Reliability of eight-year diet recall in cancer cases and controls

We addressed three questions concerning diet recall in a population of 181 incident cancer cases diagnosed between 1976 and 1984 in the Adventist Health Study, and 225 controls randomly selected from the same population after removing cancer cases: (1) Are recalls of past dietary habits reliable? (2) Does recall ability differ between cancer cases and controls? and (3) Are current or retrospectively recalled reports the best estimator of past dietary practices? Three sets of dietary data were compared using a 35-item nonquantitative food frequency questionnaire: initial reports in 1976, recalled reports obtained retrospectively in 1984, and current reports for 1984. Recall ability was evaluated for individual foods and for all foods combined by comparing recall error scores summing the absolute differences between initial and recalled frequencies. Means and medians for all three food groups were similar for cases and controls. The Spearman rank-order correlations between pairs of reports (initial/recalled, initial/current, and recalled/current) averaged 0.48, 0.41, and 0.62, respectively. A crude difference of 2.0 between cases and controls (p less than 0.05) in the recall error score indicated that cases on the average recalled two foods one frequency category closer to the initial estimate compared with controls. The case-control difference decreased to a nonsignificant 0.4 (p = 0.07) in multivariate analysis that conditioned on dietary changes. On the average, recalled reports estimated initial reports one frequency category closer than did current reports for three foods (p less than 0.001), primarily because of changes in dietary habits.     

Determinants of long-term (24-year) diet recall ability using a 21-item food frequency questionnaire

This study sought to determine how well individuals are able to recall accurately their food habits of 24 years ago and identify those factors that are predictive of recall ability. We investigated the self-reported dietary intakes of 216 people, one-half of whom were vegetarians, including cancer cases and controls. We compared 21 key food items reported in 1960 with the same data reported in 1984. Recall ability was the highest for persons with stable diets. Vegetarian status, education, and church attendance were the other significant determinants of exact recall; age and church attendances were the only significant determinants of recall error. After excluding nonusers of particular foods, we found a positive correlation between frequency of use and recall ability.     

Comparison of a Web-based versus traditional diet recall among children

Self-administered instruments offer a low-cost diet assessment method for use in adult and pediatric populations. This study tested whether 8- to 13-year-old children could complete an early version of the Automated Self Administered 24-hour diet recall (ASA24) and how this compared to an interviewer-administered 24-hour diet recall. One-hundred twenty 8- to 13-year-old children were recruited in Houston from June through August 2009 and randomly assigned to complete either the ASA24 or an interviewer-administered 24-hour diet recall, followed by the other recall mode covering the same time interval. Multivariate analysis of variance, testing for differences by age, sex, and ethnic/racial group, were applied to percentages of food matches, intrusions, and omissions between reports on the ASA24 and the interviewer-administered 24-hour diet recall. For the ASA24, qualitative findings were reported regarding ease of use. Overall matches between interviewer-administered and ASA24 self-administered 24-hour diet recall was 47.8%. Matches were significantly lower among younger (8- to 9-year-old) compared with older (10- to 13-year-old) children. Omissions on ASA24 (18.9% overall) were most common among 8-year-olds and intermediate among 9-year-olds. Eight- and 9-year-olds had substantial difficulties and often required aid in completing ASA24. Findings from this study suggest that a simpler version of an Internet-based diet recall program would be easier for children to use.     

The ability of women to recall their oral contraceptive histories

Self-reported contraceptive histories were obtained at interview from 99 women and compared with prospectively collected data from the Oxford-Family Planning Association cohort study. The effect of different memory aids was evaluated and an assessment was made of the completeness and accuracy of contraceptive histories recorded in general practice notes. Accuracy of recall of total duration of use was sufficiently good to establish the presence or otherwise of a duration-response relationship and could be improved by the use of a contraceptive calendar. Recall of specific brands used was less accurate. In studies where accurate information on use of particular preparations is required, the use of a photo album is recommended, supplemented by data obtained from general practice records to improve the accuracy of dates. General practice records on their own are not sufficiently complete to be used as a sole source of exposure data in studies in which it is important to obtain a complete oral contraceptive history.     

