Alternative Methods of Accounting for Underreporting and Overreporting When Measuring Dietary Intake-Obesity Relations

作者:Mendez Michelle A*; Popkin Barry M; Buckland Genevieve; Schroder Helmut; Amiano Pilar; Barricarte Aurelio; Huerta Jose Maria; Quiros Jose R; Sanchez Maria Jose; Gonzalez Carlos A
来源:American Journal of Epidemiology, 2011, 173(4): 448-458.
DOI:10.1093/aje/kwq380

摘要

Misreporting characterized by the reporting of implausible energy intakes may undermine the valid estimation of diet-disease relations, but the methods to best identify and account for misreporting are unknown. The present study compared how alternate approaches affected associations between selected dietary factors and body mass index (BMI) by using data from the European Prospective Investigation Into Cancer and Nutrition-Spain. A total of 24,332 women and 15,061 men 29-65 years of age recruited from 1992 to 1996 for whom measured height and weight and validated diet history data were available were included. Misreporters were identified on the basis of disparities between reported energy intakes and estimated requirements calculated using the original Goldberg method and 2 alternatives: one that substituted basal metabolic rate equations that are more valid at higher BMIs and another that used doubly labeled water-predicted total energy expenditure equations. Compared with results obtained using the original method, underreporting was considerably lower and overreporting higher with alternative methods, which were highly concordant. Accounting for misreporters with all methods yielded diet-BMI relations that were more consistent with expectations; alternative methods often strengthened associations. For example, among women, multivariable-adjusted differences in BMI for the highest versus lowest vegetable intake tertile (beta = 0.37 (standard error, 0.07)) were neutral after adjusting with the original method (beta = 0.01 (standard error, 07)) and negative using the predicted total energy expenditure method with stringent cutoffs (beta = -0.15 (standard error, 0.07)). Alternative methods may yield more valid associations between diet and obesity-related outcomes.