Applying Recovery Biomarkers to Calibrate Self-Report Measures of Energy and Protein in the Hispanic Community Health Study/Study of Latinos

Abstract

We investigated measurement error in the self-reported diets of US Hispanics/Latinos, who are prone to obesity and related comorbidities, by background (Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American) in 2010–2012. In 477 participants aged 18–74 years, doubly labeled water and urinary nitrogen were used as objective recovery biomarkers of energy and protein intakes. Self-report was captured from two 24-hour dietary recalls. All measures were repeated in a subsample of 98 individuals. We examined the bias of dietary recalls and their associations with participant characteristics using generalized estimating equations. Energy intake was underestimated by 25.3% (men, 21.8%; women, 27.3%), and protein intake was underestimated by 18.5% (men, 14.7%; women, 20.7%). Protein density was overestimated by 10.7% (men, 11.3%; women, 10.1%). Higher body mass index and Hispanic/Latino background were associated with underestimation of energy (P < 0.05). For protein intake, higher body mass index, older age, nonsmoking, Spanish speaking, and Hispanic/Latino background were associated with underestimation (P < 0.05). Systematic underreporting of energy and protein intakes and overreporting of protein density were found to vary significantly by Hispanic/Latino background. We developed calibration equations that correct for subject-specific error in reporting that can be used to reduce bias in diet-disease association studies.

Diet Quality and Its Association with Cardiometabolic Risk Factors Vary by Hispanic and Latino Ethnic Background in the Hispanic Community Health Study/Study of Latinos

“…Foods and nutrients were analyzed by using the multiple-pass methods of the Nutrition Data System for Research software version 11 from the Nutrition Coordinating Center at University of Minnesota, which includes Hispanic and Latino foods. Although underreporting of energy and protein intakes and overreporting of protein density have been shown in an ancillary study of this cohort (24), this is a common occurrence across nutritional studies that does not diminish the value of self-reported dietary data (25).…”

“…A healthy diet is generally effective in preventing cardiometabolic conditions, so our results should not be interpreted as diet being irrelevant for some Hispanic or Latino groups. Possible explanations for the lack of associations in some groups could be smaller sample sizes, misreporting of diet in some groups (24,33), incomplete capture of specific traditional foods, or genetic variations between ethnic backgrounds (34,35) that may translate into gene-diet interactions with differential phenotypes. It is possible that other interactive or mediating factors are operating.…”

“…Methods for dietary data collection have been published (19,24). Briefly, two 24-h recalls were administered, 1 in-person at the baseline visit and 1 via telephone or in-person within 5-90 d, usually after the baseline visit.…”

Reducing Measurement Error in Nutrition Assessment: Potential Research Implications for Iran

“…Given the heterogeneity in cultural context, methodology and respondent's relationship with food, understandably there is a wide range of biases from one context to another (1). These biases distort the relationship between diet and disease (2)(3)(4)(5). Measurement errors consist of random and systematic error.…”

“…It also includes a biomarker study (5) to correct for self-report measures of diet (24 hr dietary recall and a food propensity questionnaire) (21)(22). The respondents in both studies underreported energy intake by 25-32% when compared to the biomarker doubly labeled water; however, protein intake was underreported to a lesser extent (15-19%) when compared to urinary nitrogen (2,5). Underreporting was higher using the FFQ than 24 hr …”