Heerstrass D W, Ocké M C, Bueno-de-Mesquita H B, Peeters P H, Seidell J C
Department of Chronic Disease and Environmental Epidemiology, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
Int J Epidemiol. 1998 Apr;27(2):186-93. doi: 10.1093/ije/27.2.186.
Differential underreporting of dietary intake by subgroups of body mass index (BMI) will confound associations between dietary intake and BMI-related diseases. We estimated the magnitude of BMI-related underreporting for energy, protein, and potassium intake for the Dutch cohorts of the European Prospective Investigation into Cancer and Nutrition (EPIC).
The study population consisted of 134 Dutch men and women, aged 21-71 years, who participated in a pilot of EPIC. Ratios of reported dietary intakes to biomarkers were used as measures for underreporting. Dietary intake was assessed by a food frequency questionnaire (FFQ) and repeated 24-hour dietary recalls. Biomarker for energy intake was calculated basal metabolic rate; for protein and potassium intake the biomarker was 24-hour urinary nitrogen and potassium excretion, respectively. The measures of underreporting were linearly regressed on BMI (in kg/m2).
Significant negative regression coefficients were observed when regressing energy ratio on BMI with adjustment for physical activity (FFQ: beta = -0.04 for men, beta = -0.02 for women; 24-hour recalls: beta = -0.03 for men, beta = -0.04 for women). In men, a significant negative regression coefficient (beta = -0.03) was observed when regressing protein ratio on BMI; for the recalls however only after adjustment for age and education (beta = -0.02). In women, negative regression coefficients were also obtained, but for the FFQ only after exclusion of dieting women (both FFQ and 24-hour recalls: beta = -0.02). According to the recalls, but not the FFQ, a significant negative regression coefficient (beta = -0.02) was observed among women when regressing potassium ratio on BMI.
In this Dutch population, BMI-dependent underreporting of 20-25% over the observed range of BMI is present for protein and energy, Further study on BMI-dependent underreporting of dietary intake in EPIC cohorts is warranted.
体重指数（BMI）亚组对饮食摄入量的报告差异会混淆饮食摄入量与BMI相关疾病之间的关联。我们估计了欧洲癌症与营养前瞻性调查（EPIC）荷兰队列中与BMI相关的能量、蛋白质和钾摄入量报告不足的程度。
研究人群包括134名年龄在21 - 71岁的荷兰男性和女性，他们参与了EPIC的一项试点研究。报告的饮食摄入量与生物标志物的比率被用作报告不足的衡量指标。饮食摄入量通过食物频率问卷（FFQ）和重复的24小时饮食回忆进行评估。能量摄入的生物标志物为基础代谢率；蛋白质和钾摄入的生物标志物分别为24小时尿氮和钾排泄量。报告不足的衡量指标与BMI（以kg/m²为单位）进行线性回归。
在对体力活动进行调整后，将能量比率与BMI进行回归时观察到显著的负回归系数（FFQ：男性β = -0.04，女性β = -0.02；24小时回忆：男性β = -0.03，女性β = -0.04）。在男性中，将蛋白质比率与BMI进行回归时观察到显著的负回归系数（β = -0.03）；然而对于回忆数据，仅在对年龄和教育程度进行调整后（β = -0.02）。在女性中，也获得了负回归系数，但对于FFQ数据，仅在排除节食女性后（FFQ和24小时回忆：β = -0.02）。根据回忆数据而非FFQ数据，在女性中将钾比率与BMI进行回归时观察到显著的负回归系数（β = -0.02）。
在这个荷兰人群中，在观察到的BMI范围内，蛋白质和能量的报告不足存在20 - 25%的BMI依赖性。有必要对EPIC队列中饮食摄入量的BMI依赖性报告不足进行进一步研究。
