Bias in the reporting of nutrients in the diet does not differ across European countries

Crispim SP, Geelen A, de Vries JHM, Freisling H, Souverein OW, Hulshof PJM, Ocke MC, Boshuizen H, Andersen LF, Ruprich J, De Keizer W, Huybrechts I, Lafay L, de Magistris MS, Ricceri F, Tumino R, Krogh V, Bueno-de-Mesquita HB, Beulens JWJ, Boutron-Ruault M, Naska A, Crowe FL, Boeing H, McTaggart A, Kaaks R, van’t Veer P, Slimani N. Bias in protein and potassium intake collected with 24-h recalls (EPIC-Soft) is rather comparable across European populations. Eur J Nutr. 2012;51:997-1010.


We investigated whether group-level bias of a 24-h recall estimate of protein and potassium intake, as compared to biomarkers, varied across European centers and whether this was influenced by characteristics of individuals or centers.

The combined data from EFCOVAL and EPIC studies included 14 centers from 9 countries (n = 1,841). Dietary data were collected using a computerized 24-h recall (EPIC-Soft). Nitrogen and potassium in 24-h urine collections were used as reference method. Multilevel linear regression analysis was performed, including individual-level (e.g., BMI) and center-level (e.g., food pattern index) variables.

For protein intake, no between-center variation in bias was observed in men while it was 5.7% in women. For potassium intake, the between-center variation in bias was 8.9% in men and null in women. BMI was an important factor influencing the biases across centers (p < 0.01 in all analyses). In addition, mode of administration (p = 0.06 in women) and day of the week (p = 0.03 in men and p = 0.06 in women) may have influenced the bias in protein intake across centers. After inclusion of these individual variables, between-center variation in bias in protein intake disappeared for women, whereas for potassium, it increased slightly in men (to 9.5%). Center-level variables did not influence the results.

The results suggest that group-level bias in protein and potassium (for women) collected with 24-h recalls does not vary across centers and to a certain extent varies for potassium in men. BMI and study design aspects, rather than center-level characteristics, affected the biases across centers.

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