Diet-obesity associations in children: approaches to counteract attenuation caused by misreporting
Diet-obesity associations in children: approaches to counteract attenuation caused by misreporting
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DOI：
10.1017/s1368980012004491
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发表时间：
2013-02-01
影响因子：
3.2
通讯作者：
Pigeot, Iris
中科院分区：
文献类型：
--
作者：
Boernhorst, Claudia;Huybrechts, Inge;Pigeot, Iris
目的：饮食数据中的测量误差导致对饮食暴露与健康结果之间关联的估计减弱。本研究的目的是通过对膳食摄入量之间关系的示例性分析，比较和评估处理不可信报告的不同方法（总能量、软饮料、水果/蔬菜）与儿童超重/肥胖的关系。设计：横断面多中心研究。设置：来自参与IDEFICS研究的八个欧洲国家的学生/学校。受试者：儿童（n 5357），年龄2-9岁，谁提供了一个24小时的饮食回忆和完整的协变量information.Results：24小时的回忆分为三个报告组，根据适应Goldberg截止：报告不足，合理的报告或过度报告。在基本的logistic多水平模型中，（调整年龄和性别，包括研究中心作为随机效应），膳食暴露与超重/肥胖无显著相关性（能量摄入：OR=0.996（95% CI 0.983，1.010）;软饮料：OR=0.999（95% CI 0.986，1.013）），甚至显示与水果/蔬菜呈正相关（OR=1.009（95% CI 1.001，1.018））。添加报告组时（虚拟变量）和误报的倾向得分作为调整条款，协会成为显着的能量摄入以及软饮料（能量：OR=1.074（95% CI 1.053，1.096）;软饮料：OR=1.015（95% CI 1.000，1.031）），与基本模型相比，水果/蔬菜与超重/肥胖之间的关联指向相反的方向结论：膳食暴露与健康结果之间的关系受到测量误差的强烈影响，甚至被掩盖。在本分析中，考虑报告组和纳入误报的倾向评分被证明是抵消效应估计衰减的有用工具。
Objective: Measurement errors in dietary data lead to attenuated estimates of associations between dietary exposures and health outcomes. The present study aimed to compare and evaluate different approaches of handling implausible reports by exemplary analysis of the association between dietary intakes (total energy, soft drinks, fruits/vegetables) and overweight/obesity in children.Design: Cross-sectional multicentre study.Setting: Kindergartens/schools from eight European countries participating in the IDEFICS Study.Subjects: Children (n 5357) aged 2-9 years who provided one 24 h dietary recall and complete covariate information.Results: The 24 h recalls were classified into three reporting groups according to adapted Goldberg cut-offs: under-report, plausible report or over-report. In the basic logistic multilevel model (adjusted for age and sex, including study centre as random effect), the dietary exposures showed no significant association with overweight/obesity (energy intake: OR=0.996 (95% CI 0.983, 1.010); soft drinks: OR=0.999 (95% CI 0.986, 1.013)) and revealed even a positive association for fruits/vegetables (OR=1.009 (95% CI 1.001, 1.018)). When adding the reporting group (dummy variables) and a propensity score for misreporting as adjustment terms, associations became significant for energy intake as well as soft drinks (energy: OR=1.074 (95% CI 1.053, 1.096); soft drinks: OR=1.015 (95% CI 1.000, 1.031)) and the association between fruits/vegetables and overweight/obesity pointed to the reverse direction compared with the basic model (OR=0.993 (95% CI 0.984, 1.002)).Conclusions: Associations between dietary exposures and health outcomes are strongly affected or even masked by measurement errors. In the present analysis consideration of the reporting group and inclusion of a propensity score for misreporting turned out to be useful tools to counteract attenuation of effect estimates.