Challenges in Dietary Exposure Assessment in Epidemiology: Research Trends.

Abstract

Although exposure assessment of the usual diet is an essential component of nutrition epidemiology, it remains one of the most challenging issues in the field. Dietary exposure is widely measured using Food Frequency Questionnaires (FFQs), which impose a low burden on respondents and are inexpensive in large-scale studies. FFQs have long satisfied the needs of epidemiological research, and have helped deliver the tremendous recent growth in knowledge of the diet-disease association. However, issues surrounding measurement errors with FFQs have attracted substantial research interest around the world. Attenuation of the diet-disease association due to measurement errors identified in Western populations has led to extended methodological investigations comparing the performance of FFQs with biomarkers. The need for better dietary assessment methods has increased. Dietary records or recall provide relatively accurate estimates of intake for specific days, and of the usual diet if collected on multiple days. Until recently, however, their use in large-scale studies was not feasible, mainly due to cost. One innovative tool which may overcome the limitations of dietary records or recall is computerized 24-h dietary recall systems. These systems have been demonstrated to provide high-quality dietary intake data among Western populations. Incorporation of such new technology into large-scale epidemiological studies would make multiple-day administration of 24-h recall feasible in terms of cost. Research efforts to improve dietary assessment among Japanese and Asian populations are still under development. The development of innovative methods for Japanese remains an urgent research challenge.