Comparison of a web-based food record tool and a food-frequency questionnaire and objective validation using the doubly labelled water technique in a Swedish middle-aged population

Sanna Nybacka; Heléne Bertéus Forslund; Elisabet Wirfält; Ingrid Larsson; Ulrika Ericson; Eva Warensjö Lemming; Göran Bergström; Bo Hedblad; Anna Winkvist; Anna Karin Lindroos

doi:10.1017/jns.2016.29

Comparison of a web-based food record tool and a food-frequency questionnaire and objective validation using the doubly labelled water technique in a Swedish middle-aged population

J Nutr Sci. 2016 Oct 3:5:e39. doi: 10.1017/jns.2016.29. eCollection 2016.

Affiliations

¹ Department of Internal Medicine and Clinical Nutrition , Institute of Medicine , Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden.
² Department of Clinical Sciences in Malmö , Research Group in Nutritional Epidemiology , Lund University , Lund , Sweden.
³ Department of Endocrinology, Diabetology and Metabolism , Sahlgrenska University Hospital , Gothenburg , Sweden.
⁴ Department of Clinical Sciences in Malmö , Diabetes and Cardiovascular Disease , Genetic Epidemiology , Lund University , Lund , Sweden.
⁵ National Food Agency , Uppsala , Sweden.
⁶ Wallenberg Laboratory , Sahlgrenska Centre for Cardiovascular and Metabolic Research , Sahlgrenska University Hospital , Gothenburg , Sweden.
⁷ Department of Clinical Sciences in Malmö , Cardiovascular Research Group , Lund University , Lund , Sweden.

Abstract

Two web-based dietary assessment tools have been developed for use in large-scale studies: the Riksmaten method (4-d food record) and MiniMeal-Q (food-frequency method). The aim of the present study was to examine the ability of these methods to capture energy intake against objectively measured total energy expenditure (TEE) with the doubly labelled water technique (TEE_DLW), and to compare reported energy and macronutrient intake. This study was conducted within the pilot study of the Swedish CArdioPulmonary bioImage Study (SCAPIS), which included 1111 randomly selected men and women aged 50-64 years from the Gothenburg general population. Of these, 200 were enrolled in the SCAPIS diet substudy. TEE_DLW was measured in a subsample (n 40). Compared with TEE_DLW, both methods underestimated energy intake: -2·5 (sd 2·9) MJ with the Riksmaten method; -2·3 (sd 3·6) MJ with MiniMeal-Q. Mean reporting accuracy was 80 and 82 %, respectively. The correlation between reported energy intake and TEE_DLW was r 0·4 for the Riksmaten method (P < 0·05) and r 0·28 (non-significant) for MiniMeal-Q. Women reported similar average intake of energy and macronutrients in both methods whereas men reported higher intakes with the Riksmaten method. Energy-adjusted correlations ranged from 0·14 (polyunsaturated fat) to 0·77 (alcohol). Bland-Altman plots showed acceptable agreement for energy and energy-adjusted protein and carbohydrate intake, whereas the agreement for fat intake was poorer. According to energy intake data, both methods displayed similar precision on energy intake reporting. However, MiniMeal-Q was less successful in ranking individuals than the Riksmaten method. The development of methods to achieve limited under-reporting is a major challenge for future research.

Keywords: DLW, doubly labelled water; Diet assessment; Doubly labelled water; EI, energy intake; FFQ; Food records; Nutrition epidemiology; SCAPIS, Swedish CArdioPulmonary bioImage Study; TEE, total energy expenditure; TEEDLW, total energy expenditure measured with the doubly labelled water technique; Validation; Web-based methods.