Applying Recovery Biomarkers to Calibrate Self-Report Measures of Energy and Protein in the Hispanic Community Health Study/Study of Latinos

Am J Epidemiol. 2015 Jun 15;181(12):996-1007. doi: 10.1093/aje/kwu468. Epub 2015 May 20.


We investigated measurement error in the self-reported diets of US Hispanics/Latinos, who are prone to obesity and related comorbidities, by background (Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American) in 2010-2012. In 477 participants aged 18-74 years, doubly labeled water and urinary nitrogen were used as objective recovery biomarkers of energy and protein intakes. Self-report was captured from two 24-hour dietary recalls. All measures were repeated in a subsample of 98 individuals. We examined the bias of dietary recalls and their associations with participant characteristics using generalized estimating equations. Energy intake was underestimated by 25.3% (men, 21.8%; women, 27.3%), and protein intake was underestimated by 18.5% (men, 14.7%; women, 20.7%). Protein density was overestimated by 10.7% (men, 11.3%; women, 10.1%). Higher body mass index and Hispanic/Latino background were associated with underestimation of energy (P<0.05). For protein intake, higher body mass index, older age, nonsmoking, Spanish speaking, and Hispanic/Latino background were associated with underestimation (P<0.05). Systematic underreporting of energy and protein intakes and overreporting of protein density were found to vary significantly by Hispanic/Latino background. We developed calibration equations that correct for subject-specific error in reporting that can be used to reduce bias in diet-disease association studies.

Trial registration: NCT02060344.

Keywords: 24-hour dietary recall; Hispanics/Latinos; biological markers; calibration equations; dietary measurement error; nutrition assessment.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bias
  • Biomarkers / urine
  • Diet Surveys*
  • Dietary Proteins*
  • Energy Intake / ethnology*
  • Female
  • Follow-Up Studies
  • Hispanic or Latino* / ethnology
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nitrogen / urine*
  • Self Report*
  • United States
  • Young Adult


  • Biomarkers
  • Dietary Proteins
  • Nitrogen

Associated data