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Open AccessArticle

Validity of a Food and Fluid Exercise Questionnaire for Macronutrient Intake during Exercise against Observations

College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
Sports and Exercise Nutrition, Institute for Sports and Exercise, HAN University of Applied Sciences, 6525 Nijmegen, The Netherlands
Nutrition & Performance, Team Jumbo-Visma, 5222 ‘s-Herthogenbosch, The Netherlands
Global Nutrition Development, Friesland Campina, 3818 Amersfoort, The Netherlands
Author to whom correspondence should be addressed.
Nutrients 2019, 11(10), 2391;
Received: 30 July 2019 / Revised: 24 September 2019 / Accepted: 26 September 2019 / Published: 7 October 2019
Information about the accuracy of self-reported food and fluid intake during competitions is scarce. The objective of this study was to validate a previously developed food and fluid exercise questionnaire (FFEQ) against direct observations made during competitions in athletes. Fifty-eight recreational endurance athletes participating in four different running events and one cross duathlon in the Netherlands between 2015 and 2017 were recruited. The FFEQ overestimated the median energy and carbohydrate intake by 27.6 kcal/h (20.6%) and 9.25 g/h (30.8%) (p < 0.001), respectively, compared to direct observation. Reporting bias (i.e., correlation between the difference between methods and average of both methods) increased with a higher energy (r: 0.41, p < 0.01) and carbohydrate intake (r: 0.44, p < 0.01). No statistically significant difference was found between FFEQ-reported fluid intake per hour and observations (median difference: −2.93 mL, −1.1%; p = 0.48) and no fluid reporting bias was identified (r: 0.23, p = 0.08). FFEQ-reported energy (r: 0.74), carbohydrate (r: 0.74), and fluid (r: 0.85) intake was strongly correlated with the observed intake (all p-values < 0.001). In conclusion, the FFEQ accurately estimates the fluid intake on a group level during competitions in recreational athletes. Even though FFEQ overestimates the energy and carbohydrate intake, it is still a useful tool for ranking individuals based on their intake. View Full-Text
Keywords: nutrition during competition; dietary assessment; self-reporting of intake nutrition during competition; dietary assessment; self-reporting of intake
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Wardenaar, F.C.; Hoogervorst, D.; van der Burg, N.; Versteegen, J.; Yoo, W.; Tasevska, N. Validity of a Food and Fluid Exercise Questionnaire for Macronutrient Intake during Exercise against Observations. Nutrients 2019, 11, 2391.

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