Controversy and Debate: Memory-Based Dietary Assessment Methods Paper #3

ArticleinJournal of Clinical Epidemiology 104 · July 2018with 88 Reads
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Abstract
Highlights 1. Current confusion over ‘what to eat’ and controversies on the putative health effects of dietary sugar, fat, salt, and cholesterol are not driven by legitimates differences in scientific inference from valid data, but were engendered by five-decades of deeply flawed, demonstrably misleading, and largely pseudoscientific epidemiologic reports based on memory-based (self-reported) dietary assessment methods (M-BMs). 2. The use of M-BMs is founded upon two logical fallacies: a ‘category error’ and reification (i.e., the fallacy of misplaced concreteness). 3. M-BMs do not measure dietary intake; these methods collect reported memories of perceptions of dietary intake. These data are irrelevant to the physiologic effects of consumed foods and beverages and diet-disease relations. 4. Statistical analyses of impermissibly transformed (i.e., reified) perceptions of dietary intake led to a fictional dietary discourse with significant public health consequences. 5. M-BMs are pseudo-scientific and should not be used to inform public policy or establish the Dietary Guidelines for Americans.

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    Authors of a recent study finding that underreporting of calorie intake by participants in observational studies based on surveillance data focusing on nutrition and obesity may present a problem to governments and scientists who use such flawed data to set health policy or to test hypotheses. But others disagree.People who respond to surveys based on 24-hour dietary recall have a tendency to overstate the amount of the “good” foods or water they consume and to understate the amount of “bad” foods they ingest.
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    Methodological limitations compromise the validity of U.S. nutritional surveillance data and the empirical foundation for formulating dietary guidelines and public health policies. Evaluate the validity of the National Health and Nutrition Examination Survey (NHANES) caloric intake data throughout its history, and examine trends in the validity of caloric intake estimates as the NHANES dietary measurement protocols evolved. Validity of data from 28,993 men and 34,369 women, aged 20 to 74 years from NHANES I (1971-1974) through NHANES 2009-2010 was assessed by: calculating physiologically credible energy intake values as the ratio of reported energy intake (rEI) to estimated basal metabolic rate (BMR), and subtracting estimated total energy expenditure (TEE) from NHANES rEI to create 'disparity values'. 1) Physiologically credible values expressed as the ratio rEI/BMR and 2) disparity values (rEI-TEE). The historical rEI/BMR values for men and women were 1.31 and 1.19, (95% CI: 1.30-1.32 and 1.18-1.20), respectively. The historical disparity values for men and women were -281 and -365 kilocalorie-per-day, (95% CI: -299, -264 and -378, -351), respectively. These results are indicative of significant under-reporting. The greatest mean disparity values were -716 kcal/day and -856 kcal/day for obese (i.e., ≥30 kg/m2) men and women, respectively. Across the 39-year history of the NHANES, EI data on the majority of respondents (67.3% of women and 58.7% of men) were not physiologically plausible. Improvements in measurement protocols after NHANES II led to small decreases in underreporting, artifactual increases in rEI, but only trivial increases in validity in subsequent surveys. The confluence of these results and other methodological limitations suggest that the ability to estimate population trends in caloric intake and generate empirically supported public policy relevant to diet-health relationships from U.S. nutritional surveillance is extremely limited.
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    A recent decision in the United States by the New Jersey Supreme Court has led to improved jury instructions that incorporate psychological research showing that memory does not operate like a video recording. Here we consider how cognitive neuroscience could contribute to addressing memory in the courtroom. We discuss conditions in which neuroimaging can distinguish true and false memories in the laboratory and note reasons to be skeptical about its use in courtroom cases. We also discuss neuroscience research concerning false and imagined memories, misinformation effects and reconsolidation phenomena that may enhance understanding of why memory does not operate like a video recording.
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    The evidence of informant inaccuracy ought not to lead to complaints or despair among researchers. It ought instead to lead to a rich, relatively unexplored arena of inquiry. Informants are not to blame for being wrong. People everywhere get along quite well without being able to dredge up accurately the sort of information that social scientists ask of them. If the latter have a great deal of inaccurate data, then they have only themselves to blame. The instruments of their craft have been used too uncritically. - J.Sheail
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    BACKGROUND: Nutritional epidemiology is a highly prolific field. Debates on associations of nutrients with disease risk are common in the literature and attract attention in public media. OBJECTIVE: We aimed to examine the conclusions, statistical significance, and reproducibility in the literature on associations between specific foods and cancer risk. DESIGN: We selected 50 common ingredients from random recipes in a cookbook. PubMed queries identified recent studies that evaluated the relation of each ingredient to cancer risk. Information regarding author conclusions and relevant effect estimates were extracted. When >10 articles were found, we focused on the 10 most recent articles. RESULTS: Forty ingredients (80%) had articles reporting on their cancer risk. Of 264 single-study assessments, 191 (72%) concluded that the tested food was associated with an increased (n = 103) or a decreased (n = 88) risk; 75% of the risk estimates had weak (0.05 > P ≥ 0.001) or no statistical (P > 0.05) significance. Statistically significant results were more likely than nonsignificant findings to be published in the study abstract than in only the full text (P < 0.0001). Meta-analyses (n = 36) presented more conservative results; only 13 (26%) reported an increased (n = 4) or a decreased (n = 9) risk (6 had more than weak statistical support). The median RRs (IQRs) for studies that concluded an increased or a decreased risk were 2.20 (1.60, 3.44) and 0.52 (0.39, 0.66), respectively. The RRs from the meta-analyses were on average null (median: 0.96; IQR: 0.85, 1.10). CONCLUSIONS: Associations with cancer risk or benefits have been claimed for most food ingredients. Many single studies highlight implausibly large effects, even though evidence is weak. Effect sizes shrink in meta-analyses.
