scholarly journals Bias in dietary-report instruments and its implications for nutritional epidemiology

2002 ◽  
Vol 5 (6a) ◽  
pp. 915-923 ◽  
Author(s):  
Victor Kipnis ◽  
Douglas Midthune ◽  
Laurence Freedman ◽  
Sheila Bingham ◽  
Nicholas E Day ◽  
...  
Keyword(s):  
Measurement Error ◽  
Validation Studies ◽  
Protein Intake ◽  
Dietary Assessment ◽  
Nitrogen Excretion ◽  
Nutritional Epidemiology ◽  
Assessment Instruments ◽  
Systematic Bias ◽  
Nutritional Studies ◽  
The Impact

AbstractObjective: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.

scholarly journals Uses and limitations of statistical accounting for random error correlations, in the validation of dietary questionnaire assessments

2002 ◽  
Vol 5 (6a) ◽  
pp. 969-976 ◽  
Author(s):  
Rudolf Kaaks ◽  
Pietro Ferrari ◽  
Antonio Ciampi ◽  
Martyn Plummer ◽  
Elio Riboli
Keyword(s):  
Random Error ◽  
Statistical Models ◽  
Validation Studies ◽  
Dietary Assessment ◽  
Nutritional Epidemiology ◽  
Random Errors ◽  
Doubly Labelled Water ◽  
Dietary Assessment Methods ◽  
Simultaneous Comparisons ◽  
Replicate Measurements

AbstractObjective:To examine statistical models that account for correlation between random errors of different dietary assessment methods, in dietary validation studies.Setting:In nutritional epidemiology, sub-studies on the accuracy of the dietary questionnaire measurements are used to correct for biases in relative risk estimates induced by dietary assessment errors. Generally, such validation studies are based on the comparison of questionnaire measurements (Q) with food consumption records or 24-hour diet recalls (R). In recent years, the statistical analysis of such studies has been formalised more in terms of statistical models. This made the need of crucial model assumptions more explicit. One key assumption is that random errors must be uncorrelated between measurements Q and R, as well as between replicate measurements R1 and R2 within the same individual. These assumptions may not hold in practice, however. Therefore, more complex statistical models have been proposed to validate measurements Q by simultaneous comparisons with measurements R plus a biomarker M, accounting for correlations between the random errors of Q and R.Conclusions:The more complex models accounting for random error correlations may work only for validation studies that include markers of diet based on physiological knowledge about the quantitative recovery, e.g. in urine, of specific elements such as nitrogen or potassium, or stable isotopes administered to the study subjects (e.g. the doubly labelled water method for assessment of energy expenditure). This type of marker, however, eliminates the problem of correlation of random errors between Q and R by simply taking the place of R, thus rendering complex statistical models unnecessary.

scholarly journals Evaluating the quality of dietary intake validation studies

2009 ◽  
Vol 102 (S1) ◽  
pp. S3-S9 ◽  
Author(s):  
Lluis Serra-Majem ◽  
Lene Frost Andersen ◽  
Patricia Henríque-Sánchez ◽  
Jorge Doreste-Alonso ◽  
Almudena Sánchez-Villegas ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Validation Studies ◽  
Scoring System ◽  
Dietary Assessment ◽  
Quality Score ◽  
Assessment Methods ◽  
Nutritional Epidemiology ◽  
Supplement Use ◽  
Dietary Assessment Methods

Within the EURopean micronutrient RECommendations Aligned Network of Excellence (EURRECA), a scoring system was developed to assess the quality of dietary intake validation studies. The scoring system included three steps. The first step was to give each study a quality score, which included five components: sample size, statistics used, data collection procedure, consideration of seasonality and supplement use. Scores ranged from 0 to 7, and validation studies classified as very good ( ≥ 5), good (5–3·5), acceptable/reasonable (3·5–2·5) and poor ( < 2·5). The second and third steps included an adjustment/weighting of the correlation coefficient according to the quality score and moreover a rating of the adjusted/weighted correlation. The scoring system was tested in 124 validation studies that included at least one vitamin. Only 5·6 % of the 124 studies were judged to be of very good quality according to the quality score, 41·9 % of good quality and 16·9 % had a poor rating. When adjusting for the study quality scores, crude and adjusted mean correlations of vitamins A, C, D and E intakes were similar, but the percentage of correlation values classified as poor or very good was higher after adjustment. These results show the importance of considering the quality of studies validating dietary assessment methods and the correlations obtained for the micronutrient of interest when interpreting effects observed in epidemiological studies using dietary assessment methods. Without a doubt, this subject constitutes a key topic for research in nutritional epidemiology.

scholarly journals Biomarkers in nutritional epidemiology

2002 ◽  
Vol 5 (6a) ◽  
pp. 821-827 ◽  
Author(s):  
Sheila A Bingham
Keyword(s):  
Measurement Error ◽  
Measurement Errors ◽  
Disease Risk ◽  
Dietary Assessment ◽  
Nutritional Epidemiology ◽  
Significant Development ◽  
Gene Environment ◽  
Human Volunteers ◽  
Individual Disease ◽  
Scientific Hypotheses

