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Title:   Author  item
                                            FREEDMAN, LAURENCE - The Sheba Medical Center At Tel Hashomeritem
                                            COMMINS, JOHN - Information Management Services, Incitem
                                            MOLER, JAMES - Information Management Services, Incitem
                                            ARAB, LENORE - University Of Californiaitem
                                            Baer, Daviditem
                                            KIPNIS, VICTOR - National Cancer Institute (NCI, NIH)item
                                            MIDTHUNE, DOUGLAS - National Cancer Institute (NCI, NIH)item
                                            Moshfegh, Alannaitem
                                            NEUHOUSER, MARIAN - Fred Hutchinson Cancer Research Centeritem
                                            PRENTICE, ROSS - Fred Hutchinson Cancer Research Centeritem
                                            SCHATZKIN, ARTHUR - National Cancer Institute (NCI, NIH)item
                                            SPIEGELMAN, DONNA - Harvard School Of Public Healthitem
                                            SUBAR, AMY - National Cancer Institute (NCI, NIH)item
                                            TINKER, LESLEY - Fred Hutchinson Cancer Research Centeritem
                                            WILLET, WALTER - Harvard School Of Public Health
  Submitted to: American Journal of Epidemiology
                                    Publication Type: Peer Reviewed Journal
                                    Publication Acceptance Date: 4/14/2014
                                    Publication  Date: 6/10/2014
                                    Citation: Freedman, L.S., Commins, J.M., Moler, J.E., Arab, L., Baer, D.J., Kipnis, V., Midthune, D., Moshfegh, A.J., Neuhouser, M.L., Prentice, R.L., Schatzkin, A., Spiegelman, D., Subar, A.F., Tinker, L.F., Willett, W. 2014. Pooled results from 5 validation studies of dietary self-report instruments using recovery biomarkers for energy and protein intake. American Journal of Epidemiology. 180(2):172-188. DOI: 10.1093/aje/kwu116.Interpretive Summary: This study examined self-reported dietary intake and biomarker recovery data from 5 large validation studies conducted between 1999-2009 on U.S. adult populations groups.  The objective was to compare and explain the nature and magnitude of reporting errors between food frequency questionnaires (FFQs) and 24-hour dietary recall interviews.  Underreporting of energy intakes was higher for dietary data collected using a food frequency questionnaire compared to a 24-hour dietary recall, 28 versus 15% on average.  Personal characteristics related to underreporting were body mass index, educational level, and age.  This study established that use of multiple 24-hour recalls substantially increases the correlations with truth when compared with a single 24-hour recall, that FFQs have stronger correlations with truth for protein density than for absolute protein intakes, and that body mass index strongly predicts underreporting of energy and protein intakes.  This study serves to inform nutrition researchers about the strengths and weaknesses of food frequency and 24-hour recall measures for dietary intakes.
                                Technical Abstract: We pooled data from 5 large validation studies of dietary self-report instruments that used recovery biomarkers as references to clarify the measurement properties of food frequency questionnaires (FFQs) and 24-hour recalls.  The studies were conducted in widely differing U.S. adult populations from 1999 to 2009.  We reported on total energy, protein, and protein density intakes.  Results were similar across sexes, but there was heterogeneity across studies.  Using a FFQ, the average correlation coefficients for reported versus true intakes for energy, protein, and protein density were 0.21, 0.29, and 0.41, respectively.  Using a single 24-hour recall, the coefficients were 0.26, 0.40, and 0.36, respectively, for the same nutrients and rose to 0.31, 0.49, and 0.46 when three 24-hour recalls were averaged.  The average rate of underreporting of energy intake was 28% with a FFQ and 15% with a single 24-hour recall, but the percentages were lower for protein.  Personal characteristics related to underreporting were body mass index, educational level, and age.  Calibration equations for true intake that included personal characteristics provided improved prediction.  This project establishes that FFQs have stronger correlations with truth for protein density than for absolute protein intake, that the use of multiple 24-hour recalls substantially increases the correlations when compared with a single 24-hour recall, and that body mass index strongly predicts underreporting of energy and protein intakes.


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