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Energy expenditure measured by doubly labeled water, activity recall, and diet records in the rural elderly.

OBJECTIVE: The purpose of this study was to determine whether energy expenditure estimated from physical activity and energy intake were equivalent to total daily energy expenditure in an elderly rural population. METHODS: Twenty-seven elderly male (n = 14) and female (n = 13) subjects (mean age, 74 y) were recruited from a rural Pennsylvania population. Over a 2-wk period, total daily energy expenditure was measured by doubly labeled water (TEE) and estimated from 7-d physical activity recall factors multiplied by weight (PA(WT)), estimated basal metabolic rate (PA(BMR)) and resting energy expenditure from indirect calorimetry (PA(REE)), and energy intake from 3-d self-reported diet records (EI). Analysis of variance was used to determine significant within-subject differences in physical activity, energy intake, and energy expenditure. RESULTS: PA(REE) (men: 13.69 +/- 3.23 MJ, women: 9.51 +/- 2.40 MJ) and PA(BMR) (men: 13.69 +/- 2.99 MJ, women: 10.15 +/- 2.21 MJ) were not significantly different from TEE (men: 12.43 +/- 1.63 MJ, women: 9.44 +/- 0.90 MJ). EI (men: 8.66 +/- 2.34 MJ, women: 7.12 +/- 0.93 MJ) was significantly less than TEE, and PA(WT) (men: 17.03 +/- 4.07 MJ, women: 12.86 +/- 3.41 MJ) was significantly greater than TEE. CONCLUSIONS: Whereas 7-d physical activity recall determined with an age- and gender-specific estimate of resting metabolic rate or measured using indirect calorimetry accurately estimated TEE for this group of rural elderly, self-reported diet records consistently underestimated and physical activity recall determined with weight alone consistently overestimated energy expenditure measured by doubly labeled water.

Aged↗

Determinants of diet glycemic index calculated retrospectively from diet records of 342 individuals with non-insulin-dependent diabetes mellitus.

Controlled trials have shown that a diet with a low glycemic index improves blood glucose and lipid control in patients with diabetes. To study the distribution and determinants of diet glycemic index, we obtained two 3-d diet records from 342 free-living subjects with non-insulin-dependent diabetes. Mean +/- SD 24-h intakes were as follows: energy, 7170 +/- 1890 kJ; fat, 33.6 +/- 6.5% of energy; protein, 20.1 +/- 3.2% of energy; available carbohydrate, 45.3 +/- 7.2% of energy; and dietary fiber, 17.2 +/- 6.4 g. Diet glycemic index values (85.4 +/- 4.55, range, 70-97.8) were normally distributed. Diet glycemic index was inversely associated with intake of simple sugars, whether expressed in grams (r = -0.426), percent of energy (r = -0.446), or percent of carbohydrate (r = -0.453, P < 0.001). By step-wise-multiple-linear regression, grams carbohydrate and percent protein were also independently related to diet glycemic index. Differences in diet glycemic index between men and women, and between subjects on different types of diabetes therapy were explained by differences in intake of simple sugars.

Blood Glucose↗

Relative validity of a semi-quantitative food frequency questionnaire versus 28 day weighed diet records in Japanese female dietitians.

OBJECTIVE: To assess the relative validity of a semi-quantitative food frequency questionnaire (SQFFQ) against 28 day weighed diet records (WDRs). SUBJECTS AND METHODS: The SQFFQ was administered to 106 (21 male and 85 female) Japanese dietitians in Aichi Prefecture in autumn, 1996 and four-season consecutive 7 day WDRs were carried out during 1996-1997. We evaluated validity of intakes of 15 foods and 31 macro- and micro-nutrients based on the SQFFQ against those according to 28 day WDRs among 79 Japanese female dietitians. RESULTS: Mean daily intakes of selected foods and nutrients determined by the SQFFQ were generally equivalent to those measured by 28 day WDRs. Pearson's de-attenuated correlation coefficients (CCs) with log-transformation and energy-adjustment between intakes of selected foods and nutrients quantified by the SQFFQ and 28 day WDRs (minimum-median-maximum) ranged from 0.17 (beverages)-0.52 to 0.74 (rice), and Spearman's rank CCs with energy-adjustment ranged from 0.28 (confectionery)-0.42 to 0.68 (rice). Respective Pearson's CCs for intakes of nutrients were 0.28 (PUFAs)-0.51 to 0.73 (magnesium), and Spearman's rank CCs ranged from 0.23 (n-3 PUFAs)-0.45 to 0.71 (magnesium). Favorably higher agreement for intakes of foods/nutrients was achieved along with lower disagreement. CONCLUSIONS: Satisfactorily higher relative validity was attained in Japanese female dietitians with the SQFFQ. This calibrated questionnaire seems therefore appropriate for administration to Japanese dietitians to clarify associations between diet and health/disease. SPONSORSHIP: A grant-in-aid from the Ministry of Education, Science, Sports and Culture (06454242).

