Participant characteristics associated with errors in self-reported energy intake from the Womens Health Initiative food-frequency questionnaire
Abstract
Background: Errors in self-reported dietary intake threaten inferences from studies relying on instruments such as food-frequency questionnaires (FFQs), food records, and food recalls. Objective: The objective was to quantify the magnitude, direction, and predictors of errors associated with energy intakes estimated from the Women’s Health Initiative FFQ. Design: Postmenopausal women ( n = 102) provided data on sociodemographic and psychosocial characteristics that relate to errors in self-reported energy intake. Energy intake was objectively estimated as total energy expenditure, physical activity expenditure, and the thermic effect of food (10% addition to other components of total energy expenditure). Results: Participants underreported energy intake on the FFQ by 20.8%; this error trended upward with younger age ( P = 0.07) and social desirability ( P = 0.09) but was not associated with body mass index ( P = 0.95). The correlation coefficient between reported energy intake and total energy expenditure was 0.24; correlations were higher among women with less education, higher body mass index, and greater fat-free mass, social desirability, and dissatisfaction with perceived body size (all P < 0.10). Conclusions: Energy intake is generally underreported, and both the magnitude of the error and the association of the self-reporting with objectively estimated intake appear to vary by participant characteristics. Studies relying on self-reported intake should include objective measures of energy expenditure in a subset of participants to identify person-specific bias within the study population for the dietary self-reporting tool; these data should be used to calibrate the self-reported data as an integral aspect of diet and disease association studies. Key Words: Dietary records • systematic bias • dietary measurement error • energy expenditure • postmenopausal women • Women’s Health Initiative