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    Two experiments (modeled after J. Deese's 1959 study) revealed remarkable levels of false recall and false recognition in a list learning paradigm. In Exp 1, Ss studied lists of 12 words (e.g., bed, rest, awake); each list was composed of associates of 1 nonpresented word (e.g., sleep). On immediate free recall tests, the nonpresented associates were recalled 40% of the time and were later recognized with high confidence. In Exp 2, a false recall rate of 55% was obtained with an expanded set of lists, and on a later recognition test, Ss produced false alarms to these items at a rate comparable to the hit rate. The act of recall enhanced later remembering of both studied and nonstudied material. The results reveal a powerful illusion of memory: People remember events that never happened. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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    Perception and memory are imperfect reconstructions of reality. These reconstructions are prone to be influenced by several factors, which may result in false memories. A false memory is the recollection of an event, or details of an episode, that did not actually occur. Memory formation comprises at least three different sub-processes: encoding, consolidation and the retrieval of the learned material. All of these sub-processes are vulnerable for specific errors and consequently may result in false memories. Whereas, processes like imagery, self-referential encoding or spreading activation can lead to the formation of false memories at encoding, semantic generalization during sleep and updating processes due to misleading post event information, in particular, are relevant at the consolidation stage. Finally at the retrieval stage, monitoring processes, which are assumed to be essential to reject false memories, are of specific importance. Different neuro-cognitive processes have been linked to the formation of true and false memories. Most consistently the medial temporal lobe and the medial and lateral prefrontal cortex have been reported with regard to the formation of true and false memories. Despite the fact that all phases entailing memory formation, consolidation of stored information and retrieval processes, are relevant for the forming of false memories, most studies focused on either memory encoding or retrieval. Thus, future studies should try to integrate data from all phases to give a more comprehensive view on systematic memory distortions. An initial outline is developed within this review to connect the different memory stages and research strategies.
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    “Any claim coming from an observational study is most likely to be wrong.” Startling, but true. Coffee causes pancreatic cancer. Type A personality causes heart attacks. Trans-fat is a killer. Women who eat breakfast cereal give birth to more boys. All these claims come from observational studies; yet when the studies are carefully examined, the claimed links appear to be incorrect. What is going wrong? Some have suggested that the scientific method is failing, that nature itself is playing tricks on us. But it is our way of studying nature that is broken and that urgently needs mending, say S. Stanley Young and Alan Karr; and they propose a strategy to fix it.
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    Human memory is not a literal reproduction of the past, but instead relies on constructive processes that are sometimes prone to error and distortion. Understanding of constructive memory has accelerated during recent years as a result of research that has linked together its cognitive and neural bases. This article focuses on three aspects of constructive memory that have been the target of recent research: (i) the idea that certain kinds of memory distortions reflect the operation of adaptive cognitive processes that contribute to the efficient functioning of memory; (ii) the role of a constructive memory system in imagining or simulating possible future events; and (iii) differences between true and false memories that have been revealed by functional neuroimaging techniques. The article delineates the theoretical implications of relevant research, and also considers some clinical and applied implications.
