International Journal of Epidemiology, Vol 26, S137-S151, Copyright © 1997 by International Epidemiological Association
SA Bingham, C Gill, A Welch, A Cassidy, SA Runswick, S Oakes, R Lubin, DI Thurnham, TJ Key, L Roe, KT Khaw and NE Day
BACKGROUND: In the UK EPIC validation studies, the accuracy of several
methods was assessed by comparison with to-day weighed records and the
biomarkers, 24-hour urine nitrogen (N) and potassium (K), plasma
carotenoids and plasma vitamin C. METHODS: Comparisons between methods were
made on 156 women, studied over 1 year at 3-monthly intervals at home. On
each of four occasions, volunteers completed 4 days of weighed records and
provided two 24-hour urine collections and a fasting blood sample. RESULTS:
In comparison with the 16 days of weighed records, a food frequency
questionnaire (FFQ) yielded higher values mainly due to greater reported
consumption of milk and of vegetables. A 24-hour recall was as good as the
FFQ in placing individuals in the distribution of habitual diet from
weighed records. Results obtained from a 7-day estimated record were
closest to those obtained from the weighed record. Correlations between
24-hour urine excretion and dietary N intake from weighed records were high
(0.78-0.87) as were those with estimated food diaries (0.60-0.70).
Correlations between urine N and the FFQ and 24-hour recall were lower
(0.10 to 0.27), but improved by energy adjustment using residuals for N and
K which are correlated with total energy intake. Comparisons between
dietary estimates and urinary K and serum carotenoids and vitamin C showed
broadly similar results. Limited biomarker information amongst 200 UK EPIC
participants supported the findings of the validation study. CONCLUSIONS:
UK EPIC uses three methods (the 7-day diary, an improved FFQ, and the
24-hour recall) to assess diet. 93% of first food diaries are returned
completed by participants. Repeated diaries are the main dietary assessment
method for nested case-control analyses.
ARTICLES
Validation of dietary assessment methods in the UK arm of EPIC using weighed records, and 24-hour urinary nitrogen and potassium and serum vitamin C and carotenoids as biomarkers
MRC Dunn Clinical Nutrition Centre, Cambridge, UK.
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