Willem De Keyzer Methodological Aspects of Dietary
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FACULTY OF MEDICINE AND HEALTH SCIENCES Willem De Keyzer Methodological aspects of dietary intake assessment in food consumption surveys : from a national to an international level Supervisors Prof. dr. Stefaan De Henauw Prof. dr. ir. Pieter van ‘t Veer Thesis submitted in fulfilment of the requirements for the degree of Doctor in Medical Sciences 2014 De Keyzer, Willem Methodological aspects of dietary intake assessment in food consumption surveys: from a national to an international level Doctoraatsthesis Universiteit Gent Financial support Willem De Keyzer was financially supported by the Research Fund of University College Ghent. The EFCOVAL project was supported by European Community funding under the Sixth Framework Program (FOOD-CT- 2006-022895). FWO Flanders (Fonds Wetenschappelijk Onderzoek–Vlaanderen, Krediet aan navorsers – 1519110N) Verschenen in de reeks monografieën van de vakgroep Maatschappelijke Gezondheidkunde, Universiteit Gent. Wettelijk depot: D/2014/4531/3 ISBN: 9789078344353 © 2014, De Keyzer Willem ALL RIGHTS RESERVED. This work contains material protected under Copyright Laws and Treaties. Any unauthorized reprint or use of this material is prohibited. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system without express written permission from the author. Drukkerij-Uitgeverij Jan Verhoeven nv Bergensesteenweg 776 c 1600 Sint-Pieters-Leeuw Supervisors: prof. dr. Stefaan De Henauw Department of Public Health – unit Nutrition and Food Safety Ghent University – Belgium prof. dr. ir. Pieter van ’t Veer Division of Human Nutrition Wageningen University – the Netherlands Guidance committee: prof. dr. Inge Huybrechts Department of Public Health – unit Nutrition and Food Safety Ghent University – Belgium Dietary Exposure Assessment Group International Agency for Research on Cancer – Lyon, France prof. dr. Georges Van Maele Department of Public Health – unit Medical Informatics & Statistics Ghent University – Belgium Examination committee: prof. dr. Ilse De Bourdeaudhuij (chair) Department of Movement and Sports Sciences Ghent University – Belgium dr. Michael Nelson Emeritus Reader King’s College London Public Health Nutrition Research – London, United Kingdom prof. dr. Heiner Boeing Department of Epidemiology German Institute of Human Nutrition – Potsdam, Germany prof. em. dr. Guy De Backer Department of Public Health – unit Epidemiology and Preventive Medicine Ghent University – Belgium dr. Sophie Marchand Department of Endocrinology and Metabolic diseases University Hospital Ghent – Belgium dr. ir. Isabelle Sioen (secretary) Department of Public Health – unit Nutrition and Food Safety Ghent University – Belgium Table of contents General introduction ...................................................................................................13 Dietary assessment methods ........................................................................................16 Indirect measurement of food consumption ..........................................................16 Food balance sheets ............................................................................................16 Household budget surveys .................................................................................16 Direct measurement of food consumption. 17 Dietary history. .17 Food records ........................................................................................................18 24-hour dietary recalls .......................................................................................19 Food frequency questionnaires ..........................................................................21 Validation research ........................................................................................................24 Validity and reproducibility ....................................................................................24 Types and sources of errors .....................................................................................25 Biomarkers ................................................................................................................28 Harmonization of food consumption surveys ............................................................29 Aims and research questions of this dissertation. 30 Outline of the dissertation ............................................................................................31 References ......................................................................................................................33 PART 1 Relative validity of instruments used during food consumption surveys ..................39 Chapter 1: 24-h Recalls using EPIC-soft versus 5-day estimated food records ......................................................................................................................40 Background ....................................................................................................................41 Methods ........................................................................................................................41 Study design .............................................................................................................41 Participants ...............................................................................................................42 24-h Recall and EPIC-Soft .....................................................................................42 Estimated dietary record .........................................................................................43 Nutrients .................................................................................................................43 Accelerometry ..........................................................................................................44 Underreporting ........................................................................................................45 Statistical analysis ....................................................................................................46 Results ........................................................................................................................46 Discussion .....................................................................................................................50 Main results and comparison with the literature ..................................................50 Strengths and limitations ........................................................................................51 Conclusions ....................................................................................................................53 Acknowledgements .......................................................................................................53 References ......................................................................................................................54 Chapter 2: Errors in portion size estimation using food photographs ................57 Background ....................................................................................................................58 Methods ........................................................................................................................60 Subjects .....................................................................................................................60 Overall study design ................................................................................................60 Portions size measurement aids tested ...................................................................61 Perception .................................................................................................................61 Conceptualization and memory .............................................................................63 Data analysis .............................................................................................................63 Results ........................................................................................................................64 Discussion .....................................................................................................................71 Findings ....................................................................................................................71 Strengths ..................................................................................................................71 Limitations ...............................................................................................................71 Comparison with other studies ..............................................................................72 Conclusions ....................................................................................................................74 Acknowledgements .......................................................................................................74 References ......................................................................................................................75 Chapter 3: A short food frequency questionnaire versus 7-day estimated food records .....................................................................................77 Background ....................................................................................................................78