Hebert James R, Patterson Ruth E, Gorfine Malka, Ebbeling Cara B, St Jeor Sachiko T, Chlebowski Rowan T
Department of Epidemiology and Biostatistics, and the Center for Research on Nutrition and Health Disparities, University of South Carolina, Arnold School of Public Health, and the South Carolina Cancer Center, Columbia, SC 29203, USA.
Ann Epidemiol. 2003 Oct;13(9):629-37. doi: 10.1016/S1047-2797(03)00051-6.
To compare energy intake derived from a food frequency questionnaire (FFQ) with estimated energy expenditure in postmenopausal women participating in a large clinical study.
A total of 161,856 women aged 50 to 79 years enrolled in the Women's Health Initiative (WHI) Observational Study (OS) or Clinical Trial (CT) [including the Diet Modification (DM) component] completed the WHI FFQ, from which energy intake (FFQEI) was derived. Population-adjusted total energy expenditure (PATEE) was calculated according to the Harris-Benedict equation weighted by caloric intakes derived from the National Health and Nutrition Examination Survey. Stepwise regression was used to examine the influence of independent variables (e.g., demographic, anthropometric) on FFQEI-PATEE. Race, region, and education were forced into the model; other variables were retained if they increased model explanatory ability by more than 1%.
On average, FFQEI was approximately 25% lower than PATEE. Regression results (intercept=-799 kcal/d) indicated that body mass index (b=-23 kcal/day/kg.m(-2)); age (b=15 kcal/day/year of age); and study arm (relative to women in the OS, for DM women b=169 kcal/d, indicating better agreement with PATEE) increased model partial R(2)>.01. Results for CT women not eligible for DM were similar to those of women in the OS (b=14 kcal/d). There also were apparent differences by race (b=-152 kcal/d in Blacks) and education (b=-67 kcal/d in women with<high school).
This large, carefully studied population confirms previous observations regarding underestimates in self-reported caloric intake relative to estimates of metabolic need in younger women, and those with higher weight, with less education, and in Blacks. These differences, along with effects related to intervention assignment, underline the need for additional research to enhance understanding of errors in dietary measurement.
在参与一项大型临床研究的绝经后女性中，比较通过食物频率问卷（FFQ）得出的能量摄入量与估计能量消耗。
共有161856名年龄在50至79岁的女性参与了女性健康倡议（WHI）观察性研究（OS）或临床试验（CT）[包括饮食调整（DM）部分]，她们完成了WHI FFQ，从中得出能量摄入量（FFQEI）。根据哈里斯-本尼迪克特方程，以来自国家健康与营养检查调查的热量摄入量为权重，计算人群调整后的总能量消耗（PATEE）。采用逐步回归分析来检验自变量（如人口统计学、人体测量学变量）对FFQEI - PATEE的影响。种族、地区和教育程度被强制纳入模型；如果其他变量能使模型解释能力提高超过1%，则予以保留。
平均而言，FFQEI比PATEE低约25%。回归结果（截距 = -799千卡/天）表明，体重指数（b = -23千卡/天/千克·米²）、年龄（b = 15千卡/天/岁）以及研究分组（相对于OS组女性，DM组女性b = 169千卡/天，表明与PATEE的一致性更好）使模型的偏R²>0.01。不符合DM条件的CT组女性的结果与OS组女性相似（b = 14千卡/天）。不同种族（黑人b = -152千卡/天）和教育程度（高中以下女性b = -67千卡/天）之间也存在明显差异。
这个经过精心研究的大样本人群证实了先前的观察结果，即相对于年轻女性、体重较高、教育程度较低的女性以及黑人的代谢需求估计值，自我报告的热量摄入量存在低估情况。这些差异以及与干预分配相关的影响，突显了开展更多研究以增进对饮食测量误差理解的必要性。
