Background: A predictive biomarker for total sugars intake was recently developed under controlled conditions. We used this biomarker to assess measurement error (ME) structure in self-reported total sugars intake in free-living individuals. Methods: The Observing Protein and Energy Nutrition (OPEN) study involved 484 participants aged 40-69 years. Diet was assessed using two administrations of a food frequency questionnaire (FFQ) and two non-consecutive 24-hour dietary recalls (24HDR). Two 24-hour urine samples checked for completeness were analyzed on sucrose and fructose. We applied the biomarker calibrated in a feeding study to OPEN data to assess the ME structure and the attenuation factors (AFs) for intakes of absolute total sugars and sugars density for the FFQ and 24HDR. Results: The AFs for absolute sugars were similar for a single FFQ and 24HDR, but attenuation decreased with repeated 24HDRs. For sugars density, the AFs for FFQ (men: 0.39; women: 0.33) were greater than for single 24HDR (men: 0.30; women: 0.24), and similar to two 24HDRs (men: 0.41; women: 0.35). The attenuation associated with both instruments was greater in women than in men. Conclusions: Both the FFQ and 24HDR were found to be biased; hence incorporation of the sugars biomarker in calibration studies within the cohorts may be necessary in order to more reliably estimate sugars-disease associations. Impact: In this article we propose a new dietary reference instrument based on the recently defined class of "predictive" biomarkers. Using sugars biomarker, we quantify measurement error in the FFQ- and 24HDR-reported absolute total sugars and total sugars density.
- Received July 29, 2010.
- Revision received November 24, 2010.
- Accepted January 10, 2011.
- Copyright © 2011, American Association for Cancer Research.