AbstractObjective:To illustrate biomarkers of diet that can be used to validate estimates of dietary intake in the study of gene–environment interactions in complex diseases.Design:Prospective cohort studies, studies of biomarkers where diet is carefully controlled.Setting:Free–living individuals, volunteers in metabolic suites.Subjects:Male and female human volunteers.Results:Recent studies using biomarkers have demonstrated substantial differences in the extent of measurement error from those derived by comparison with other methods of dietary assessment. The interaction between nutritional and genetic factors has so far largely gone uninvestigated, but can be studied in epidemiological trials that include collections of biological material. Large sample sizes are required to study interactions, and these are made larger in the presence of measurement errors.Conclusions:Diet is of key importance in affecting the risk of most chronic diseases in man. Nutritional epidemiology provides the only direct approach to the quantification of risks. The introduction of biomarkers to calibrate the measurement error in dietary reports, and as additional measures of exposure, is a significant development in the effort to improve estimates of the magnitude of the contribution of diet in affecting individual disease risk within populations. The extent of measurement error has important implications for correction for regression dilution and for sample size. The collection of biological samples to improve and validate estimates of exposure, enhance the pursuit of scientific hypotheses, and enable gene–nutrient interactions to be studied, should become the routine in nutritional epidemiology.

scholarly journals Combining self‐report dietary assessment instruments to reduce the effects of measurement error

2012 ◽  
Vol 26 (S1) ◽  
Author(s):  
Douglas Neil Midthune ◽  
Raymond J Carroll ◽  
Amy F Subar ◽  
Laurence S Freedman ◽  
Frances E Thompson ◽  
...  
Keyword(s):  
Measurement Error ◽  
Dietary Assessment ◽  
Self Report ◽  
Assessment Instruments

scholarly journals Comparison of self-reported alcohol intake with the urinary excretion of 5-hydroxytryptophol:5-hydroxyindole-3-acetic acid, a biomarker of recent alcohol intake

2001 ◽  
Vol 85 (5) ◽  
pp. 621-627 ◽  
Author(s):  
Anja Kroke ◽  
Kerstin Klipstein-Grobusch ◽  
Kurt Hoffmann ◽  
Ines Terbeck ◽  
Heiner Boeing ◽  
...  
Keyword(s):  
Acetic Acid ◽  
Urinary Excretion ◽  
Validation Study ◽  
Alcohol Intake ◽  
Dietary Assessment ◽  
Reference Method ◽  
Alcoholic Beverages ◽  
Nutritional Epidemiology ◽  
Assessment Instruments ◽  
Objective Reference

Under-reporting of alcohol intake has been frequently reported. However, due to the lack of an objective reference method, e.g. a biomarker, information about the extent of under-reporting of alcohol intake obtained with dietary assessment instruments is not available. The objective of this study was to compare reported alcohol intake data derived from a 24 h recall with a biomarker of recent alcohol intake, the urinary excretion of 5-hydroxytryptophol (5-HTOL):5-hydroxyindole-3-acetic acid (5-HIAA). Embedded into the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study, Germany, a validation study that collected 24 h recall data and 24 h urine samples was conducted. Cohort study participants (n107) volunteered to participate in this validation study. Among them were five subjects who reported no consumption of alcoholic beverages but had a 5-HTOL:5-HIAA ratio that indicated recent alcohol intake when the clinical cut-off point was taken as a judging criterion. After exclusion of these under-reporters, the Pearson's correlation coefficient between reported alcohol intake and the 5-HTOL:5-HIAA ratio was 0.92 (P<0.0001). Except for low alcohol intake of <0.1 g/kg body mass, a significant increase in 5-HTOL:5-HIAA excretion was observed with increasing amounts of alcohol intake. In conclusion, the 5-HTOL:5-HIAA excretion ratio appears to be a valuable quantitative biomarker of recent alcohol consumption. Denial of alcohol intake can be detected, but for the quantification of under-reporting of alcohol intake 24 h reference data are not yet available. With these data at hand, however, 5-HTOL:5-HIAA could become a biomarker for validation purposes in nutritional epidemiology.

scholarly journals Taking Advantage of the Strengths of 2 Different Dietary Assessment Instruments to Improve Intake Estimates for Nutritional Epidemiology

2012 ◽  
Vol 175 (4) ◽  
pp. 340-347 ◽  
Author(s):  
R. J. Carroll ◽  
D. Midthune ◽  
A. F. Subar ◽  
M. Shumakovich ◽  
L. S. Freedman ◽  
...  
Keyword(s):  
Dietary Assessment ◽  
Nutritional Epidemiology ◽  
Assessment Instruments

scholarly journals Development and use of FFQ among adults in diverse settings across the globe

2011 ◽  
Vol 70 (2) ◽  
pp. 232-251 ◽  
Author(s):  
Sangita Sharma
Keyword(s):  
Dietary Intake ◽  
Sodium Intake ◽  
Dietary Assessment ◽  
Heterocyclic Aromatic Amines ◽  
Nutritional Epidemiology ◽  
High Risk Population ◽  
Assessment Instruments ◽  
Intervention Programme ◽  
Dietary Changes ◽  
Cross Country

