Subar Amy F, Freedman Laurence S, Tooze Janet A, Kirkpatrick Sharon I, Boushey Carol, Neuhouser Marian L, Thompson Frances E, Potischman Nancy, Guenther Patricia M, Tarasuk Valerie, Reedy Jill, Krebs-Smith Susan M
Divisions of Cancer Control and Population Sciences and
Biostatistics Unit, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel;
J Nutr. 2015 Dec;145(12):2639-45. doi: 10.3945/jn.115.219634. Epub 2015 Oct 14.
Recent reports have asserted that, because of energy underreporting, dietary self-report data suffer from measurement error so great that findings that rely on them are of no value. This commentary considers the amassed evidence that shows that self-report dietary intake data can successfully be used to inform dietary guidance and public health policy. Topics discussed include what is known and what can be done about the measurement error inherent in data collected by using self-report dietary assessment instruments and the extent and magnitude of underreporting energy compared with other nutrients and food groups. Also discussed is the overall impact of energy underreporting on dietary surveillance and nutritional epidemiology. In conclusion, 7 specific recommendations for collecting, analyzing, and interpreting self-report dietary data are provided: (1) continue to collect self-report dietary intake data because they contain valuable, rich, and critical information about foods and beverages consumed by populations that can be used to inform nutrition policy and assess diet-disease associations; (2) do not use self-reported energy intake as a measure of true energy intake; (3) do use self-reported energy intake for energy adjustment of other self-reported dietary constituents to improve risk estimation in studies of diet-health associations; (4) acknowledge the limitations of self-report dietary data and analyze and interpret them appropriately; (5) design studies and conduct analyses that allow adjustment for measurement error; (6) design new epidemiologic studies to collect dietary data from both short-term (recalls or food records) and long-term (food-frequency questionnaires) instruments on the entire study population to allow for maximizing the strengths of each instrument; and (7) continue to develop, evaluate, and further expand methods of dietary assessment, including dietary biomarkers and methods using new technologies.
最近的报告断言，由于能量摄入报告不足，膳食自我报告数据存在巨大的测量误差，以至于依赖这些数据的研究结果毫无价值。本评论考虑了大量证据，这些证据表明自我报告的膳食摄入数据可成功用于为膳食指南和公共卫生政策提供信息。讨论的主题包括对于使用自我报告膳食评估工具收集的数据中固有的测量误差已知的情况以及可以采取的措施，以及与其他营养素和食物组相比能量摄入报告不足的程度和规模。还讨论了能量摄入报告不足对膳食监测和营养流行病学的总体影响。总之，提供了关于收集、分析和解释自我报告膳食数据的7条具体建议：（1）继续收集自我报告的膳食摄入数据，因为它们包含有关人群所消费的食物和饮料的有价值、丰富且关键的信息，可用于为营养政策提供信息并评估饮食与疾病的关联；（2）不要将自我报告的能量摄入量用作真实能量摄入量的衡量标准；（3）确实将自我报告的能量摄入量用于对其他自我报告的膳食成分进行能量调整，以改善饮食与健康关联研究中的风险估计；（4）认识到自我报告膳食数据的局限性并进行适当的分析和解释；（5）设计研究并进行分析，以便对测量误差进行调整；（6）设计新的流行病学研究，从整个研究人群中收集来自短期（回忆或食物记录）和长期（食物频率问卷）工具的膳食数据，以充分发挥每种工具的优势；（7）继续开发、评估并进一步扩展膳食评估方法，包括膳食生物标志物和使用新技术的方法。
