Validation of protein intake assessed from weighed dietary records against protein estimated from 24 h urine samples in children, adolescents and young adults participating in the Dortmund Nutritional and Longitudinally Designed (DONALD) Study

Abstract

Objective: To date, only a few nutritional assessment methods have been validated against the biomarker of urinary-N excretion for use in children and adolescents. The aim of the present study was to validate protein intake from one day of a weighed dietary record against protein intake estimated from a simultaneously collected 24 h urine sample. Design: Cross-sectional analyses including 439 participants of the Dortmund Nutritional and Longitudinally Designed (DONALD) Study from four age groups (3-4, 7-8, 11-13 and 18-23 years). Mean differences, Pearson correlation coefficients (r), cross-classifications and Bland-Altman plots were used to assess agreement between methods. Results: Weighed dietary records significantly underestimated mean protein intake by 26?4 (95 % CI 28?2, 24?7) g/d or -11 %, with the difference increasing across the age groups from 20?6 (95 % CI 22?7, 1?5) g/d at age 3-4 years to -13?5 (95 % CI -18?7, -8?3) g/d at age 18-23 years. Correlation coefficients were r 5 0?7 for the total study sample and ranged from r 5 0?5 to 0?6 in the different age groups. Both methods classified 85 % into the same/adjacent quartile for the whole study group (83-86 % for the different age groups) and 2?5 % into the opposite quartile (1?9-3?1 % for the different age groups). Bland-Altman plots for the total sample indicated that differences in protein intake increased across the range of protein intake, while this bias was not obvious within the age groups. Conclusions: Protein intake in children and adolescents can be estimated with acceptable validity by weighed dietary records. In this age-heterogeneous sample, validity was lower among adolescents and young adults.

Die DONALD Kohorte

“…Mädchen Jungen n (gesamt) a n (%) n (gesamt) a n (% ) Geburtskohorte 706 688 Vor 1985 144 (20,4) 142 (20,6) 1985-1992 211 (29,9) 203 (29,5) 1993-1998 124 (17,6) 106 (15,4) 1999-2003 104 ( …”

“…So wurde die protokollierte Proteinzufuhr mit dem anerkannten Biomarker für Proteinzufuhr, der Stickstoffausscheidung im Urin, verglichen. Dabei zeigte sich eine akzeptable Übereinstimmung der von 439 DONALD Teilnehmern protokollierten Proteinaufnahme mit der aus parallel gesammelten 24-Stunden-Urinen geschätzten Proteinzufuhr [9]. Insgesamt war die Methodenübereinstimmung bei Kleinkindern (Drei-bis Vierjährige) und Schulkindern (Sieben-bis Achtjährige) höher als bei Jugendlichen (Elf-bis 13-Jährige) und jungen Erwachsenen (18-bis 23-Jährige).…”

“…Insgesamt war die Methodenübereinstimmung bei Kleinkindern (Drei-bis Vierjährige) und Schulkindern (Sieben-bis Achtjährige) höher als bei Jugendlichen (Elf-bis 13-Jährige) und jungen Erwachsenen (18-bis 23-Jährige). Ebenso war die protokollierte Energiezufuhr nur bei 1% beziehungsweise 2% der Kleinkinder und Schulkinder unplausibel niedrig, bei den Jugendlichen und jungen Erwachsenen waren 8% beziehungsweise 11% der Protokolle laut den altersund geschlechtsspezifischen Grenzwerten als unplausibel einzustufen [9]. Die Genauigkeit der Wiegeprotokolle wird zudem durch die Tatsache gestützt, dass aus den Wiegeprotokollen geschätzte Beiträge von Lebensmittelgruppen (zum Beispiel Milch, Ei, Fleisch) zur 24-StundenJodausscheidung den durchschnittlichen Jodgehalten dieser Lebensmittelgruppen (laut Nährwerttabellen) entsprechen [10].…”

Validation of protein and potassium intakes assessed from 24 h recalls against levels estimated from 24 h urine samples in children and adolescents of Turkish descent living in Germany: results from the EVET! Study

“…Overestimation of protein intake by 1?31 g/d was observed in only one study (35) , whereas other studies reported underestimations (18,33,34) . In the majority of cases, validation studies in children, adolescents and adults investigated other nutrients and/or validated nutrient intakes against nutritional assessment tools different from ours (32)(33)(34)(35)(36)(37) . Most of them found an acceptable validity of their tested instruments.…”

Early Diet and Later Cancer Risk: Prospective Associations of Dietary Patterns During Critical Periods of Childhood with the GH-IGF Axis, Insulin Resistance and Body Fatness in Younger Adulthood

“…The 3-day weighed dietary records have been shown to have acceptable validity in DONALD participants of various ages (32). They are analyzed using the in-house nutrient database LEBTAB (24), which incorporates information from standard nutrient tables, product labels, or recipe simulation based on the labeled ingredients and nutrients.…”