Determinants of physical ability in 7th grade schoolchildren

The aim of the study was to determine factors associated with running time in children aged 12 years, according to sex and sexual maturation of girls. The physical ability was measured, using a 1000 meter run in a group of 942 boys and girls aged 12. In addition, data was collected on family sports activities and the children's sports activities, using questionnaires for parents and children. Before the 1000 meter run, physical examination was carried out. Nutrition habits of the family in the home and outside were self-reported in a questionnaire.The mean time for run in boys was shorter by 40 seconds than that for girls. Premenarche girls ran significantly faster than postmenarche girls (p > 0.05). The best predictors for short running time were triceps skinfold thickness and sport motivation of the children. Weaker correlation was observed between food variables, family characteristics and running time. The highest prediction of running time by the measured variables was found for postmenarche girls, explained by the high correlation of running time with the behavioral variables. In boys and premenarche girls, the best predictors for running time were the physical and physiological characteristics of the children.Corresponding author.     

Validity of retrospective diet history: Assessing recall of midlife diet using food frequency questionnaire in later life

Objectives

Limited information exists on the validity of dietary information given by elderly people on their past diet. Here we test the relative validity of a food frequency questionnaire asking older persons about their midlife diet.

Design

Retrospective food intake of 56–72-year-old subjects was estimated using a food frequency questionnaire designed for the AGES-Reykjavik Study (AGES-FFQ), an epidemiological study of older individuals. Results were compared with detailed dietary data gathered from the same individuals 18–19 years previously, i.e., in midlife, as part of a national cohort. Spearman correlation and cross-classifications were used to assess the ability of the AGES-FFQ to rank subjects according to their intake.

Setting

Nationwide, Iceland.

Participants

Subjects, born 1937–1952 (n=174), who participated in the 1990 Icelandic National Dietary Survey.

Measurements

Dietary intake, estimated by the AGES-FFQ (2008–2009), and dietary history obtained from the 1990 Icelandic National Dietary Survey as a reference method.

Results

The strongest correlation between the AGES-FFQ and the reference method was found for cod liver oil, r=0.53, p<0.001 and r=0.56, p<0.001, for men and women, respectively. For men the corresponding correlation coefficient for milk and dairy products was r=0.43, p<0.001. The correlation coefficients were lower but within a reasonably acceptable range (r=0.26–0.40) for meat, fish and potatoes for both genders, as well as fresh fruits and milk/dairy products for women and whole-wheat bread, oatmeal/muesli and blood/liver-sausage for men. No correlation was found between the AGES-FFQ and the dietary history for rye bread and vegetable consumption. Subjects were categorized into five groups according to level of consumption by the two methods. Cross-classification showed that 16–59% were classified into same group and 43–91% into same or adjacent group, 0–14% were grossly misclassified into opposite groups.

Conclusion

The AGES-FFQ on midlife diet was found suitable to rank individuals by their intake of several important food groups.     

Adult recall of adolescent diet: reproducibility and comparison with maternal reporting

Many cancers have long latency periods, and dietary factors in adolescence may plausibly affect cancer occurrence in adulthood. Because of a lack of prospective data, retrospective collection of data on adolescent diet is essential. The authors evaluated a 124-item high school food frequency questionnaire (HS-FFQ) assessing diet during high school (15-35 years in the past) that was completed in 1998 by 45,947 US women in the Nurses' Health Study II (NHSII) cohort. To assess reproducibility, the authors readministered the HS-FFQ approximately 4 years later to 333 of these women. The mean Pearson correlation for 38 nutrient intakes was 0.65 (range, 0.50-0.77), and the mean Spearman rank correlation for food intakes was 0.60 (range, 0.37-0.77). Current adult diet was only weakly correlated with recalled adolescent diet (for nutrient intakes, mean r = 0.20). For assessment of validity, 272 mothers of the NHSII participants were asked to report information on their daughters' adolescent diets using the HS-FFQ. In this comparison, the mean Pearson correlation was 0.40 (range, 0.13-0.59) for nutrients, and the mean Spearman rank correlation for foods was 0.30 (range, 0.10-0.61). While further studies are warranted, these findings imply that this food frequency questionnaire provides a reasonable record of adolescent diet.     

