Participant characteristics associated with errors in self-reported energy intake from the Women’s Health Initiative food-frequency questionnaire

Abstract

Errors in self-reported dietary intake threaten inferences from studies relying on instruments such as food-frequency questionnaires (FFQs), food records, and food recalls. The objective was to quantify the magnitude, direction, and predictors of errors associated with energy intakes estimated from the Women's Health Initiative FFQ. Postmenopausal women (n = 102) provided data on sociodemographic and psychosocial characteristics that relate to errors in self-reported energy intake. Energy intake was objectively estimated as total energy expenditure, physical activity expenditure, and the thermic effect of food (10% addition to other components of total energy expenditure). Participants underreported energy intake on the FFQ by 20.8%; this error trended upward with younger age (P = 0.07) and social desirability (P = 0.09) but was not associated with body mass index (P = 0.95). The correlation coefficient between reported energy intake and total energy expenditure was 0.24; correlations were higher among women with less education, higher body mass index, and greater fat-free mass, social desirability, and dissatisfaction with perceived body size (all P < 0.10). Energy intake is generally underreported, and both the magnitude of the error and the association of the self-reporting with objectively estimated intake appear to vary by participant characteristics. Studies relying on self-reported intake should include objective measures of energy expenditure in a subset of participants to identify person-specific bias within the study population for the dietary self-reporting tool; these data should be used to calibrate the self-reported data as an integral aspect of diet and disease association studies.