Evaluation of under- and overreporting of energy intake in the 24-hour diet recalls in the European Prospective Investigation into Cancer and Nutrition (EPIC)
Evaluation of under- and overreporting of energy intake in the 24-hour diet recalls in the European Prospective Investigation into Cancer and Nutrition (EPIC)
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DOI：
10.1079/phn2002409
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发表时间：
2002-12-01
影响因子：
3.2
通讯作者：
Riboli, E
中科院分区：
文献类型：
--
作者：
Ferrari, P;Slimani, N;Riboli, E
目的：评估EPIC中的低报和高报及其决定因素：欧洲癌症与营养前瞻性调查（EPIC）中收集的24小时饮食回忆（24-HDR）测量结果。设计：横断面分析。24-通过标准化计算机化访谈程序（EPIC-SOFT）获得HDR测量结果。报告的能量摄入量（EI）估计的基础代谢率（BMR）的比例被用来确定误报的程度，影响和决定因素。戈德堡的临界点被用来确定参与者的生理极低或极高的能量摄入。在总体水平上，选择体力活动水平（PAL）的值1.55作为参考。在个体水平上，我们使用多变量统计技术来确定可以解释EI/BMR变异性的因素。通过调整体重、身高、回忆时的年龄、特殊饮食、吸烟状况、回忆日进行分析。（工作日与周末）和体力活动。设置：参与EPIC项目的10个国家的27个重新定义的中心。受试者：总共有35955名男性和女性，年龄35-74岁，参与嵌套EPIC校准子研究。结果：虽然多报的影响很小，但被确定为极端少报的受试者比例在女性和男性中分别为13.8%和10.3%。包括所有受试者在内，男性和女性的平均EI/BMR值分别为1.44和1.36，排除误报后分别为1.50和1.44。排除误报后，调整后的EI/BMR均值与PAL的预期值1.55的差异始终小于10%（希腊和英国的女性除外），男性和女性的总体差异分别为4.0%和7.4%。我们模拟了与几个个体特征相关的报道不足的概率。在调整了年龄，身高，特殊饮食，吸烟状况后，回忆日和工作时体力活动的logistic回归分析结果显示，身体质量指数（BMI）最高与最低四分位数的比值比（OR）为3.52（95%置信区间（CI）2.91-4.26），男性和4.80（95% CI 4.11-5.61），女性，表明超重的受试者更有可能低估的能量摄入量比受试者在底部的BMI类别。老年人不太可能低估能量摄入：年龄（大于或等于65岁vs.< 50岁）的OR分别为0.58（95% CI 0.45-0.77）和0.74（95% CI 0.63-0.88）。特殊的饮食和一周的日子表现出强烈的effects.Conclusion：EI往往被低估，在绝大多数的EPIC中心，虽然在不同程度上，在总体水平上大多数中心低于预期的参考值1.55。在EPIC校准样本中，妇女的低报现象似乎比男子更为普遍。BMI（或体重）和年龄与低报有因果关系的假设似乎在目前的工作中得到证实。这进一步增加了组内（中心或国家）和组间饮食问卷测量校准的复杂性，以减弱饮食-疾病关系。
Objective: To evaluate under- and overreporting and their determinants in the EPIC :24-hour diet recall (24-HDR) measurements collected in the European Prospective Investigation into Cancer and Nutrition (EPIC).Design: Cross-sectional analysis. 24-HDR measurements were obtained by means of a standardised computerised interview program (EPIC-SOFT). The ratio of reported energy intake (EI) to estimated basal metabolic rate (BMR) was used-to ascertain the magnitude, impact and determinants of misreporting. Goldberg's cut-off points were used to identify participants with physiologically extreme low or high energy intake. At the aggregate level the value of 1.55 for physical activity level (PAL) was chosen as reference. At the individual level we used multivariate statistical techniques to identify factors that could explain EI/BMR variability. Analyses were performed by adjusting for weight, height, age at recall, special diet, smoking status, day of recall (weekday vs. weekend day) and physical activity.Setting: Twenty-seven redefined centres in the 10 countries participating in the EPIC project.Subjects: in total, 35955 men and women, aged 35-74 years, participating in the nested EPIC calibration sub-studies.Results: While overreporting has only a minor impact, the percentage of subjects identified as extreme underreporters was 13.8% and 10.3% in women and men, respectively. Mean EI/BMR values in men and women were 1.44 and 1.36 including all subjects, and 1.50 and 1.44 after exclusion of misreporters. After exclusion of misreporters, adjusted EI/BMR means were consistently less than 10% different from the expected value of 1.55 for PAL (except for women in Greece and in the UK), with overall differences equal to 4.0% and 7.4% for men and women, respectively. We modelled the probability of being an underreporter in association with several individual characteristics. After adjustment for age, height, special diet,- smoking status, day of recall and physical activity at work logistic regression analyses resulted in an odds ratio (OR) of being an underreporter for the highest vs. the lowest quartile of body mass index (BMI) of 3.52 (95% confidence interval (CI) 2.91-4.26) in men and 4.80 (95% CI 4.11-5.61) in women, indicating that overweight subjects are significantly more likely to underestimate energy intake than subjects in the bottom BMI category. Older people were less likely to underestimate energy intake: ORs were 0.58 (95% CI 0.45-0.77) and 0.74 (95% CI 0.63-0.88) for age (greater than or equal to 65 years vs. < 50 years). Special diet and day of the week showed strong effects.Conclusion: EI tends to be underestimated in the vast majority of the EPIC centres, although to varying degrees; at the aggregate level most centres were below the expected reference value of 1.55. Underreporting seems to be more prevalent among women than men in the EPIC calibration sample. The hypothesis that BMI (or weight) and age are causally related to underreporting seems to be confirmed in the present work. This introduces further complexity in the within-group (centre or country) and between-group calibration of dietary questionnaire measurements to deattenuate the diet-disease relationship.