Comparison of self-reported dietary intakes from the Automated Self-Administered 24-h recall, 4-d food records, and food-frequency questionnaires against recovery biomarkers

Abstract

Background: A limited number of studies have evaluated self-reported dietary intakes against objective recovery biomarkers.

Objective: The aim was to compare dietary intakes of multiple Automated Self-Administered 24-h recalls (ASA24s), 4-d food records (4DFRs), and food-frequency questionnaires (FFQs) against recovery biomarkers and to estimate the prevalence of under- and overreporting.

Design: Over 12 mo, 530 men and 545 women, aged 50-74 y, were asked to complete 6 ASA24s (2011 version), 2 unweighed 4DFRs, 2 FFQs, two 24-h urine collections (biomarkers for protein, potassium, and sodium intakes), and 1 administration of doubly labeled water (biomarker for energy intake). Absolute and density-based energy-adjusted nutrient intakes were calculated. The prevalence of under- and overreporting of self-report against biomarkers was estimated.

Results: Ninety-two percent of men and 87% of women completed ≥3 ASA24s (mean ASA24s completed: 5.4 and 5.1 for men and women, respectively). Absolute intakes of energy, protein, potassium, and sodium assessed by all self-reported instruments were systematically lower than those from recovery biomarkers, with underreporting greater for energy than for other nutrients. On average, compared with the energy biomarker, intake was underestimated by 15-17% on ASA24s, 18-21% on 4DFRs, and 29-34% on FFQs. Underreporting was more prevalent on FFQs than on ASA24s and 4DFRs and among obese individuals. Mean protein and sodium densities on ASA24s, 4DFRs, and FFQs were similar to biomarker values, but potassium density on FFQs was 26-40% higher, leading to a substantial increase in the prevalence of overreporting compared with absolute potassium intake.

Conclusions: Although misreporting is present in all self-report dietary assessment tools, multiple ASA24s and a 4DFR provided the best estimates of absolute dietary intakes for these few nutrients and outperformed FFQs. Energy adjustment improved estimates from FFQs for protein and sodium but not for potassium. The ASA24, which now can be used to collect both recalls and records, is a feasible means to collect dietary data for nutrition research.

Keywords: 24-h recalls; 4-d food records, under-reporting, and overreporting; dietary assessment, food-frequency questionnaire, recovery biomarker.

Published by Oxford University Press on behalf of the American Society for Nutrition 2018.

Figures

FIGURE 1

Timeline of dietary assessments and biomarker measurements in the IDATA study. Participants were recruited on a rolling basis until the quota for each group and total sample size were met. On average, groups 3 and 4 started their study activities ∼3 mo later than groups 1 and 2. *The second DLW was administered to a small subset of participants. ASA24, Automated Self-Administered 24-h recall; DLW, doubly labeled water; FC, 7-d food checklist; FFQ, food-frequency questionnaire; IDATA, Interactive Diet and Activity Tracking in AARP; M, month; 4DFR, 4-day food record.

FIGURE 2

(A–D) Prevalence of under- and overreporting of nutrient intakes in self-reported dietary assessment tools. For energy intake analysis, n = 345, 307, 272, 294, and 290 in men and 350, 305, 260, 320, and 284 in women for all ASA24s, 4DFR-1, 4DFR-2, FFQ-1, and FFQ-2, respectively. For protein, potassium, and sodium analyses, n = 470, 414, 365, 386, and 388 in men and 464, 404, 346, 406, and 378 in women for all ASA24s, 4DFR-1, 4DFR-2, FFQ-1, and FFQ-2, respectively. ASA24, Automated Self-Administered 24-h recall; FFQ, food-frequency questionnaire; 4DFR, 4-d food record.

FIGURE 3

(A–C) Prevalence of under- and overreporting of energy-adjusted nutrient intakes by using a density method in self-reported dietary assessment tools. For protein, potassium, and sodium density analyses, n = 345, 307, 272, 294, and 290 in men and 350, 305, 260, 320, and 284 in women for all ASA24s, 4DFR-1, 4DFR-2, FFQ-1, and FFQ-2, respectively. ASA24, Automated Self-Administered 24-h recall; FFQ, food-frequency questionnaire; 4DFR, 4-d food record.

FIGURE 4

(A–D) Prevalence of underreporting of nutrient intakes by BMI in men and women. ASA24, Automated Self-Administered 24-h recall; FFQ, food-frequency questionnaire; 4DFR, 4-d food record.