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IJE Advance Access published online on June 25, 2008
International Journal of Epidemiology, doi:10.1093/ije/dyn111
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2008; all rights reserved.

Associations between dietary methods and biomarkers, and between fruits and vegetables and risk of ischaemic heart disease, in the EPIC Norfolk Cohort Study

Sheila Bingham1,2,3,*, Robert Luben3, Ailsa Welch3, Yen Ling Low1, Kay Tee Khaw3, Nick Wareham3,4 and Nick Day3

1Medical Research Council, Dunn Human Nutrition Unit, Welcome Trust/MRC Building, Cambridge, UK.
2MRC Centre for Nutritional Epidemiology in Cancer Prevention and Survival, Institute of Public Health, University of Cambridge, Cambridge, UK.
3EPIC Norfolk UK, Institute of Public Health, University of Cambridge, Cambridge, UK.
4MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK.

*Corresponding author. MRC Centre for Nutritional Epidemiology, University of Cambridge, Wort's Causeway, Cambridge CBI 8RN. E-mail: sab{at}mrc-dunn.cam.ac.uk, sheila.bingham{at}srl.cam.ac.uk


  Abstract

Background Methods for assessing diet are prone to measurement error, which may be substantial in large cohort investigations. Biomarkers can be used as objective measures with which to compare estimates of nutritional exposure using different methods

Methods Cross sectional comparisons in 12 474 men and women of regression between biomarkers for vitamin C, sodium, potassium, fibre, carbohydrate, fat and phytoestrogens with intakes derived from food diaries and food frequency questionnaires (FFQ), and odds ratios for risk of ischaemic heart disease (IHD) by dietary and plasma vitamin C.

Results There were strong (P < 0.001) associations between biomarkers and intakes as assessed by food diary. Coefficients were markedly attenuated for data obtained from the FFQ, especially so for vitamin C, potassium and phytoestrogens (Z P < 0.05). Risk of IHD was associated with plasma vitamin C (P < 0.001) and intake of vitamin C and fruit and vegetables assessed by food diary (P quintile trends <0.001, 0.001) but not by the FFQ (P quintile trends 0.923, 0.186).

Conclusions Nutritional data that reflect the findings from biomarkers reduce measurement error and will thus improve statistical power in studies of gene nutrient interactions in cohort studies.

Keywords Diet, food frequency questionnaires, food diaries, biomarkers, EPIC, ischaemic heart disease

Accepted 12 May 2008


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