Structure of dietary measurement error: Results of the OPEN biomarker study
Structure of dietary measurement error: Results of the OPEN biomarker study
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DOI：
10.1093/aje/kwg091
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发表时间：
2003-07-01
影响因子：
5
通讯作者：
Carroll, RJ
中科院分区：
文献类型：
--
作者：
Kipnis, V;Subar, AF;Carroll, RJ
多天食物记录或24小时饮食召回(24小时)通常被用作“参考”工具，以校准食物频率问卷(FFQ)，并调整营养流行病学研究的结果，以防止测量误差。正确的调整要求采用的参考仪器中的误差与FFQ中的误差和真实摄入量无关。作者报告了1999年9月至2000年3月进行的观察蛋白质和能量营养(OPEN)研究的数据，在该研究中，来自马里兰州蒙哥马利县的484名健康志愿者观察到了能量(双标记水)和蛋白质(尿氮)的有效参考生物标记物，以及FFQ和24HR。考虑到参考生物标记物，数据表明，FFQ导致绝对蛋白质或能量摄入的估计疾病相对风险严重减弱(真正的相对风险为2将显示为1.1或更小)。对于通过使用营养密度或营养残留物调整能量摄入量的蛋白质，衰减不那么严重(相对风险为2将出现约1.3)，为能量调整的使用增加了权重。使用24HR作为参考仪器可能会严重低估真正的衰减(能量调整蛋白质的衰减率高达60%)。结果表明，对以FFO为基础的饮食-疾病相关性流行病学研究结果的解释需要重新评估。
Multiple-day food records or 24-hour dietary recalls (24HRs) are commonly used as "reference" instruments to calibrate food frequency questionnaires (FFQs) and to adjust findings from nutritional epidemiologic studies for measurement error. Correct adjustment requires that the errors in the adopted reference instrument be independent of those in the FFQ and of true intake. The authors report data from the Observing Protein and Energy Nutrition (OPEN) Study, conducted from September 1999 to March 2000, in which valid reference biomarkers for energy (doubly labeled water) and protein (urinary nitrogen), together with a FFQ and 24HR, were observed in 484 healthy volunteers from Montgomery County, Maryland. Accounting for the reference biomarkers, the data suggest that the FFQ leads to severe attenuation in estimated disease relative risks for absolute protein or energy intake (a true relative risk of 2 would appear as 1.1 or smaller). For protein adjusted for energy intake by using either nutrient density or nutrient residuals, the attenuation is less severe (a relative risk of 2 would appear as approximately 1.3), lending weight to the use of energy adjustment. Using the 24HR as a reference instrument can seriously underestimate true attenuation (up to 60% for energy-adjusted protein). Results suggest that the interpretation of findings from FFO-based epidemiologic studies of diet-disease associations needs to be reevaluated.