Cited by 528Nutritional Studies and DietNutrition and Health StudiesStatistical Methods in Epidemiology

Pooled Results From 5 Validation Studies of Dietary Self-Report Instruments Using Recovery Biomarkers for Energy and Protein Intake

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Freedman, Laurence S., Commins, John M., Moler, James E., Arab, Lenore, Baer, David J., Kipnis, Victor, Midthune, Douglas, Moshfegh, Alanna J. +7 more·2014·American Journal of Epidemiology

Abstract

We pooled data from 5 large validation studies of dietary self-report instruments that used recovery biomarkers as references to clarify the measurement properties of food frequency questionnaires (FFQs) and 24-hour recalls. The studies were conducted in widely differing US adult populations from 1999 to 2009. We report on total energy, protein, and protein density intakes. Results were similar across sexes, but there was heterogeneity across studies. Using a FFQ, the average correlation coefficients for reported versus true intakes for energy, protein, and protein density were 0.21, 0.29, and 0.41, respectively. Using a single 24-hour recall, the coefficients were 0.26, 0.40, and 0.36, respectively, for the same nutrients and rose to 0.31, 0.49, and 0.46 when three 24-hour recalls were averaged. The average rate of under-reporting of energy intake was 28% with a FFQ and 15% with a single 24-hour recall, but the percentages were lower for protein. Personal characteristics related to under-reporting were body mass index, educational level, and age. Calibration equations for true intake that included personal characteristics provided improved prediction. This project establishes that FFQs have stronger correlations with truth for protein density than for absolute protein intake, that the use of multiple 24-hour recalls substantially increases the correlations when compared with a single 24-hour recall, and that body mass index strongly predicts under-reporting of energy and protein intakes.

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  1. Willett WC. Nutritional Epidemiology. 3rd ed. New York: Oxford University Press; 2013.
  2. Women's Health Initiative. Section 10: Dietary Assessment. In: WHI Procedure Manual. Vol. 2. (https://www.whi.org/ studydoc/WHI%20and%20ES1%20Manual%20of% 20Operations/1993-2005%20WHI%20CT%20and%20OS/ Vol%202,%2010%20-%20Dietary%20Assessment.pdf ). Published 1993. Updated 1997. Accessed April 11, 2014.
  3. Kipnis V, Izmirlian G. The impact of categorization of continuous exposure measured with error [abstract]. Am J Epidemiol. 2002;155:S28.

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Authors
Freedman, L. S., Commins, J. M., Moler, J. E., Arab, L., Baer, D. J., Kipnis, V., Midthune, D., Moshfegh, A. J., Neuhouser, M. L., Prentice, R. L., Schatzkin, A., Spiegelman, D., Subar, A. F., Tinker, L. F., & Willett, W.
Affiliations
Sheba Medical Center (IL)
Venue
American Journal of Epidemiology
Published
2014-06-10
Volume
180
Issue
2
Pages
172-188
ISSN
  • 0002-9262 (ISSN-L)
  • 1476-6256
OpenAlex
W2128117277
Cited by
528
References
34
Citations by year
2026: 57 · 2025: 36 · 2024: 29 · 2023: 43 · 2022: 50 · 2021: 43 · 2020: 47 · 2019: 43 · 2018: 52 · 2017: 44 · 2016: 41 · 2015: 34 · 2014: 6
FWCI
6.53
Type
journal article
Language
en
Open access
Locations
  • American Journal of Epidemiology (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion, public-domain)
  • PubMed Central (publishedVersion, public-domain)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders
  • National Institutes of Health (HHSN268201100004C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C)
  • National Institute on Aging (HHSN-271-2011-00004C,)
  • National Heart, Lung, and Blood Institute (HHSN2682011-00001I, HHSN2682011-00002I, HHSN2682011‐00004I, HHSN268201100046C, HHSN2682011-00003I)
  • National Cancer Institute (P01CA053996, R01CA119171, P30CA015704)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
  • Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
Keywords
food frequency questionnaire, 24-hour dietary recall, energy intake, protein intake, protein density, underreporting, body mass index, calibration equations, measurement validity
MeSH terms
Adult, Aged, Calibration, Energy Intake, Diet, Dietary Proteins, Female, Humans, Male, Middle Aged, Nitrogen, Surveys and Questionnaires, Mental Recall, Biomarkers, Diet Records, Validation Studies as Topic, Self Report

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