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      Validity of an online 24-h recall tool (myfood24) for dietary assessment in population studies: comparison with biomarkers and standard interviews

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          Abstract

          Background

          Online dietary assessment tools can reduce administrative costs and facilitate repeated dietary assessment during follow-up in large-scale studies. However, information on bias due to measurement error of such tools is limited. We developed an online 24-h recall (myfood24) and compared its performance with a traditional interviewer-administered multiple-pass 24-h recall, assessing both against biomarkers.

          Methods

          Metabolically stable adults were recruited and completed the new online dietary recall, an interviewer-based multiple pass recall and a suite of reference measures. Longer-term dietary intake was estimated from up to 3 × 24-h recalls taken 2 weeks apart. Estimated intakes of protein, potassium and sodium were compared with urinary biomarker concentrations. Estimated total sugar intake was compared with a predictive biomarker and estimated energy intake compared with energy expenditure measured by accelerometry and calorimetry. Nutrient intakes were also compared to those derived from an interviewer-administered multiple-pass 24-h recall.

          Results

          Biomarker samples were received from 212 participants on at least one occasion. Both self-reported dietary assessment tools led to attenuation compared to biomarkers. The online tools resulted in attenuation factors of around 0.2–0.3 and partial correlation coefficients, reflecting ranking intakes, of approximately 0.3–0.4. This was broadly similar to the more administratively burdensome interviewer-based tool. Other nutrient estimates derived from myfood24 were around 10–20% lower than those from the interviewer-based tool, with wide limits of agreement. Intraclass correlation coefficients were approximately 0.4–0.5, indicating consistent moderate agreement.

          Conclusions

          Our findings show that, whilst results from both measures of self-reported diet are attenuated compared to biomarker measures, the myfood24 online 24-h recall is comparable to the more time-consuming and costly interviewer-based 24-h recall across a range of measures.

          Electronic supplementary material

          The online version of this article (10.1186/s12916-018-1113-8) contains supplementary material, which is available to authorized users.

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          Most cited references33

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          Measurement in Medicine: The Analysis of Method Comparison Studies

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            Pooled results from 5 validation studies of dietary self-report instruments using recovery biomarkers for energy and protein intake.

            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 US adult populations from 1999 to 2009. We report 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 under-reporting 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 under-reporting 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 under-reporting of energy and protein intakes.
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              Development and evaluation of the Oxford WebQ, a low-cost, web-based method for assessment of previous 24 h dietary intakes in large-scale prospective studies.

              To describe the development of the Oxford WebQ, a web-based 24 h dietary assessment tool developed for repeated administration in large prospective studies; and to report the preliminary assessment of its performance for estimating nutrient intakes. We developed the Oxford WebQ by repeated testing until it was sufficiently comprehensive and easy to use. For the latest version, we compared nutrient intakes from volunteers who completed both the Oxford WebQ and an interviewer-administered 24 h dietary recall on the same day. Oxford, UK. A total of 116 men and women. The WebQ took a median of 12·5 (interquartile range: 10·8-16·3) min to self-complete and nutrient intakes were estimated automatically. By contrast, the interviewer-administered 24 h dietary recall took 30 min to complete and 30 min to code. Compared with the 24 h dietary recall, the mean Spearman's correlation for the 21 nutrients obtained from the WebQ was 0·6, with the majority between 0·5 and 0·9. The mean differences in intake were less than ±10 % for all nutrients except for carotene and vitamins B12 and D. On rare occasions a food item was reported in only one assessment method, but this was not more frequent or systematically different between the methods. Compared with an interviewer-based 24 h dietary recall, the WebQ captures similar food items and estimates similar nutrient intakes for a single day's dietary intake. The WebQ is self-administered and nutrients are estimated automatically, providing a low-cost method for measuring dietary intake in large-scale studies.
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                Author and article information

                Contributors
                0113 343 6946 , j.e.cade@leeds.ac.uk
                Journal
                BMC Med
                BMC Med
                BMC Medicine
                BioMed Central (London )
                1741-7015
                9 August 2018
                9 August 2018
                2018
                : 16
                : 136
                Affiliations
                [1 ]ISNI 0000000106754565, GRID grid.8096.7, Centre for Innovative Research Across the Life Course (CIRAL), Faculty of Health and Life Sciences, , Coventry University, ; Coventry, CV1 5FB UK
                [2 ]ISNI 0000 0001 2113 8111, GRID grid.7445.2, Global eHealth Unit, Department of Primary Care and Public Health, Imperial College, , Imperial College, ; London, SW7 2AZ UK
                [3 ]ISNI 0000 0004 1936 8403, GRID grid.9909.9, Division of Epidemiology and Biostatistics, Leeds Institute for Cardiovascular and Metabolic Medicine, School of Medicine, , University of Leeds, ; Leeds, LS2 9JT UK
                [4 ]ISNI 0000 0001 2113 8111, GRID grid.7445.2, Nutrition and Dietetic Research Group, Division of Diabetes, Endocrinology and Metabolism, Faculty of Medicine, , Imperial College London, ; London, W12 ONN UK
                [5 ]ISNI 0000 0004 1936 9297, GRID grid.5491.9, Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, , University of Southampton, ; Southampton, SO16 6YD UK
                [6 ]ISNI 0000 0004 1936 8403, GRID grid.9909.9, Nutritional Epidemiology Group, School of Food Science and Nutrition, , University of Leeds, ; Leeds, LS2 9JT UK
                [7 ]ISNI 0000 0001 2113 8111, GRID grid.7445.2, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, , Imperial College London, ; London, W2 1PG UK
                [8 ]ISNI 0000 0004 1936 8403, GRID grid.9909.9, Leeds Institute of Data Analytics, , University of Leeds, ; Leeds, LS2 9JT UK
                [9 ]ISNI 0000 0000 9137 6644, GRID grid.412832.e, Department of Clinical Nutrition, Faculty of Applied Medical Sciences, , Umm Al-Qura University, ; P.O. Box 715, Makkah, 21955 Saudi Arabia
                [10 ]GRID grid.430506.4, NIHR Southampton Biomedical Research Centre, , University of Southampton and University Hospital Southampton NHS Foundation Trust, ; Southampton, SO16 6YD UK
                Author information
                http://orcid.org/0000-0003-3421-0121
                Article
                1113
                10.1186/s12916-018-1113-8
                6083628
                30089491
                0ef4a103-a683-41bd-ad11-c1bc55bed24e
                © The Author(s). 2018

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 17 November 2017
                : 29 June 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000265, Medical Research Council;
                Award ID: G1100235
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Medicine
                nutrition assessment,online,biomarkers,validation,nutritional epidemiology,nutrient intake,food,diet,adult

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