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  • Title: 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.
    Author: Bokhof B, Günther AL, Berg-Beckhoff G, Kroke A, Buyken AE.
    Journal: Public Health Nutr; 2010 Jun; 13(6):826-34. PubMed ID: 20074394.
    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 -6.4 (95 % CI -8.2, -4.7) g/d or -11 %, with the difference increasing across the age groups from -0.6 (95 % CI -2.7, 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 = 0.7 for the total study sample and ranged from r = 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.
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