Black A E, Cole T J
Medical Research Council Dunn Nutrition Centre, Cambridge, England.
J Am Diet Assoc. 2001 Jan;101(1):70-80. doi: 10.1016/S0002-8223(01)00018-9.
Seven studies with repeated measurements of energy intake and/or nitrogen intake were examined to determine whether misreporting is characteristic of some persons or occurs randomly. Four of the studies were validated by doubly labeled water measurements of energy expenditure. Reporting validity was expressed as the ratio of energy intake to energy expenditure. Ratios were consistently below the expected value of 1.0 for some subjects and consistently above 1.0 for others, indicating characteristic reporting validity within subjects. Two year-long studies provided 4 to 12 measurements and a total number of days sufficient to measure individual habitual intake. Subjects mean energy intake to basal metabolic rate (BMR) ratios were < 1.35 in 45% and 47% and < 1.35 at every measurement in 25% of subjects. This indicated persistent underreporting over time, because 1.35 x BMR is the minimum energy expenditure compatible with a normally active lifestyle. Three of the studies used more than 1 assessment method (validated by doubly labeled water and/or urinary nitrogen excretion). There was a tendency for persons determined to be underreporters by 1 method to be also underreporters when tested by other methods. We conclude that biased over- or underreporting is characteristic of some persons. Thus, repeat measurements do not necessarily provide valid measures of individual intake, extreme intakes may reflect under- and overreporting rather than true low or high intakes, and subjects most prone to reporting bias may be repeatedly misclassified in quantiles of the distribution. This presents a challenge to dietitians nutritionists, and statisticians both for the design of surveys and the handling of flawed data.
对七项重复测量能量摄入和/或氮摄入的研究进行了分析,以确定误报是某些人的特征还是随机发生的。其中四项研究通过双标水测量能量消耗进行了验证。报告有效性以能量摄入与能量消耗的比率表示。对于一些受试者,该比率始终低于预期值1.0,而对于另一些受试者则始终高于1.0,这表明受试者内部存在特征性的报告有效性。两项为期一年的研究提供了4至12次测量,且测量天数足以测量个体的习惯性摄入量。45%和47%的受试者平均能量摄入与基础代谢率(BMR)的比率<1.35,25%的受试者每次测量时该比率均<1.35。这表明随着时间的推移存在持续的低报情况,因为1.35×BMR是与正常活跃生活方式相适应的最低能量消耗。其中三项研究使用了不止一种评估方法(通过双标水和/或尿氮排泄进行验证)。被一种方法判定为低报者的人,在通过其他方法测试时也有低报的倾向。我们得出结论,有偏差的高报或低报是某些人的特征。因此,重复测量不一定能提供个体摄入量的有效测量值,极端摄入量可能反映的是低报和高报,而非真正的低摄入量或高摄入量,最容易出现报告偏差的受试者在分布的分位数中可能会被反复误分类。这给营养师、营养学家和统计学家在调查设计和处理有缺陷的数据方面都带来了挑战。