Adult↗

Calorie intake misreporting by diet record and food frequency questionnaire compared to doubly labeled water among postmenopausal women.

OBJECTIVE: We assessed the extent of energy misreporting from the use of a self-administered 7-day diet record (7-DDR) and a widely used food frequency questionnaire (FFQ) compared to total energy expenditure from doubly labeled water (DLW) in a group of postmenopausal women. DESIGN: At baseline, 65 healthy postmenopausal women were instructed to fill out the National Cancer Institute's (NCI) FFQ and a 7-DDR. Average total energy expenditure using the DLW method was also performed at baseline. RESULTS: On average, the women underestimated total energy intake compared to total energy expenditure assessed from DLW by 37% on the 7-DDR and 42% on the FFQ. CONCLUSIONS: These findings suggest that the interpretation of findings from the 7-DDR- and FFQ-based energy-disease association studies in postmenopausal women needs further evaluation. SPONSORSHIP: This research was supported (in part) by the Intramural Program of the NIH (National Cancer Institute).

Aged↗

Daily, weekly, seasonal, within- and between-individual variation in nutrient intake according to four season consecutive 7 day weighed diet records in Japanese female dietitians.

OBJECTIVE: To study daily, weekly, seasonal, within- and between-individual variance in intake of selected nutrients and minimal days necessary for assessing true intake with a specified degree of error based on four season consecutive 7 day weighed diet records (WDRs). SUBJECTS AND METHODS: We evaluated consumption of energy and 30 nutrients based on four season consecutive 7 day WDRs from 80 Japanese female dietitians in 1996-1997. We examined daily, weekly, seasonal, within- and between-individual variation in nutrient intake, relative contributions of their variances to total variance, and minimal days required to estimate a person's nutrient intake within 10% and 20% of their true mean with 95% confidence intervals. RESULTS: The relative contributions of variation for all nutrients by person were larger than those by day, week and season. Within-individual variances were greater than the between-individual variances. The ratios of within- vs. between-individual variances thus ranged from 1.3-26.9. Minimal days necessary for estimating nutrient consumption per person within 10% (20%) of the true mean with 95% confidence intervals ranged from 10-35 (3-9) days for energy and major nutrients and 15-640 (4-160) days for micro-nutrients. CONCLUSIONS: The relative contributions of variability by person were largest for all nutrients, followed by those due to sequence of days, season and day of week. Within-individual variation was greater than between-individual variation. Minimal days necessary for ascertaining major nutrients were in general fewer than micro-nutrients.

Adult↗

Four-day multimedia diet records underestimate energy needs in middle-aged and elderly women as determined by doubly-labeled water.

