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. 2018 May 1;187(5):1051-1063.
doi: 10.1093/aje/kwx328.

Relative Validity of Nutrient Intakes Assessed by Questionnaire, 24-Hour Recalls, and Diet Records as Compared With Urinary Recovery and Plasma Concentration Biomarkers: Findings for Women

Changzheng Yuan  1   2 , Donna Spiegelman  1   2   3 , Eric B Rimm  1   2   4 , Bernard A Rosner  3   4 , Meir J Stampfer  1   2   4 , Junaidah B Barnett  1   5 , Jorge E Chavarro  1   2   4 , Jennifer C Rood  6 , Lisa J Harnack  7 , Laura K Sampson  1   4 , Walter C Willett  1   2   4
Affiliations

Relative Validity of Nutrient Intakes Assessed by Questionnaire, 24-Hour Recalls, and Diet Records as Compared With Urinary Recovery and Plasma Concentration Biomarkers: Findings for Women

Changzheng Yuan et al. Am J Epidemiol. .

Abstract

We evaluated the performance of a semiquantitative food frequency questionnaire (SFFQ), the Automated Self-Administered 24-Hour Dietary Recall (ASA24), and 7-day dietary records (7DDRs), in comparison with biomarkers, in the estimation of nutrient intakes among 627 women in the Women's Lifestyle Validation Study (United States, 2010-2012). Two paper SFFQs, 1 Web-based SFFQ, 4 ASA24s (beta version), 2 7DDRs, 4 24-hour urine samples, 1 doubly labeled water measurement (repeated among 76 participants), and 2 fasting blood samples were collected over a 15-month period. The dietary variables evaluated were energy, energy-adjusted intakes of protein, sodium, potassium, and specific fatty acids, carotenoids, α-tocopherol, retinol, and folate. In general, relative to biomarkers, averaged ASA24s had lower validity than the SFFQ completed at the end of the data-collection year (SFFQ2); SFFQ2 had slightly lower validity than 1 7DDR; the averaged SFFQs had validity similar to that of 1 7DDR; and the averaged 7DDRs had the highest validity. The deattenuated correlation of energy-adjusted protein intake assessed by SFFQ2 with its biomarker was 0.46, similar to its correlation with 7DDRs (deattenuated r = 0.54). These data indicate that the SFFQ2 provides reasonably valid measurements of energy-adjusted intake for most of the nutrients assessed in our study, consistent with earlier conclusions derived using 7DDRs as the comparison method. The ASA24 needs further evaluation for use in large population studies, but an average of 3 days of measurement will not be sufficient for some important nutrients.

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Figures

Figure 1.
Figure 1.
Timeline of the dietary assessment activities undertaken by group 1 participants in the Women’s Lifestyle Validation Study, United States, 2010–2012. The study participants completed 2 paper semiquantitative food frequency questionnaires (SFFQs)—SFFQ1, which was completed at study baseline, and SFFQ2, completed at the end of the data-collection year—and 1 Web-based food frequency questionnaire (WebFFQ) 2 weeks before or after completion of the second SFFQ. Group 3 had the same data collection timeline as group 1; groups 2 and 4 were assigned similar data collection timelines as group 1, except that groups 2 and 4 were asked to complete 7-day dietary records (7DDRs) and give fasting blood samples in study phases 2 and 4 instead. The first doubly labeled water (DLW) measurement (DLW1) was completed in phases 1, 2, 3, and 4 of the study by women in groups 1, 2, 3, and 4, respectively. A subgroup of women in group 1 completed a second DLW measurement (DLW2) at 9, 12, or 15 months (mo.). Within the same phase, 7DDRs, Automated Self-Administered 24-Hour Dietary Recalls (ASA24s), DLW, 24-hour urine samples, and blood samples were completed 1–5 weeks apart to avoid artificially high correlations. For groups 1 and 3, the ASA24 was completed first, followed by the 7DDR in phase 1, but this order was reversed in phase 3. For groups 2 and 4, the 7DDR was completed first, followed by the ASA24 in phase 2, but this order was reversed in phase 4. Additionally, groups 1 and 3 completed the WebFFQ about 2 weeks before completion of SFFQ2, and groups 2 and 4 about 2 weeks after completion of SFFQ2. To minimize alteration in eating behavior, the participants were not told in advance the day on which they would be asked to complete the ASA24; days were randomly selected and may or may not have included a weekend day.
Figure 2.
Figure 2.
Deattenuated and energy-adjusted Spearman correlation coefficients for correlations between dietary intakes estimated from a semiquantitative food frequency questionnaire (SFFQ), the Automated Self-Administered 24-Hour Dietary Recall (ASA24), 7-day dietary records (7DDRs), and urinary recovery biomarkers, Women’s Lifestyle Validation Study, United States, 2010–2012. A) Energy (kcal/day); B) protein (percentage of energy); C) potassium (mg/1,000 kcal); D) sodium (mg/1,000 kcal). Correlation coefficients and corresponding P values for pairwise comparisons are presented in Web Tables 2 and 3. Bars, lower 95% confidence limit.
Figure 3.
Figure 3.
Deattenuated and adjusted Spearman correlation coefficients for correlations between fatty acid intakes (percentage of total fatty acids) estimated from a semiquantitative food frequency questionnaire (SFFQ), 7-day dietary records (7DDRs), the Automated Self-Administered 24-Hour Dietary Recall (ASA24), and plasma biomarkers, Women’s Lifestyle Validation Study, United States, 2010–2012. A) Saturated fat; B) α-linolenic acid (ALA); C) long-chain n-3 fatty acids; D) linoleic acid; E) polyunsaturated fatty acids (PUFAs); F) trans-fat. Correlation coefficients and corresponding P values for pairwise comparisons are presented in Web Tables 4 and 6. Bars, lower 95% confidence limit.
Figure 4.
Figure 4.
Deattenuated and adjusted Spearman correlation coefficients for correlations between carotenoid (μg/L or μg/day) intakes estimated from a semiquantitative food frequency questionnaire (SFFQ), 7-day dietary records (7DDRs), the Automated Self-Administered 24-Hour Dietary Recall (ASA24), and plasma biomarkers, Women’s Lifestyle Validation Study, United States, 2010–2012. A) Lycopene; B) α-carotene; C) β-carotene; D) lutein-zeaxanthin. Correlation coefficients and corresponding P values for pairwise comparisons are presented in Web Tables 5 and 7. The unit for carotenoid biomarkers is μg/L, while the unit for self-reported carotenoid intake is μg/day. Bars, lower 95% confidence limit.
Figure 5.
Figure 5.
Deattenuated and adjusted Spearman correlation coefficients for correlations between retinol (μg/L or μg/day), α-tocopherol (mg/L or mg/day), and folate (ng/mL or μg/day) intakes estimated from a semiquantitative food frequency questionnaire (SFFQ), 7-day dietary records (7DDRs), the Automated Self-Administered 24-Hour Dietary Recall (ASA24), and plasma biomarkers, Women’s Lifestyle Validation Study, United States, 2010–2012. A) Retinol; B) α-tocopherol; C) α-tocopherol with supplement use; D) folate. Correlation coefficients and corresponding P values for pairwise comparisons are presented in Web Tables 5 and 7. The unit for retinol biomarkers is μg/L, while the unit for self-reported retinol intake is μg/day. The unit for tocopherol biomarkers is mg/L, while the unit for self-reported tocopherol intake is mg/day. The unit for folate biomarkers is ng/mL, while the unit for self-reported folate intake is μg/day. Bars, lower 95% confidence limit.
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