Determinants of work ability and its predictive value for disability

Background Maintaining the ability of workers to cope with physicaland psychosocial demands at work becomes increasingly importantin prolonging working life. Aims To analyse the effects of work-related factors and individualcharacteristics on work ability and to determine the predictivevalue of work ability on receiving a work-related disabilitypension. Methods A longitudinal study was conducted among 850 constructionworkers aged 40 years and older, with average follow-up periodof 23 months. Disability was defined as receiving a disabilitypension, granted to workers unable to continue working in theirregular job. Work ability was assessed using the work abilityindex (WAI). Associations between work-related factors and individualcharacteristics with work ability at baseline were evaluatedusing linear regression analysis, and Cox regression analysiswas used to evaluate the predictive value of work ability fordisability. Results Work-related factors were associated with a lower workability at baseline, but had little prognostic value for disabilityduring follow-up. The hazard ratios for disability among workerswith a moderate and poor work ability at baseline were 8 and32, respectively. All separate scales in the WAI had predictivepower for future disability with the highest influence of currentwork ability in relation to job demands and lowest influenceof diseases diagnosed by a physician. Conclusion A moderate or poor work ability was highly predictivefor receiving a disability pension. Preventive measures shouldfacilitate a good balance between work performance and healthin order to prevent quitting labour participation.     

Elaboration during problem-based group discussion: Effects on recall for high and low ability students

Although elaboration has been investigated frequently, there is little evidence for the beneficial effect of elaboration in problem-based learning. A controlled experiment tested the effect of elaboration during problem-based discussion on recall. Sixty-seven students observed a video-recorded, problem-based discussion. In one experimental condition, a tutor in the video encouraged participants to elaborate by asking elaborative questions. In a second condition, the tutor asked superficial questions. After the discussion, all participants studied a text with relevant new information. Elaborative questions had no significant effect on recall of idea units from the text, p = .39, η² = .01. High-ability students outperformed low-ability students, p = .04, η² = .07, but this effect did not interact with the experimental treatment, p = .22, η² = .02. Suggestions for further research are presented.     

A comparison of food frequency and diet recall methods in studies of nutrient intake of low-income pregnant women

The aim of this study was to develop a self-administered food frequency questionnaire for use with low-income pregnant women and to evaluate its performance in classifying women according to nutrient intake. Index nutrients used were energy, protein, calcium, iron, zinc, and vitamins A, B-6, and C. Two hundred ninety-five Massachusetts women, aged 14 to 43 years, participated in the field test of the questionnaire. A subset of 95 women provided three 24-hour diet recalls for use in comparative studies. Correlation coefficients between questionnaire and diet recall scores were adjusted for measurement error resulting from the limited number of 24-hour recalls per subject, and their confidence intervals were computed. When subjects with implausibly high energy scores (greater than 4,500/day) were removed from the sample, reducing sample size by about 15%, correlation coefficients increased substantially (25% to 64%) for all nutrients except vitamin A. Adjusted correlation coefficients exceeded 0.5, excluding vitamin A (r approximately 0.15), and quintile comparisons indicated that the questionnaire would correctly identify a high proportion of the women having low intake of selected nutrients. We conclude that a self-administered questionnaire can provide useful data about individual recent intake of selected nutrients in a majority of English-speaking, low-income pregnant women, but that overestimation of food use may occur among up to 20% of this population.     

An eight-year study of internet-based remote medical counselling

We carried out a prospective study of an Internet-based remote counselling service. A total of 15456 Internet users visited the Website over eight years. From these, 1500 users were randomly selected for analysis. Medical counselling had been granted to 901 of the people requesting it (60%). One hundred and sixty-four physicians formed project groups to process the requests and responded using email. The distribution of patients using the service was similar to the availability of the Internet: 78% were from the European Union, North America and Australia. Sixty-seven per cent of the patients lived in urban areas and the remainder were residents of remote rural areas with limited local medical coverage. Sixty-five per cent of the requests were about problems of internal medicine and 30% of the requests concerned surgical issues. The remaining 5% of the patients sought information about recent developments, such molecular medicine or aviation medicine. During the project, our portal became inaccessible five times, and counselling was not possible on 44 days. There was no hacking of the Website. Internet-based medical counselling is a helpful addition to conventional practice.     

Perceptions of aging and health behavior: Determinants of a healthy diet in an older German population

Objectives  

The objectives of this study were to assess the association between perceptions of aging and health behavior, and to identify determinants of a healthy diet.     

