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How can we find out what people are eating?


Assessing diet in the MetaCardis study



Small changes in dietary habits can have large consequences on your gut microbiome – the large collection of different bacteria existing in the alimentary tract. We now know that our gut microbiome can have a huge impact on our general health and wellbeing, including raising or lowering risks to certain diseases, as well as influencing their severity. As such, greater efforts are being focused on understanding the role of the gut microbiota in both health and disease. One such multicenter study is MetaCardis, funded by the European Union’s Seventh Framework Programme. This collaborative five-year project aims to identify the biological relationships between gut microbiota and host (human) genome expression, in order to improve understanding and develop innovative care for cardiometabolic diseases and their comorbidities, including obesity, diabetes, and heart disease.

The MetaCardis project takes place across centres in France, Germany, and Denmark, and is led by Professor Karine Clément from the ICAN Institute of Cardiometabolism and Nutrition and the Pitié-Salpêtrière Hospital in Paris, France.

Many of us are familiar with the age old adage “you are what you eat”. But how do we really know what we are eating? Dietary assessment is the best way for us to find out!

Dietary assessment is the collection of information on the quantity and usually frequency of foods and drinks consumed over a specified time, and, using food composition tables, a calculation of energy and nutrient intakes.

Although many methods of dietary assessment exist, the two most relevant methods for the MetaCardis study were identified to be the food frequency questionnaire (FFQ) and the repeated 24-hour recall.

Participating MetaCardis consortium members worked to adapt targeted national FFQs that could provide a clear snapshot of habitual dietary habits over the previous 12months in the three different countries. Three detailed, online FFQs were developed, containing country specific food lists and portion sizes, available in the local language but consistent and standardized in terms of layout and format. The three FFQs were then linked to country-specific food composition tables, so that energy and nutrient intakes could be calculated.

In France, validation work was undertaken to understand how the FFQ performed against web-based 24h dietary recalls. Over 300 adult patients recruited between September 2013 and June 2015 completed the French FFQ, which was then compared to results from the 24h dietary recalls.

The French MetaCardis FFQ was found to have an acceptable level of validity and will be a useful instrument to rank individuals based on their food and nutrient intakes. This FFQ will be critical to examine the links between nutrition, the gut microbiota and cardiometabolic disorders.

Within the MetaCardis program, detailed dietary data from cardiometabolic disease patients is now being analyzed in conjunction with collected clinical and lifestyle parameters.



Dietary assessment in the MetaCardis Study: Development and Relative Validity of an Online Food Frequency Questionnaire
Eric O Verger, Patrice Armstrong, Trine Nielsen, Rima Chakaroun, Judith Aron-Wisnewsky, Rikke Juul Gøbel, Tatjana Schütz, Fabien Delaere, Nicolas Gausseres, Karine Clément, Bridget A Holmes, on behalf of the MetaCardis Consortium.
Journal of the Academy of Nutrition and Dietetics, 14 December 2016


Research contact

Karine Clément
ICAN Institute of Cardiometabolism and Nutrition
L’Hôpital Pitié-Salpêtrière
01 42 17 79 28


About the MetaCardis Consortium

MetaCardis is a major EU-funded research investigation into the role of gut microbes in cardiometabolic diseases (CMDs). The goal of the European study MetaCardis is to identify biological relationships between gut microbiota and host phenotypes in order to improve physio-pathological understanding and develop innovative care for cardiometabolic diseases (CMD) like obesity, diabetes and coronary diseases. Fourteen partners in six countries are involved in this project, led by Karine Clément (ICAN).

Danone Research is one of the fourteen partners involved in this project.

Bridget Holmes from the Global Nutrition Department at Danone Research is leading the dietary work, together with Eric Verger (ICAN, Paris). Karen Assmann (Inserm, Paris) will be working on the analysis of the dietary data.



The MetaCardis study has received funding from the European Union’s Seventh Framework Program for research, technological development, and demonstration under grant agreement HEALTH-F4-2012-305312 ( The Assistance Publique-Hôpitaux de Paris is the promoter of the clinic program. This work was also supported by the French National Agency through the national program Investissements d’avenir (reference no. ANR-10-IAHU-05).

The MetaCardis clinical study is referenced under number NCT02059538


ICAN Institute contact

Rachel Peat


Image credit Owen-Wahl