VALIDITY IN DIETARY

ASSESSMENT METHODS
 GROUP 6 :
01 Patmawati (141 2018 0154)

02 Merlyani basir (141 2018 0171)

03 Indah Ayu Lestari (141 2018 0172)

04 Avitha Paradita Wiratman (141 2018 0203)

05 Andi melinia Taslim (141 2018 0216)

06 Chitra Mutmainnah (141 2018 0224)

 01 Design of relative validity studies

Disscussion 02 Relative Validity in dietary studies

Material
Use of Biomarkers to validate
03 dietary intakes.
 Validity in dietary assessment
methods

Validity describes the degree to which a dietary

method measures what it is intended to measure.
Dietary methods designed to characterize usual
intakes of individuals are the most difficult to
validate because the “truth” is never known with
absolute certainty.
 Validity in dietary assessment
methods

 To detect any changes in usual intake during the study, observations of

actual food intake during, and either before of after the study period
should be compared. Such a procedure attempts to measure absolute
validity, but it is very time consuming and presents overwhelming
practical difficulties. Consequently, absolute validity is generally
determined in dietary studies that involve a limited number of subjects
or only cover a relatively short time frame.
 Validity in dietary assessment
methods

 Relative validity can be defined as the comparison of the “test” method

with another method, termed the “reference” method, which has a
greater degree of demonstrated validity ( Bailey, 1978 ). Ideally, the
reference is generally a dietary method, chosen in such a way the errors
in two dietary methods are independent. In practice, however, reference
dietary methods seldom meet this criterion.
 1. Design of relative
validity studies

Because of the difficulties in measuring the absolute

validity of dietary intake data, researchers have
adopted an approach that measures relative validity.
In this approach, the “test”dietary method is
evaluated against an-other “reference” dietary
method performed on the same subjects.
 Factors in the design of such a
validition study
1. Selection of subjects for a validation study.
The test dietary method should be validated on
subjects who are representative of the population under
study. This is particularly important in multicenter trials,
when cultural or language differences may influence the
way in which subjects respond to a dietary assessment
method.
 2. Study objective and time frame.
The reference dietary method chosen must
have the same objective and must measure
similar parameteres over the same time frame
(the current, past, or usual intake), as the test
method.

3. Sequence and spacing of test and reference methods.

 In general, the test method should be administered prior to
the reference method in a validation study, so as to mimic
the situation that will actually take place in the proposed
study.
 Furthermore, the test and reference methods must be
carefully spaced so that completion of the test method does
not influence the responses to the reference method.
 4. Independent errors.
Eroros in the reference dietary method should be
independet of those in the test method and also of the
true intake. As a result, the selected reference dietary
method must be different from the test method. For
example, both methods should not rely on memory or
use the same method for estimating portion sizes.
5. Sex and age.
 The relative validity of a dietary method should be tested separately
on both men and women. Studies have shown that the response of
women to dietary assessment differs from that of men.
 In contrast, age does not appear to influence the validity of a dietary
method for adults ranging in age from 18 to 64 years. However, not
surprisingly, memory and conceptualization skills affect the response
of both younger and older individuals
 6. Socioeconomic status, ethnicity, and health
status.
Socioeconomic status and ethnicity may affect
the outcome of a relative validity study, through a
link with dietary diversity.

7. Other factors.
A variety of external factors :
 including those of day of the week,
 Season
 Training
 The use of vitamin and mineral supplements
 2. Relative Validity in
dietary studies

No reference method provides a true measure of the

dietary intake. Instead, the extent of the agreement
between the test and reference method is used to
indicate the relative validity of the test method, as
well as the extent to which the reference method is
believed to yield the truth.
Type of Relative Validity
1. Relative validity of 24-h recalls.
Unlike the other dietary assessment methods, it is possible
in some setting todetermine the absolute validity of a 24-h recall.
Methods used include surreptitious observation or weighing of
duplicate portions of the actual intake of foods recalled by the
same subjects, ove the same 24-h period or for one meal.
This procedure has been employed in institutional settings
such as congregate meal sites (Madden et al., 1976 ; Gersovitz et
al., 1978), school lunch programs (Emmons and Hayes, 1973;
Warren et al., 2003), college cafeterias (Krantzler et al., 1982), a
metabolic unit (Greger and Etnyre, 1978; Poppitt et al., 1998),
hospital (Linusson et al., 1974), and summer camps (Carter et al.,
1981.
 Type of Relative Validity

