Document Detail

Bias in dietary-report instruments and its implications for nutritional epidemiology.
MedLine Citation:
PMID:  12633516     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate measurement error structure in dietary assessment instruments and to investigate its implications for nutritional studies, using urinary nitrogen excretion as a reference biomarker for protein intake. DESIGN: The dietary assessment methods included different food-frequency questionnaires (FFQs) and such conventional dietary-report reference instruments as a series of 24-hour recalls, 4-day weighed food records or 7-day diaries. SETTING: Six original pilot validation studies within the European Prospective Investigation of Cancer (EPIC), and two validation studies conducted by the British Medical Research Council (MRC) within the Norfolk cohort that later joined as a collaborative component cohort of EPIC. SUBJECTS: A sample of approximately 100 to 200 women and men, aged 35-74 years, from each of eight validation studies. RESULTS: In assessing protein intake, all conventional dietary-report reference methods violated the critical requirements for a valid reference instrument for evaluating, and adjusting for, dietary measurement error in an FFQ. They displayed systematic bias that depended partly on true intake and partly was person-specific, correlated with person-specific bias in the FFQ. Using the dietary-report methods as reference instruments produced substantial overestimation (up to 230%) of the FFQ correlation with true usual intake and serious underestimation (up to 240%) of the degree of attenuation of FFQ-based log relative risks. CONCLUSION: The impact of measurement error in dietary assessment instruments on the design, analysis and interpretation of nutritional studies may be much greater than has been previously estimated, at least regarding protein intake.
Victor Kipnis; Douglas Midthune; Laurence Freedman; Sheila Bingham; Nicholas E Day; Elio Riboli; Pietro Ferrari; Raymond J Carroll
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Public health nutrition     Volume:  5     ISSN:  1368-9800     ISO Abbreviation:  Public Health Nutr     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2003-03-13     Completed Date:  2003-05-13     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9808463     Medline TA:  Public Health Nutr     Country:  England    
Other Details:
Languages:  eng     Pagination:  915-23     Citation Subset:  IM    
Biometry Research Group, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD 20892-7354, USA.
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MeSH Terms
Bias (Epidemiology)*
Diet Surveys
Dietary Proteins / administration & dosage*,  metabolism
Linear Models*
Middle Aged
Nitrogen / urine*
Nutritional Status*
Reproducibility of Results
Grant Support
CA-57030/CA/NCI NIH HHS; P30-E509106//PHS HHS
Reg. No./Substance:
0/Dietary Proteins; 7727-37-9/Nitrogen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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