Using intake biomarkers to evaluate the extent of dietary misreporting in a large sample of adults: the OPEN study.

Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.
American Journal of Epidemiology (Impact Factor: 4.98). 08/2003; 158(1):1-13.
Source: PubMed

ABSTRACT This paper describes the Observing Protein and Energy Nutrition (OPEN) Study, conducted from September 1999 to March 2000. The purpose of the study was to assess dietary measurement error using two self-reported dietary instruments-the food frequency questionnaire (FFQ) and the 24-hour dietary recall (24HR)-and unbiased biomarkers of energy and protein intakes: doubly labeled water and urinary nitrogen. Participants were 484 men and women aged 40-69 years from Montgomery County, Maryland. Nine percent of men and 7% of women were defined as underreporters of both energy and protein intake on 24HRs; for FFQs, the comparable values were 35% for men and 23% for women. On average, men underreported energy intake compared with total energy expenditure by 12-14% on 24HRs and 31-36% on FFQs and underreported protein intake compared with a protein biomarker by 11-12% on 24HRs and 30-34% on FFQs. Women underreported energy intake on 24HRs by 16-20% and on FFQs by 34-38% and underreported protein intake by 11-15% on 24HRs and 27-32% on FFQs. There was little underreporting of the percentage of energy from protein for men or women. These findings have important implications for nutritional epidemiology and dietary surveillance.

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    ABSTRACT: Daily dietary intake data derived from self-reported dietary recall surveys are widely considered inaccurate. In this study, methods were developed for adjusting these dietary recalls to more plausible values. In a simulation model of two National Health and Nutrition Examination Surveys (NHANES), NHANES I and NHANES 2007-2008, a predicted one-third of raw data fell outside a range of physiologically plausible bounds for dietary intake (designated a 33% failure rate baseline). To explore the nature and magnitude of this bias, primary data obtained from an observational study were used to derive models that predicted more plausible dietary intake. Two models were then applied for correcting dietary recall bias in the NHANES datasets: (a) a linear regression to model percent under-reporting as a function of subject characteristics and (b) a shift of dietary intake reports to align with experimental data on energy expenditure. After adjustment, the failure rates improved to <2% with the regression model and 4-9% with the intake shift model - both substantial improvements over the raw data. Both methods gave more reliable estimates of plausible dietary intake based on dietary recall and have the potential for more far-reaching application in correction of self-reported exposures.
    Frontiers in Public Health 11/2014; 2:249.
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    ABSTRACT: Socioeconomic status (SES) and body composition of dietary energy under-reporting (UR) and non-under-reporting youth (non-UR) were compared. Analyses covered the data obtained from 547 persons aged 15–18 years. SES discriminants included: declared economic situation of the family, the size of the place of residence, mother’s/father’s educational background and main source of mother’s/father’s income. This was used as a basis to calculate SES index and to distinguish persons of low, average and high SES. Nutritional patterns were assessed using the 24-h recall method. UR individuals were established on the basis of energy value of diets, according to criterion described by Goldberg et al. [1991]. The body composition of respondents was assessed by anthropometric methods. Due to the low participation of the UR boys, the comparison of SES and body composition between the UR and non-UR persons was performed among 278 girls aged 15–17. One hundred and thirty-six UR individuals were identified (24.8% of total sample). UR boys accounted for 4.0% of total sample, and UR girls for 20.8% of the total sample. More UR than non-UR girls revealed an average SES index level (38.6% vs. 26.8%, respectively), and less of them were characterised by a low level of SES index (21.1% vs. 35.4%, respectively). Differences in body composition and measurements between UR and non-UR individuals were established only for girls aged 15. UR girls aged 15 had a higher body weight (on average by 6.6 kg), BMI (1.8 kg/m2), hip circumference (4.0 cm), upper arm muscle circumference (1.9 cm), upper arm muscle area (652.0 mm2), fat mass (3.9 kg) and fat free mass (2.7 kg). It was found that under-reporting of energy intake from food was related to sex and SES, and in girls aged 15 years – to body weight and body composition. Energy under-reporting was definitely associated with the female sex and in girls aged 15 – by an increased body weight resulting from the increased amount of fat and muscle tissue. Proper energy reporting by girls was associated with the lowest level of socioeconomic status, which was related to living in a rural area, a low level of father’s education and a worse economic situation of the family. The results obtained suggest that for young people, reliability of a nutritional recall can be more dependent on their individual features than the features of the social environment of their family.
    Polish Journal of Food and Nutrition Sciences 01/2011; 61:279-288.
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    ABSTRACT: Glycemic index (GI) and glycemic load (GL) have been investigated as etiologic factors for some cancers, but epidemiological data on possible associations between dietary carbohydrate intake and esophageal cancer are scant. This study examined the association between GI, GL, and other dietary carbohydrate components and risk of adenocarcinomas and squamous cell carcinoma of the esophagus accounting for established risk factors. We analyzed data from a population-based Australian case-control study (2002-05) comprising 299 adenocarcinoma (EAC), 337 gastro-esophageal junction adenocarcinoma (EGJAC), 245 squamous cell carcinoma (ESCC), and 1507 controls sampled from a population registry. Dietary information was obtained using a 135-item food frequency questionnaire (FFQ); GI and GL were derived from an Australian GI database. Multivariable logistic regression models were used to derive odds ratios (ORs). All three case groups tended to have a lower intake of fiber, and significantly higher intake of fat, total energy, and alcohol (ESCC only) compared to controls. GI was unrelated to all histological types. Higher GL was not associated with risk of EAC and EGJAC, but was inversely associated with risk of ESCC (adjusted model, ptrend =0.006), specifically among men where we observed a 58% reduced risk of ESCC in the highest versus the lowest quartile. Increased intake of total carbohydrates and starch was related to similarly large risk reductions of ESCC. Fiber intake was strongly and inversely associated with risk of EAC, EGJAC and ESCC (all ptrend <=0.001), indicating risk reductions of 28%-37% per 10 g/day. This study suggests a reduced risk of esophageal SCC with higher GL level particularly in men, but provides no evidence for the role of GI in the development of esophageal cancer. In addition, increased fiber intake appears to be associated with lower risk of all histological types of esophageal cancer.
    BMC Cancer 11/2014; 14(1):877. · 3.32 Impact Factor

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