In nutritional epidemiology, development of valid dietary assessment instruments specific to populations in diverse settings is of paramount importance. Such instruments are essential when trying to characterise dietary patterns and intake, investigate diet–disease associations, inform and evaluate nutrition interventions, assess nutrient–gene interactions, conduct cross-country comparison studies and monitor nutrition transitions. The FFQ is a relatively inexpensive tool for measuring long-term dietary intake for large populations and for allowing researchers to track dietary changes over time. However, FFQ must be population specific to capture the local diet and available foods. Collecting 24-h dietary recalls and utilising community feedback to build the FFQ ensures that a culturally appropriate instrument is developed. This article presents several examples describing FFQ development and utilisation in different settings globally. In the Canadian Arctic, FFQ were developed and utilised to inform and evaluate a community-based intervention programme, characterise the diet and track dietary changes occurring among Inuit and Inuvialuit, populations experiencing rising rates of chronic disease and likely to be extremely vulnerable to the potential effects of climate change. Another example is an FFQ developed to assess sodium intake and evaluate a sodium reduction trial in a high-risk population in Barbados. An example is provided from Brazil, where an FFQ was developed to assess associations between diet, heterocyclic aromatic amines and colorectal adenoma among Japanese Brazilians and to conduct cross-country comparisons. These and other case studies highlight the diversity in dietary intake between populations and the need for FFQ to be developed to capture this diversity.

scholarly journals Impact of price and non-price policies on household cigarette consumption and nutrient intake in smoking-tolerant Indonesia

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e039211
Author(s):  
Triasih Djutaharta ◽  
Nachrowi Djalal Nachrowi ◽  
Aris Ananta ◽  
Drajat Martianto
Keyword(s):  
Protein Intake ◽  
Smoking Prevalence ◽  
National Health Survey ◽  
Secondary Outcome ◽  
Household Expenditure ◽  
Food Groups ◽  
Cigarette Price ◽  
Cross Sectional ◽  
Budget Share ◽  
The Impact

ObjectiveTo examine the impact of cigarette price and smoking environment on allocation of household expenditure and its implication on nutrition consumption.DesignA cross-sectional study was conducted using the 2014 National Socioeconomic Survey (SUSENAS), the 2014 Village Potential Survey (PODES) and the 2013 Basic National Health Survey (RISKESDAS). SUSENAS and PODES data were collected by the Central Bureau of Statistics. RISKESDAS was conducted by National Institute of Health Research and Development (Balitbangkes), Indonesian Ministry of Health (MOH).Setting and participantsThe sample covered all districts in Indonesia; with sample size of 285 400 households. These households are grouped into low, medium and high smoking prevalence districts.Primary and secondary outcome measuresThe impact of cigarette price and smoking environment on household consumption of cigarette, share of eight food groups, as well as calorie and protein intake.Result1% increase in cigarette price will increase the cigarette budget share by 0.0737 points and reduce the budget share for eggs/milk, prepared food, staple food, nuts, fish/meat and fruit, from 0.0200 points (eggs/milk) up to 0.0033 points (fruit). Reallocation of household expenditure brings changes in food composition, resulting in declining calorie and protein intake. A 1% cigarette price increase reduces calorie and protein intake as much as 0.0885% and 0.1052%, respectively. On the other hand, existence of smoke-free areas and low smoking prevalence areas reduces the household budget for cigarettes.ConclusionA pricing policy must be accompanied by non-pricing policies to reduce cigarette budget share.

scholarly journals Reporting on one's behavior: a survey experiment on the nonvalidity of self-reported COVID-19 hygiene-relevant routine behaviors

2021 ◽  
pp. 1-18
Author(s):  
Pelle Guldborg Hansen ◽  
Erik Gahner Larsen ◽  
Caroline Drøgemüller Gundersen
Keyword(s):  
Measurement Error ◽  
Crucial Role ◽  
Test Validity ◽  
Self Report ◽  
Systematic Bias ◽  
Survey Experiment ◽  
Policy Decisions ◽  
Policy Responses ◽  
Randomized Controlled ◽  
Self Reports

Abstract Surveys based on self-reported hygiene-relevant routine behaviors have played a crucial role in policy responses to the COVID-19 pandemic. In this article, using anchoring to test validity in a randomized controlled survey experiment during the COVID-19 pandemic, we demonstrate that asking people to self-report on the frequency of routine behaviors are prone to significant measurement error and systematic bias. Specifically, we find that participants across age, gender, and political allegiance report higher (lower) frequencies of COVID-19-relevant behaviors when provided with a higher (lower) anchor. The results confirm that such self-reports should not be regarded as behavioral data and should primarily be used to inform policy decisions if better alternatives are not available. To this end, we discuss the use of anchoring as a validity test relative to self-reported behaviors as well as viable alternatives to self-reports when seeking to behaviorally inform policy decisions.

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