Systematic problems exist in the quantification of food intake in populations using traditional self-reported measures. The objective of this study was to determine the effectiveness of an innovative multimedia diet record (MMDR) for dietary energy intake assessment. Dietary intake was estimated by combining the use of a microcassette tape recorder and 35-mm camera in 53 women whose ages ranged from 50 to 93 y (64.9 +/- 11.3 y), with body weights of 62.4 +/- 12.2 kg and body mass indexes (BMI) of 24.4 +/- 4.0 kg/m(2). Using household measures, subjects voice-recorded and photographed all food and beverages consumed for four consecutive days. A two-point doubly-labeled water (DLW) method was used over 13 d to calculate carbon dioxide production, total body water, and subsequently, total energy expenditure (TEE) through the use of a food quotient. Mean body weight did not change between d 1 and 14. TEE and reported energy intake were compared using MMDR. Mean reported energy intakes 7.5 +/- 1.9 MJ/d (1774 +/- 476 kcal/d) were lower (P < 0.01) than TEE by 10.4 +/- 3.1 MJ/d (2477 +/- 736 kcal/d), indicating underreporting of food intake. Reporting accuracy (reported energy intake/TEE' 100%) was 76.0 +/- 22.9%. Mean energy expenditure (MJ/d), as determined by doubly-labeled water, was higher (P < 0.01) in each stratified age range when compared to reported energy intake by MMDR. There were no significant differences in reporting accuracy among the stratified age groups. Using the MMDR method, this population of weight-stable women underreported their food intakes compared to their determined energy expenditure estimated by DLW.

Aged↗

Relative validity of a short food frequency questionnaire for assessing nutrient intake versus three-day weighed diet records in middle-aged Japanese.

BACKGROUND: Validation studies on brief food frequency questionnaires (FFQs) for measuring consumption of macro- and micro-nutrients for the general populace are not fully executed in Japan. METHODS: Two hundred and two middle-aged Japanese (73 males and 129 females) in Aichi Prefecture, Japan completed an FFQ and 3day-weighed diet records (3d-WDRs) in February 2004. We compared intakes of energy and 26 nutrients computed with the FFQ against those with the 3d-WDRs as a reference. RESULTS: Mean daily intakes of selected nutrients determined with the FFQ were generally less than those with 3d-WDRs. The ratios assessed with the FFQ vs. 3d-WDRs (minimum-median-maximum) were distributed from 0.57-0.79-1.09 for males, and 0.61-0.86-1.04 for females. De-attenuated, log-transformed and energy-adjusted Pearson's correlation coefficients between intakes of selected nutrients quantified with both devices were distributed from 0.12-0.45-0.86 and energy-adjusted Spearman's rank correlation coefficients were from 0.13-0.35-0.76, for males. The respective values for females were 0.10-0.38-0.66, and 0.11-0.34-0.47. Median percentages for exact agreement, agreement within adjacent categories, and disagreement according to quartile classification of the energy-adjusted nutrient intakes measured with both methods were 33, 74, and 5 for males, and 35, 76, and 7 for females, respectively. CONCLUSION: Satisfactorily high relative validity indices of most nutrient intakes computed with the FFQ were attained against those with the 3d-WDRs. The questionnaire therefore appears applicable for categorizing individuals according to consumption of energy and selected nutrients in dietary studies of middle-aged Japanese.

Diet Records↗

[Validity assessment of a food frequency questionnaire by comparison with a 4-day diet record].

When dietary methods are used to evaluate nutritional intake, it is important to know which methods are most appropriate to ensure validity in nutrient intake studies. Our main objective was to assess the validity of a semi-quantitative food-frequency questionnaire (FFQ) developed for Portuguese adults by comparing nutrient intake (energy and 44 nutrients) assessed by FFQ with the nutritional data from a four-day diet record (DR). The FFQ was developed by the Epidemiology Department, Faculty of Medicine, University of Porto, and allowed the subjects to indicate their daily, weekly or monthly intake of 89 foods. Subjects were 246 university students (159 females and 87 males, aged 18 to 29 years). Mean intakes from the FFQ were generally higher than those from the DR. Pearson correlation coefficients between FFQ and DR ranged from 0.21 for vitamin D, to 0.73, for iodine. When energy-adjusted, this coefficients ranged from 0.20, for selenium, to 0.75 for iodine. Misclassification in opposite extreme quintiles varied from 0% to 16%, and the proportion of subjects correctly classified within the lowest two quintiles ranged between 52% and 84%. The distribution of those correctly classified within the highest two quintiles ranged between 51% and 88%. Exact classification in the same quintile of ingestion varied from 26% and 41%. These data suggest that this FFQ provides valid estimates of intakes for major nutrients, comparable to those reported from other studies in the literature.

