Estimating nitrate intake in the Australian diet: Design and validation of a food frequency questionnaire

Abstract

Background

Dietary nitrates may play a role in mediating several key physiological processes impacting health and/or exercise performance. However, current methods for assessing dietary nitrate (NO ₃ ⁻) consumption are inadequate. The present study aimed to examine the dietary nitrate intake in a sample of 50 healthy adults, as well as test the validity of a purposefully developed food frequency questionnaire (FFQ).

Methods

Dietary nitrate intake was estimated over a week using (i) three 24‐h dietary recalls; (ii) a short‐term (7‐day) FFQ; and (iii) a biomarker (urinary nitrate), in conjunction with a nitrate reference database.

Results

Daily dietary nitrate intake estimates were 130.94 mg (average of three 24‐h recalls) and 180.62 mg (FFQ). The mean urinary NO ₃ ⁻ excretion was 1974.79 µmol day ^–1 (or 917.9 µmol L ^–1). Despite the difference between the two dietary assessment methods, there was a moderate positive correlation ( r = 0.736, ρ < 0.001) between the two tools. There was also a positive correlation between urinary NO ₃ ⁻ and 24‐h recall data ( r = 0.632, ρ < 0.001), as well as between urinary NO ₃ ⁻ and FFQ ( r = 0.579, ρ < 0.001).

Conclusions

The ability to accurately estimate nitrate intakes depends on having suitable reference methods to estimate the concentrations of nitrate in the food supply, coupled with valid and reliable dietary assessment tools. Based on the findings from the present study, at an individual level, dietary recalls or records may be more accurate in estimating intakes of NO ₃ ⁻. However, given the lower cost and time needed for administration relative to recalls, the FFQ has merit for estimating NO ₃ ⁻ intakes in health interventions, dietary surveys and surveillance programs.

Key points

• Nitrate occurs naturally in plant foods and water, and are also commonly used as food additives in cured products. Dietary nitrates may be beneficial for health and exercise performance; however, current methods to assess dietary nitrate consumption are inadequate.

• Estimates of nitrate intake from our purposefully designed food frequency questionnaire showed moderate associations with estimates from 24‐h food recalls, as well as from a urinary biomarker.

• At an individual level, dietary recalls or records may be more accurate in estimating dietary nitrate intake. However, the food frequency questionnaire developed in the present study may be useful to estimate nitrate intake in health interventions, dietary surveys and surveillance programs.

Abstract

Estimating nitrate intake among Australians