FFQ used in Cancer Prevention Study-3 has good reproducibility over 1 year and yields estimates comparable to a more detailed assessment for commonly consumed dietary supplements.

Original languageEnglish (US)
Pages (from-to)1665-1676.e2
JournalJournal of the Academy of Nutrition and Dietetics
Issue number9
StatePublished - Sep 2022

All Science Journal Classification (ASJC) codes

  • Food Science
  • Nutrition and Dietetics


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