A short 18 items food frequency questionnaire biochemically validated to estimate zinc status in humans

Inadequate dietary zinc intake is wide-spread in the world's population. Despite the clinical significance of zinc deficiency there is no established method or biomarker to reliably evaluate the zinc status. The aim of our study was to develop a biochemically validated questionnaire as a clinically useful tool that can predict the risk of an individual being zinc deficient. From 71 subjects aged 18-55 years blood and urine samples were collected. Zinc concentrations in serum and urine were determined by atomic absorption spectrometry. A food frequency questionnaire (FFQ) including 38 items was filled out representing the consumption during the last 6 months obtaining nutrient diet scores. Latter were calculated by multiplication of the particular frequency of consumption, the nutrient intake of the respective portion size and the extent of the consumed quantity. Results from the FFQ were compared with nutrient intake information gathered in 24-h dietary recalls. A hemogram was performed and cytokine concentrations were obtained using Enzyme-linked Immunosorbent Assay. Reducing the items of the primary FFQ from 38 to 18 did not result in a significant variance between both calculated scores. Zinc diet scores showed highly significant correlation with serum zinc (r = 0.37; p < 0.01) and urine zinc concentrations (r = 0.34; p < 0.01). Serum zinc concentrations and zinc diet scores showed a significant positive correlation with animal protein intake (r = 0.37; p < 0.01/r = 0.54; p < 0.0001). Higher zinc diet scores were found in omnivores compared to vegetarians (213.5 vs. 111.9; p < 0.0001). The 18 items FFQ seems to be a sufficient tool to provide a good estimation of the zinc status. Moreover, shortening of the questionnaire to 18 items without a loss of predictive efficiency enables a facilitated and resource-saving routine use. A validation of the questionnaire in other cohorts could enable the progression towards clinical utilization of this promising tool.