Evaluation and comparison of food records, recalls, and frequencies for energy and protein assessment by using recovery biomarkers

Abstract

The food frequency questionnaire approach to dietary assessment is ubiquitous in nutritional epidemiology research. Food records and recalls provide approaches that may also be adaptable for use in large epidemiologic cohorts, if warranted by better measurement properties. The authors collected (2007-2009) a 4-day food record, three 24-hour dietary recalls, and a food frequency questionnaire from 450 postmenopausal women in the Women's Health Initiative prospective cohort study (enrollment, 1994-1998), along with biomarkers of energy and protein consumption. Through comparison with biomarkers, the food record is shown to provide a stronger estimate of energy and protein than does the food frequency questionnaire, with 24-hour recalls mostly intermediate. Differences were smaller and nonsignificant for protein density. Food frequencies, records, and recalls were, respectively, able to "explain" 3.8%, 7.8%, and 2.8% of biomarker variation for energy; 8.4%, 22.6%, and 16.2% of biomarker variation for protein; and 6.5%, 11.0%, and 7.0% of biomarker variation for protein density. However, calibration equations that include body mass index, age, and ethnicity substantially improve these numbers to 41.7%, 44.7%, and 42.1% for energy; 20.3%, 32.7%, and 28.4% for protein; and 8.7%, 14.4%, and 10.4% for protein density. Calibration equations using any of the assessment procedures may yield suitable consumption estimates for epidemiologic study purposes.

Trial registration: ClinicalTrials.gov NCT00000611.

Figure 1.

Women’s Health Initiative Nutrition and Physical Activity Assessment Study (NPAAS; 2007–2009) procedures. DLW, doubly labeled water; FFQ, food frequency questionnaire.

Figure 2.

Scatterplot of the Women’s Health Initiative Nutrition and Physical Activity Assessment Study (NPAAS; 2007–2009) primary versus reliability sample. Each plot provides the Pearson correlation for the log-measure. DLW, doubly labeled water; FFQ, food frequency questionnaire; UN, urinary nitrogen; 4DFR, 4-day food record.