Whitton Clare, Healy Janelle D, Dhaliwal Satvinder S, Shoneye Charlene, Harray Amelia J, Mullan Barbara A, McVeigh Joanne A, Boushey Carol J, Kerr Deborah A
Curtin School of Population Health, Curtin University, Kent Street, GPO Box U1987, Perth 6845, Australia.
Curtin Health Innovation Research Institute, Curtin University, Kent Street, GPO Box U1987, Perth 6845, Australia.
Br J Nutr. 2022 May 19;129(4):1-39. doi: 10.1017/S0007114522001532.
Improving dietary reporting among people living with obesity is challenging as many factors influence reporting accuracy. Reactive reporting may occur in response to dietary recording but little is known about how image-based methods influence this process. Using a 4-day image-based mobile food record (mFRTM), this study aimed to identify demographic and psychosocial correlates of measurement error and reactivity bias, among adults with BMI 25-40kg/m2. Participants (n=155, aged 18-65y) completed psychosocial questionnaires, and kept a 4-day mFRTM. Energy expenditure (EE) was estimated using ≥4 days of hip-worn accelerometer data, and energy intake (EI) was measured using mFRTM. Energy intake: energy expenditure ratios were calculated, and participants in the highest tertile were considered to have Plausible Intakes. Negative changes in EI according to regression slopes indicated Reactive Reporting. Mean EI was 72% (SD=21) of estimated EE. Among participants with Plausible Intakes, mean EI was 96% (SD=13) of estimated EE. Higher BMI (OR 0.81, 95%CI 0.72-0.92) and greater need for social approval (OR 0.31, 95% CI 0.10-0.96), were associated with lower likelihood of Plausible Intakes. Estimated EI decreased by 3% per day of recording (IQR -14%,6%) among all participants. The EI of Reactive Reporters (n=52) decreased by 17%/day (IQR -23%,-13%). A history of weight loss (>10kg) (OR 3.4, 95% CI 1.5-7.8), and higher percentage of daily energy from protein (OR 1.1, 95%CI 1.0-1.2) were associated with greater odds of Reactive Reporting. Identification of reactivity to measurement, as well as Plausible Intakes, is recommended in community-dwelling studies to highlight and address sources of bias.
提高肥胖人群的饮食报告准确性具有挑战性，因为许多因素会影响报告的准确性。反应性报告可能会因饮食记录而出现，但对于基于图像的方法如何影响这一过程知之甚少。本研究使用基于图像的4天移动食物记录（mFRTM），旨在确定体重指数（BMI）为25-40kg/m²的成年人中测量误差和反应性偏差的人口统计学和心理社会相关因素。参与者（n=155，年龄18-65岁）完成了心理社会问卷调查，并进行了为期4天的mFRTM记录。使用≥4天佩戴在髋部的加速度计数据估计能量消耗（EE），并使用mFRTM测量能量摄入（EI）。计算能量摄入与能量消耗的比率，处于最高三分位数的参与者被认为摄入量合理。根据回归斜率，EI的负变化表明存在反应性报告。平均EI为估计EE的72%（标准差=21）。在摄入量合理的参与者中，平均EI为估计EE的96%（标准差=13）。较高的BMI（比值比0.81，95%置信区间0.72-0.92）和更强的社会认可需求（比值比0.31，95%置信区间0.10-0.96）与合理摄入量的可能性较低相关。在所有参与者中，记录的每一天估计EI下降3%（四分位距-14%，6%）。反应性报告者（n=52）的EI每天下降17%（四分位距-23%，-13%）。有体重减轻史（>10kg）（比值比3.4，95%置信区间1.5-7.8）和每日蛋白质能量百分比更高（比值比1.1，95%置信区间1.0-1.2）与反应性报告的可能性更大相关。建议在社区居住研究中识别对测量的反应性以及合理摄入量，以突出和解决偏差来源。