Energy expenditure measured by doubly labeled water,activity recall,and diet records in the rural elderly

OBJECTIVE: The purpose of this study was to determine whether energy expenditure estimated from physical activity and energy intake were equivalent to total daily energy expenditure in an elderly rural population. METHODS: Twenty-seven elderly male (n = 14) and female (n = 13) subjects (mean age, 74 y) were recruited from a rural Pennsylvania population. Over a 2-wk period, total daily energy expenditure was measured by doubly labeled water (TEE) and estimated from 7-d physical activity recall factors multiplied by weight (PA(WT)), estimated basal metabolic rate (PA(BMR)) and resting energy expenditure from indirect calorimetry (PA(REE)), and energy intake from 3-d self-reported diet records (EI). Analysis of variance was used to determine significant within-subject differences in physical activity, energy intake, and energy expenditure. RESULTS: PA(REE) (men: 13.69 +/- 3.23 MJ, women: 9.51 +/- 2.40 MJ) and PA(BMR) (men: 13.69 +/- 2.99 MJ, women: 10.15 +/- 2.21 MJ) were not significantly different from TEE (men: 12.43 +/- 1.63 MJ, women: 9.44 +/- 0.90 MJ). EI (men: 8.66 +/- 2.34 MJ, women: 7.12 +/- 0.93 MJ) was significantly less than TEE, and PA(WT) (men: 17.03 +/- 4.07 MJ, women: 12.86 +/- 3.41 MJ) was significantly greater than TEE. CONCLUSIONS: Whereas 7-d physical activity recall determined with an age- and gender-specific estimate of resting metabolic rate or measured using indirect calorimetry accurately estimated TEE for this group of rural elderly, self-reported diet records consistently underestimated and physical activity recall determined with weight alone consistently overestimated energy expenditure measured by doubly labeled water.     

Determinants of glycated haemoglobin in the general population: associations with diet, alcohol and cigarette smoking

OBJECTIVE: We evaluated cigarette smoking, alcohol intake and consumption of different foods as determinants of glycated haemoglobin in a general population sample. DESIGN: Cross-sectional survey. SETTING: England. SUBJECTS: Representative sample of 15 809 adults aged 16 y and older. Data analysed for 9772 non-diabetic, white European subjects. MAIN OUTCOME MEASURES: Glycated haemoglobin (GHb). Analyses were adjusted for age, sex, body mass index (BMI), waist-hip circumference ratio, activity level, and educational attainment. RESULTS: After adjusting for confounding, GHb was 0.277% (95% confidence interval 0.218 to 0.336) higher in current smokers of 20 or more per day, compared with non-smokers. GHb was 0.189% (0.101 to 0.277) lower in those drinking 42 or more units of alcohol per week than in non-drinkers. GHb was not associated with frequency of consumption of pulses, fruit, vegetables and salads, cakes, bread or confectionery. GHb was higher in subjects who took sugar in tea (0.051%, 0.015 to 0.087%) or in coffee (0.069%, 0.034 to 0.105%). GHb was higher in subjects who used solid fat for cooking (0.082%, 0.022 to 0.142%), or who drank whole rather than reduced-fat milk (0.088%, 0.036 to 0.140%), or used butter or hard margarine rather than low-fat spreads (0.075%, 0.029 to 0.121%). CONCLUSIONS: In the general population, higher GHb may be associated with cigarette smoking, or frequent consumption of fat-containing foods. Consumption of alcohol may be associated with lower GHb. SPONSORSHIP: None.     

Potential sources of carcinogenic heterocyclic amines in the Chinese diet: results from a 24-h dietary recall study in Singapore

OBJECTIVE: Heterocyclic amines (HCAs) from high-temperature cooking of meat have been linked to increased cancer incidence in Western populations, but data on the sources of HCAs in Asian diets are scarce. Our aim was to identify potential sources of HCAs in the Chinese diet, and to provide the basis for efforts to quantify dietary exposure to these compounds. DESIGN AND SETTING: We conducted 24-h dietary recall interviews among 986 Chinese men and women in Singapore, who were a randomly selected subpopulation of participants from the Singapore Chinese Health Study, a population-based cohort. Details of all foods and beverages consumed by each subject in the past 24 h were recorded, and information on meat type, cooking method and portion size were abstracted from all meat-containing dishes, and gram weight equivalents computed. RESULTS: The mean meat intake per person was 103.0 g/day (standard deviation 74.2), of which 97.2% was fresh meat. Fish (38.0%), pork (30.6%), and poultry (21.0%) accounted for 89.6% of meat consumed. Patterns of meat consumption and cooking methods differed markedly from Western populations. Documented high-temperature cooking methods, combined with stir-frying, accounted for 44.3% of fish, 35.1% of pork and 25.6% of poultry consumed. Specifically, potentially significant sources of HCAs were pan-fried fish and barbecued pork. CONCLUSIONS: Our results identify the potential sources of HCA in the Chinese diet, highlight aspects which are relevant to HCA formation and intake, and call for novel approaches to estimating individual exposure to dietary HCAs in this and similar populations.