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Title: Applying recovery biomarkers to calibrate self-report measures of energy and protein in the Hispanic Community Health Study/Study of Latinos

Author
item MOSSAVAR-RAHMANI, YASMIN - Albert Einstein College Of Medicine
item SHAW, PAMELA - University Of Pennsylvania
item WONG, WILLIAM - Children'S Nutrition Research Center (CNRC)
item SOTRES-ALVAREZ, DANIELA - University Of North Carolina
item GELLMAN, MARC - University Of Miami
item VAN HORN, LINDA - Northwestern University
item STOUTENBERG, MARK - University Of Miami
item DAVIGLUS, MARTHA - University Of Illinois
item WYLIE-ROSETT , JUDITH - Albert Einstein College Of Medicine
item SIEGA-RIZ, ANNA - University Of North Carolina
item OU, FANG-SHU - University Of North Carolina
item PRENTICE, ROSS - Fred Hutchinson Cancer Research Center

Submitted to: American Journal of Epidemiology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/18/2014
Publication Date: 5/20/2015
Citation: Mossavar-Rahmani, Y., Shaw, P.A., Wong, W.W., Sotres-Alvarez, D., Gellman, M.D., Van Horn, L., Stoutenberg, M., Daviglus, M.L., Wylie-Rosett, J., Siega-Riz, A.M., Ou, F., Prentice, R.L. 2015. Applying recovery biomarkers to calibrate self-report measures of energy and protein in the Hispanic Community Health Study/Study of Latinos. American Journal of Epidemiology. 181(12):996-1007.

Interpretive Summary: Self-reported dietary intakes have often been used to define the link between food intakes and the risk of obesity and obesity-related illnesses. However, self-reported dietary intakes are known for huge errors, especially among minority groups. Therefore, any links reported between self-reported food intakes and the risk of obesity and obesity-related illnesses might not be real. In a study of 477 Hispanic/Latino adults between 18 and 74 years of age in Chicago, Miami, Bronx and San Diego, we compared the self-reported energy and protein intakes based on two 24-hour dietary recalls with the energy intake assessed using the doubly labeled water method and protein intake by the urinary nitrogen method. The doubly labeled water method is considered the most accurate method for assessing energy intake. The urinary nitrogen method is considered the most accurate method for assessing protein intake. The 24-hour dietary recalls underestimated energy intake by 25.3% and protein intake by 18.5%. The underestimations were affected by body weight and age. The underestimation also varied depending on Hispanic/Latino background. Based on these findings, we were able to develop equations to correct the errors. These equations can be used to reduce the errors in future studies to assess the diet-disease links among Hispanics/Latinos who are known for increased risk of obesity and obesity-related illnesses.

Technical Abstract: We investigated measurement error in the self-reported diets of US Hispanics/Latinos, who are prone to obesity and related comorbidities, by background (Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American) in 2010–2012. In 477 participants aged 18–74 years, doubly labeled water and urinary nitrogen were used as objective recovery biomarkers of energy and protein intakes. Self-report was captured from two 24-hour dietary recalls. All measures were repeated in a subsample of 98 individuals. We examined the bias of dietary recalls and their associations with participant characteristics using generalized estimating equations. Energy intake was underestimated by 25.3% (men, 21.8%; women, 27.3%), and protein intake was underestimated by 18.5% (men, 14.7%; women, 20.7%). Protein density was overestimated by 10.7% (men, 11.3%; women, 10.1%). Higher body mass index and Hispanic/Latino background were associated with underestimation of energy (P < 0.05). For protein intake, higher body mass index, older age, nonsmoking, Spanish speaking, and Hispanic/Latino background were associated with underestimation (P < 0.05). Systematic underreporting of energy and protein intakes and overreporting of protein density were found to vary significantly by Hispanic/Latino background. We developed calibration equations that correct for subject-specific error in reporting that can be used to reduce bias in diet-disease association studies.