Use of a urinary sugars biomarker to assess measurement error in self-reported sugars intake in the Nutrition and Physical Activity Assessment Study (NPAAS)

Natasha 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

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: 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.

Original languageEnglish (US)
Pages (from-to)2874-2883
Number of pages10
JournalCancer Epidemiology Biomarkers and Prevention
Volume23
Issue number12
DOIs
StatePublished - Dec 1 2014

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Biomarkers
Exercise
Food
Self Report
Calibration
Dietary Sucrose
Women's Health
Fructose
Observational Studies
Sucrose
Epidemiologic Studies
Neoplasms
Population
Surveys and Questionnaires

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Use of a urinary sugars biomarker to assess measurement error in self-reported sugars intake in the Nutrition and Physical Activity Assessment Study (NPAAS). / Tasevska, Natasha; Midthune, Douglas; Tinker, Lesley F.; Potischman, Nancy; Lampe, Johanna W.; Neuhouser, Marian L.; Beasley, Jeannette M.; Van Horn, Linda; Prentice, Ross L.; Kipnis, Victor.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 23, No. 12, 01.12.2014, p. 2874-2883.

Research output: Contribution to journalArticle

Tasevska, N, Midthune, D, Tinker, LF, Potischman, N, Lampe, JW, Neuhouser, ML, Beasley, JM, Van Horn, L, Prentice, RL & Kipnis, V 2014, 'Use of a urinary sugars biomarker to assess measurement error in self-reported sugars intake in the Nutrition and Physical Activity Assessment Study (NPAAS)', Cancer Epidemiology Biomarkers and Prevention, vol. 23, no. 12, pp. 2874-2883. https://doi.org/10.1158/1055-9965.EPI-14-0594
Tasevska, Natasha ; Midthune, Douglas ; Tinker, Lesley F. ; Potischman, Nancy ; Lampe, Johanna W. ; Neuhouser, Marian L. ; Beasley, Jeannette M. ; Van Horn, Linda ; Prentice, Ross L. ; Kipnis, Victor. / Use of a urinary sugars biomarker to assess measurement error in self-reported sugars intake in the Nutrition and Physical Activity Assessment Study (NPAAS). In: Cancer Epidemiology Biomarkers and Prevention. 2014 ; Vol. 23, No. 12. pp. 2874-2883.
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abstract = "Background: 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.",
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AU - Tasevska, Natasha

AU - Midthune, Douglas

AU - Tinker, Lesley F.

AU - Potischman, Nancy

AU - Lampe, Johanna W.

AU - Neuhouser, Marian L.

AU - Beasley, Jeannette M.

AU - Van Horn, Linda

AU - Prentice, Ross L.

AU - Kipnis, Victor

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N2 - Background: 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.

AB - Background: 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.

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