Validation of the Oxford WebQ Online 24-Hour Dietary Questionnaire Using Biomarkers

Abstract

The Oxford WebQ is an online 24-hour dietary questionnaire that is appropriate for repeated administration in large-scale prospective studies, including the UK Biobank study and the Million Women Study. We compared the performance of the Oxford WebQ and a traditional interviewer-administered multiple-pass 24-hour dietary recall against biomarkers for protein, potassium, and total sugar intake and total energy expenditure estimated by accelerometry. We recruited 160 participants in London, United Kingdom, between 2014 and 2016 and measured their biomarker levels at 3 nonconsecutive time points. The measurement error model simultaneously compared all 3 methods. Attenuation factors for protein, potassium, total sugar, and total energy intakes estimated as the mean of 2 applications of the Oxford WebQ were 0.37, 0.42, 0.45, and 0.31, respectively, with performance improving incrementally for the mean of more measures. Correlation between the mean value from 2 Oxford WebQs and estimated true intakes, reflecting attenuation when intake is categorized or ranked, was 0.47, 0.39, 0.40, and 0.38, respectively, also improving with repeated administration. These correlations were similar to those of the more administratively burdensome interviewer-based recall. Using objective biomarkers as the standard, the Oxford WebQ performs well across key nutrients in comparison with more administratively burdensome interviewer-based 24-hour recalls. Attenuation improves when the average value is taken over repeated administrations, reducing measurement error bias in assessment of diet-disease associations.

Meat consumption and risk of 25 common conditions: outcome-wide analyses in 475,000 men and women in the UK Biobank study

“…In the present study, BMI was calculated from standardised measurements of weight and height, whereas previous studies used self-reported weight and height. Therefore, it is possible that adjusting for BMI in this study explained a larger proportion of the observed associations; high BMI has been consistently shown to be associated with a large increase in the risk of gallbladder disease in both observational and genetic studies [ 18 – 20 ]. We observed a novel association between poultry intake and gallbladder disease, though additional research is needed to assess this association.…”

“…Participants recruited after 2009, as well as participants who provided UK Biobank with an email address and agreed to be re-contacted, were additionally invited to complete the Oxford WebQ [ 18 ], an online 24-h recall questionnaire. Participants were asked to select how many portions of each food item they consumed over the previous 24 h, enabling calculation of mean grams per day by multiplying frequencies of consumption by standard portion sizes.…”

The associations of sugar-sweetened, artificially sweetened and naturally sweet juices with all-cause mortality in 198,285 UK Biobank participants: a prospective cohort study

“…In our study, dietary information was obtained via repeated 24-h recall questionnaires where available which have been shown to be more accurate than food frequency questionnaires for commonly consumed foods [37]. We used the data from all completed questionnaires to correct for within-person variation in diet.…”

Future Directions for Integrative Objective Assessment of Eating Using Wearable Sensing Technology

“…Online versions of "traditional" dietary assessment methods have been developed, but errors and biases remain. Validation studies of a range of online 24-h recall and food diary tools have shown the same problems as their paper-based equivalents; misreporting, portion size estimation, accurately matching foods consumed to foods in composition databases, and high participant burden (16,20,21). With the best methods currently available, on paper or online, a maximum of 80% of true intake can be captured and there are systematic differences in the 20% of food intake missing (10,15).…”