Adult↗

Agreement between a brief food frequency questionnaire and diet records using two statistical methods.

OBJECTIVE: To compare intra- and inter-method reliability of a semi-quantitative food frequency questionnaire (FFQ) designed specifically to measure beta carotene (BC) and retinol intake, using two methods - the limits of agreement (LOA) and the correlation coefficient. DESIGN: A cross-sectional study of dietary intake. SETTING: A randomized trial of vitamin A supplements in 2769 subjects with past asbestos exposure. SUBJECTS: Data from 57 men and 26 women, aged 28-72 years, living in Western Australia. METHODS: The FFQ was administered at baseline (FFQ1) and repeated 1 year later (FFQ2). Four 1-week diet records (DRs) were completed during the year. RESULTS: Mean agreement between FFQ2 and FFQ1 was 120% for BC and 98% for retinol. LOA were 47-306% and 21-459%, respectively. Mean agreement between FFQ2 and the DR was 149% for BC and 63% for retinol; LOA were 50-447% and 11-349%, respectively. Mean agreement and LOA varied across energy intakes. Between the DR and FFQ2, correlation coefficients were 0.36 for BC and 0.51 for retinol. These varied considerably across age, gender and energy intakes and were not in accordance with limits of agreement findings. CONCLUSION: Although correlation coefficients were positive and significant, there was less than ideal intra-method and inter-method reliability shown by the limits of agreement method. Bias was uneven across the range of intakes, the LOA were wide and, compared with the DR, the FFQ significantly over-estimated BC and under-estimated retinol. This shows the limitations of calculating correlation coefficients alone, for assessing reliability and validity.

Adult↗

Relative validity of a semi-quantitative food frequency questionnaire versus 3 day weighed diet records in middle-aged inhabitants in Chaoshan area, China.

OBJECTIVE: The purpose of the study was to validate a semi-quantitative food frequency questionnaire1 (SQFFQ) against 3 day weighted diet records (WDRs) for middle-aged inhabitants in the Chaoshan area, China. SUBJECTS: 100 middle-age healthy residents. METHODS: Validity was examined via descriptive statistics and Pearson's correlations. RESULTS: Pearson's correlation coefficients (CCs) with energy-adjustment quantified by the SQFFQ and 3 day WDRs (minimum-median-maximum) ranged from 0.31(Vegetables)-0.35-0.53 (Cereals) for the selected foods, and 0.12 (retinol)-0.41-0.58 (phosphorous) for the selected nutrients. Favorably high agreement for intakes of foods/nutrients was achieved along with low disagreement. CONCLUSION: A moderate level of relative validity was observed; this food frequency questionnaire is reliable and valid for dietary assessment with middle-aged inhabitants in the Chaoshan area, China.

Adult↗

Comparison of dietary assessment methods in nutritional epidemiology: weighed records v. 24 h recalls, food-frequency questionnaires and estimated-diet records.

Women (n 160) aged 50 to 65 years were asked to weigh their food for 4 d on four occasions over the period of 1 year, using the PETRA (Portable Electronic Tape Recorded Automatic) scales. Throughout the year, they were asked to complete seven other dietary assessment methods: a simple 24 h recall, a structured 24 h recall with portion size assessments using photographs, two food-frequency questionnaires, a 7 d estimated record or open-ended food diary, a structured food-frequency (menu) record, and a structured food-frequency (menu) record with portion sizes assessed using photographs. Comparisons between the average of the 16 d weighed records and the first presentation of each method indicated that food-frequency questionnaires were not appreciably better at placing individuals in the distribution of habitual diet than 24 h recalls, due partly to inaccuracies in the estimation of frequency of food consumption. With a 7 d estimated record or open-ended food diary, however, individual values of nutrients were most closely associated with those obtained from 16 d weighed records, and there were no significant differences in average food or nutrient intakes.

Diet Records↗

Alcohol intake and high density lipoprotein-cholesterol: comparison of food frequency questionnaire and diet record in a general population sample.

