title: Pooled results from 5 validation studies of dietary self-report instruments using recovery biomarkers for energy and protein intake.
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.
authors.forename: Laurence S
authors.initials: LS
authors.lastname: Freedman
authors.forename: John M
authors.initials: JM
authors.lastname: Commins
authors.forename: James E
authors.initials: JE
authors.lastname: Moler
authors.forename: Lenore
authors.initials: L
authors.lastname: Arab
authors.forename: David J
authors.initials: DJ
authors.lastname: Baer
authors.forename: Victor
authors.initials: V
authors.lastname: Kipnis
authors.forename: Douglas
authors.initials: D
authors.lastname: Midthune
authors.forename: Alanna J
authors.initials: AJ
authors.lastname: Moshfegh
authors.forename: Marian L
authors.initials: ML
authors.lastname: Neuhouser
authors.forename: Ross L
authors.initials: RL
authors.lastname: Prentice
authors.forename: Arthur
authors.initials: A
authors.lastname: Schatzkin
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.forename: Amy F
authors.initials: AF
authors.lastname: Subar
authors.forename: Lesley F
authors.initials: LF
authors.lastname: Tinker
authors.forename: Walter
authors.initials: W
authors.lastname: Willett
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000652:urine; D002138:Calibration; D004032:Diet; D015930:Diet Records; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D009584:Nitrogen / Q000652:urine; D057566:Self Report; D011795:Surveys and Questionnaires; D054928:Validation Studies as Topic
chemical_list: D015415:Biomarkers; D004044:Dietary Proteins; D009584:Nitrogen
keywords: 24-hour recall; attenuation factors; calibration equations; dietary measurement error; food frequency questionnaire; under-reporting