2. Relative validity of food records.

A few studies have attempted to determine the absolute
validity of weighed of estimated food records. Weighed food
records are often regarded as the “gold” standard against
which other dietary assessment methods are compared.
Hence, the relative validity of weighed food records cannot
be determined in the normal way; potential reference dietary
methods are less accurate and their use inappropriate. As an
alternative, the doubly labeled water method has been used in
several studies to validate mean energy intakes based on
weighed food records.
 Type of Relative Validity

Relative validity of dietary histories.

One of the major advantages of the dietary history
method is its ability to assess meal pattern and specific
details about the prepation and consumption of food
over an extended period of time. However, some
respondents find the task of reporting their usual food
intake and the amounst eaten difficult. Further, for certain
sub-populations or age groups (e.g., adolescents), who
may lack set meal patterns, such a meal-based approach is
not useful.
Type of Relative Validity

Relative validity of food frequency questionnaires.

Numerous food frequency quetionnairesexist for
use among different populations and for a variety of
purposes. The focus on the food preferences served to
lessen the emphasis on food selection in an effort to
prevent changes in usual food intake. Correlation
analysis in dicated that a large proportion of
individuals could accurately estimate their own food in
take using the food frequency questionnaire.
3. Use of Biomarkers to validate
dietary intakes.

The approach uses external variabels,

termed “biomarkers”, to measure the
relative validity of the dietary assessment
methods prior to their use in a research
study.
1 2 Alternatively, biomarkers can be used
3
to calibrate dietary data collected in
4
prospective multicenter cohort studies so
that adjustments for possible sources of bias
can be made.
Several consideres before adopting
a biomarker for use in dietary
validation

1. Temporal relations with the dietary intake must be

considered, when selecting a suitable biomarker. The latter
must reflect the intake of the dietary constituent of interest
over the same time period as the dietary method. Nutrient
levels in serum or plasma and urin, for example, tend to
reflect recent dietary intake, and thus they are only
appropriate biomarkers for validating dietary methods that
are designed to cover short time period, such as recalls or
records.
Several consideres before adopting
a biomarker for use in dietary
validation

2. Within-subject variation of a biomarker, if large in relation to

between-subject variation, may obscure relationships with
the usual nutrient intakes of an individual. In such cases,
replicate samples of the biomarker should be obtained,
where possible, so that misclassification can be minimized.
 Several consideres before adopting
a biomarker for use in dietary
validation

3. Biological confounders may cause considerable variation in

biomarker levels unrelated to the dietary component of
interest. Confounding factors may in clude the genetic
background of the individual, the nutritional status of the
subject, the presence of other environmental constituents (e.g.,
cigarette smoke), marked homeostatic regulation of biomarker
levels (e.g., plasma retional levels), metabolism and excretion
of the biomarker, interactions of the biomarker in the gut or
during absorption and metabolism, and medication use of the
subject.
Several consideres before adopting
a biomarker for use in dietary
validation

4. Sample collection, transport, and storage

Of biological fluids and tissues for analyses of
biomarkers must be carried out using trained staff and
standardized protocols and conditions appropriate for
the chosen biomarker. Careful storage and use of
aliquots of a pooled sample are essential for all
multicenter trials to monitor the sampling, subsequent
storage, and handling of the samples.
Several consideres before adopting
a biomarker for use in dietary
validation

5. Analytical measurement error

May result from failure to comply with the appropriate protocols.
The analytical accuracy and precision must be closely monitored. This
Should involve the routine analysis of suitable certified reference
materials,determination of recoveries, use of internal standards,
comparison with analyses by a second labolatory or another
previously validated method, as well as some statistical quality control
prosedures.
Section Break
Thank You