  • Chapter
    For centuries knowledge meant proven knowledge — proven either by the power of the intellect or by the evidence of the senses. Wisdom and intellectual integrity demanded that one must desist from unproven utterances and minimize, even in thought, the gap between speculation and established knowledge. The proving power of the intellect or the senses was questioned by the sceptics more than two thousand years ago; but they were browbeaten into confusion by the glory of Newtonian physics. Einstein’s results again turned the tables and now very few philosophers or scientists still think that scientific knowledge is, or can be, proven knowledge. But few realize that with this the whole classical structure of intellectual values falls in ruins and has to be replaced: one cannot simply water down the ideal of proven truth - as some logical empiricists do — to the ideal of’probable truth’1 or — as some sociologists of knowledge do — to ‘truth by [changing] consensus’.2
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    Prevalence estimates of illicit drug use by teens are typically generated from confidential or anonymous self-report. While data comparing teen self-report with biological measures are limited, adult studies identify varying degrees of under-reporting. Hair analyses for cocaine, opiates and marijuana were compared to confidential teen self- and parent-reported teen drug use in a longitudinal cohort of >400 high-risk urban teens and parents. Both teens and parents substantially underreported recent teen cocaine and opiate use. However, compared with parents, teens were more likely to deny biomarker-verified cocaine use. Teen specimens (hair) were 52 times more likely to identify cocaine use compared with self-report. Parent hair analyses for cocaine and opiate use were 6.5 times and 5.5 times, respectively, more likely to indicate drug use than were parental self-report. The lack of concordance between self-report and bioassay occurred despite participant's knowledge that a "certificate of confidentiality" protected both teen and adult participants, and that the biological specimens would be tested for drugs. These findings confirm prior reports of adult under-reporting of their own drug use while extending our understanding of teen's self-admitted drug use. The lack of concordance between teen self- or parent-reported teen drug use and biomarkers confirm our concerns that both teen- and parent-reported teen drug use is limited, at least for youth in high-risk urban settings. Methods of ascertainment other than self- or parent-report must be considered when health care providers, researchers and public health agencies attempt to estimate teen drug-use prevalence.
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    This article reviews research using the Deese/Roediger-McDermott (DRM) associative memory illusion, whereby people falsely remember words that were not presented. This illusion has broadly influenced basic theories of memory in cognitive psychology and neuroscience and naturally raises the question as to how these theories apply to more complex autobiographical memories. Some applicability is evident from research linking individual differences in the DRM illusion to false autobiographical memories (e.g., misremembering public events) and fantastic autobiographical beliefs (e.g., memories from past lives). But which aspects generalize? Here it is argued that a process-oriented approach is needed in order to answer this question. Many productive years of DRM research indicate that multiple and often opposing psychological processes cause even the most basic false memories. In light of these discoveries, more researchers need to use methods that isolate these component processes if the goal is to understand false memories both in the lab and in life.
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    Objective: To support research and to provide food and nutrition practitioners with a strong foundation for nutrient-based counseling, there is a need for affordable automated 24-hour dietary recalls. Multiple days of intake, along with repeated reports over time, are needed to achieve stable indicators of individual intakes and to support evaluation of success in meeting dietary goals because of intraindividual intake variability. Little information has been published on subject responses, participation rates, and the perceived subject burden of repeated 24-hour recalls. Our aim was to determine the willingness of subjects to conduct eight 24-hour recalls via the Internet. Design: A study to validate a Web-based, automated, self-administered 24-hour recall (DietDay, Centrax Corporation, Chicago, IL). Subjects/setting: Two-hundred and sixty-one white and African-American subjects within 50 miles of the University of California-Los Angeles participated in the study. Subjects completed 3 DietDays at the study visits and another 5 days on their own. The last 2 DietDays were completed 1 and 2 months after the final clinic visit. Subjects were notified by automatic e-mail of the need for DietDay completion, and nonresponders were followed up with personalized e-mails and phone calls. Results: The perceived subject burden was minimal and, even after completing six recalls, 92% were willing to continue reporting their daily diets 1 and 2 months later. White subjects had a slightly higher rate of return, with 94% completing all eight recalls, compared to 91% of African-American subjects. Participants were able to access the Internet in their homes, offices, library, or homes of friends or family. It is also of interest that 82% of subjects believed the 24-hour recall was superior to a diet history in reflecting their normal diet. Conclusion: These results open up new opportunities for food and nutrition practitioners to strengthen their nutritional counseling in an efficient and affordable manner without additional time investment.
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    In order to assess nutritional adequacy, valid estimates of nutrient intake are required. One of the main errors in dietary assessment is misreporting. The objective was to review the extent, nature and determinants of misreporting in dietary assessment, how this affects reported intakes of micronutrients and how this is identified and measured, and to identify the best ways of dealing with misreporting when interpreting results. A systematic literature search was conducted for studies of misreporting of dietary intake in adults by 24 hour recalls or by estimated or weighed food records, published up to March 2008. Thirty-seven relevant studies were identified. Possible causes of misreporting were identified. Methods most used to identify misreporting were the Goldberg cut-off (46 % studies) and the doubly labelled water technique (24 % studies). The magnitude of misreporting of energy intake was similar in all three dietary assessment methods. The percentage of under-reporters was about 30 % and energy intake was underestimated by approximately 15 %. Seven papers presented usable data for micronutrient intake. Absolute intakes of Fe, Ca and vitamin C (the three micronutrients addressed in all papers) were on average 30 % lower in low-energy reporters (LER) than that in non-LER and, although results were not consistent, there was a tendency for micronutrient density to be higher in LER. Excluding underreporters or using energy adjustment methods for micronutrient intakes is discussed. Residual method of energy adjustment seems to be a good tool for practice to decrease an influence of misreporting when interpreting results of studies based on food records and 24 hour recalls.