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Use of a urinary sugars biomarker to assess measurement error in self-reported sugars intake in the nutrition and physical activity assessment study (NPAAS).

AbstractBACKGROUND:
Measurement error in self-reported sugars intake may be obscuring the association between sugars and cancer risk in nutritional epidemiologic studies.
METHODS:
We used 24-hour urinary sucrose and fructose as a predictive biomarker for total sugars, to assess measurement error in self-reported sugars intake. The Nutrition and Physical Activity Assessment Study (NPAAS) is a biomarker study within the Women's Health Initiative (WHI) Observational Study that includes 450 postmenopausal women ages 60 to 91 years. Food Frequency Questionnaires (FFQ), four-day food records (4DFR), and three 24-hour dietary recalls (24HRs) were collected along with sugars and energy dietary biomarkers.
RESULTS:
Using the biomarker, we found self-reported sugars to be substantially and roughly equally misreported across the FFQ, 4DFR, and 24HR. All instruments were associated with considerable intake- and person-specific bias. Three 24HRs would provide the least attenuated risk estimate for sugars (attenuation factor, AF = 0.57), followed by FFQ (AF = 0.48) and 4DFR (AF = 0.32), in studies of energy-adjusted sugars and disease risk. In calibration models, self-reports explained little variation in true intake (5%-6% for absolute sugars and 7%-18% for sugars density). Adding participants' characteristics somewhat improved the percentage variation explained (16%-18% for absolute sugars and 29%-40% for sugars density).
CONCLUSIONS:
None of the self-report instruments provided a good estimate of sugars intake, although overall 24HRs seemed to perform the best.
IMPACT:
Assuming the calibrated sugars biomarker is unbiased, this analysis suggests that measuring the biomarker in a subsample of the study population for calibration purposes may be necessary for obtaining unbiased risk estimates in cancer association studies.
AuthorsNatasha Tasevska, Douglas Midthune, Lesley F Tinker, Nancy Potischman, Johanna W Lampe, Marian L Neuhouser, Jeannette M Beasley, Linda Van Horn, Ross L Prentice, Victor Kipnis
JournalCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology (Cancer Epidemiol Biomarkers Prev) Vol. 23 Issue 12 Pg. 2874-83 (Dec 2014) ISSN: 1538-7755 [Electronic] United States
PMID25234237 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, Non-P.H.S.)
Copyright©2014 American Association for Cancer Research.
Chemical References
  • Carbohydrates
Topics
  • Aged
  • Carbohydrates (urine)
  • Diet Surveys
  • Energy Intake (physiology)
  • Female
  • Humans
  • Middle Aged
  • Motor Activity
  • Nutritional Status
  • Prospective Studies
  • Self Report
  • Surveys and Questionnaires

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