BACKGROUND: Moderate alcohol consumption is known to affect several cardiovascular risk factors, including high density lipoprotein-cholesterol (HDL-C). Accurate measurement of alcohol intake in epidemiological studies is crucial for valid estimation of alcohol-related effects. METHODS: We compared two widely used alcohol-intake assessment methods, a food frequency questionnaire (FFQ) and a 7-day diet record (DR) regarding the association between alcohol intake and HDL-C in the general population. RESULTS: In a representative sample (842 men, 1103 women) of the population of former West Germany (VERA study), 75.6% of the participants reported drinking alcoholic beverages in the FFQ, whereas the percentage was 84.9% according to the DR. The median daily alcohol intake of consumers was 10.3 and 12.1 g, as assessed by the FFQ and the DR, respectively. There was moderate agreement between reported consumption levels ranked by quintiles according to FFQ and DR (kappa = 0.49). With both approaches alcohol intake showed a strong positive association with HDL-C in linear regression models. The estimated increases in HDL-C (mg dL(-1)) per gram alcohol per day from the FFQ and DR were 0.15 [95% confidence interval (CI): 0.12-0.18] and 0.14 (95% CI: 0.11-0.17), respectively. When participants with different classification of the amount of alcohol consumed by FFQ and DR were excluded from the analysis, the association between alcohol intake and HDL-C was more pronounced. DISCUSSION: Our analyses suggest that both FFQ and DR lead to similar results regarding the alcohol-HDL-C association in the general population, despite major differences in the recorded prevalence of drinking and amount of alcohol consumed. Both methods may tend to under-estimate the true alcohol-HDL-C association.

Adult↗

What are people really eating? The relation between energy intake derived from estimated diet records and intake determined to maintain body weight.

Two hundred sixty-six free-living human volunteers, 21-64 y old, were trained by dietitians to record daily their food intake for at least 7 d. Subsequently, they were fed diets of conventional foods adjusted in amounts to maintain their body weight for greater than or equal to 45 d. Comparing their estimated energy intake with the intake determined to maintain weight yielded mean differences of 2365 and 1792 kJ (565 and 428 kcal) in men and women, respectively, representing an underreporting of 18%. Twenty-two individuals (8%) overestimated and 29 (11%) were accurate to within 419 kJ (100 kcal) of their maintenance requirement. The remaining 215 individuals (81%) reported their habitual intake at 2930 +/- 1586 kJ (700 +/- 379 kcal) below that subsequently determined as their maintenance requirement. These findings suggest caution in the interpretation of food-consumption data.

Adult↗

Macronutrient, copper, and zinc intakes of young German children as determined by duplicate food samples and diet records.

Daily energy, protein, fat, carbohydrate, zinc, and copper intakes of 47 healthy 5- to 9-year-old children living in Duisburg, an industrial area of North Rhine-Westphalia, and consuming self-selected diets were calculated using a 4-day weighed dietary records and food composition values. In addition, the parents of the subjects also collected a 24-hour food composite on 2 of the recording days for analysis of the nutrients. This allowed us to compare the calculated value of the nutrients on days when only dietary records were made with those on which also duplicate samples were collected. Daily analyzed intakes were also compared with those calculated from the recording days. Zinc and copper were estimated by atomic absorption spectrometry. The results show that there were reductions in the intake of all nutrients on days when duplicate samples were also collected as compared with the days when only dietary records were made. Median daily calculated intakes for all children on the 4 record days were: energy 1,578 kcal, protein 46.5 g, fat 67.3, carbohydrates 174.7 g, zinc 5.3 mg, and copper 1.0 mg. The median analyzed intakes were: energy 1,367.7 kcal, protein 37.1 g, fat 49.1, carbohydrates 178.7 g, zinc 5.3 mg, and copper 0.7 mg. The use of the duplicate diet method has shown that a 4-day recording period gives an overestimation of the nutrient intake. The calculated and the analyzed zinc intakes did not meet the recommended levels of the Deutsche Gesellschaft für Ernährung. The median copper intakes were in the lower range of the levels recommended by the Deutsche Gesellschaft für Ernährung.

Child↗