Using Biomarker Data to Adjust Estimates of the Distribution of Usual Intakes for Misreporting: Application to Energy Intake in the US Population
Refers to erratum:
May 2008 Erratum
Journal of the American Dietetic Association
May 2008 (Vol. 108, Issue 5, Page 890) Full Text |
Full-Text PDF (25 KB)
Abstract
Objective
It is now well-established that individuals misreport their dietary intake. We propose a new method (National Research Council-Biomarker [NRC-B]) for estimating population distributions of usual dietary intake from national survey 24-hour recall data, using additional biomarker data from an external study to adjust for such dietary misreporting.
Statistical analyses performed
NRC-B is an extension of the NRC method, and is based upon two developed assumptions: the ratio of the mean of true intake to that of reported intake is equal in the survey and external biomarker study; and the ratio of the variance of true intake to that of reported intake is equal in these two studies. NRC-B adjusts the usual intake distribution both for within-person variation and for bias (underreporting) that occur with 24-hour recall reports. Using doubly labeled water (2H218O) measurements from the Observing Protein and Energy Nutrition study, we applied NRC-B to data on energy intake for adults aged 40 to 69 years from two national surveys, the Continuing Survey of Food Intakes by Individuals and National Health and Nutrition Examination Survey. We compared the results with the NRC and traditional methods that used only the survey data to estimate dietary intake distributions.
Results
Estimated distributions from NRC-B and NRC were much narrower and less skewed than from the traditional method. However, unlike NRC, the median of the NRC-B based distribution was higher by 8% to 16% than the traditional method in our examples.
Conclusions
The proposed method adjusts for the well-documented problem of underreporting of energy intake.
Address correspondence to: Laurence S. Freedman, PhD, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer 52161, Israel.
ABSTRACT