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Validity of reported energy expenditure and reported intake of energy, protein, sodium and potassium in rheumatoid arthritis patients in a dietary intervention study

European Journal of Clinical Nutrition volume 59, pages 238–245 (2005)Cite this article

Abstract

Objectives: The aim of the study was to validate a diet history interview (DHI) method and a 3-day activity registration (AR) with biological markers.

Subjects and study design: The reported dietary intake of 33 rheumatoid arthritis patients (17 patients on a Mediterranean-type diet and 16 patients on a control diet) participating in a dietary intervention study was assessed using the DHI method. The total energy expenditure (TEE), estimated by a 3-day AR, was used to validate the energy intake (EI). For nine subjects the activity registration was also validated by means of the doubly labelled water (DLW) method. The excretion of nitrogen, sodium and potassium in 24-h urine samples was used to validate the intake of protein, sodium and potassium.

Results: There was no significant difference between the EI and the TEE estimated by the activity registration or between the intake of protein, sodium and potassium and their respective biological markers. However, in general, the AR underestimated the TEE compared to the DLW method. No significant differences were found between the subjects in the Mediterranean diet group and the control diet group regarding the relationship between the reported intakes and the biological markers.

Conclusion: The DHI could capture the dietary intake fairly well, and the dietary assessment was not biased by the dietary intervention. The AR showed a bias towards underestimation when compared to the DLW method. This illustrates the importance of valid biological markers.

Sponsorship: The Faculty of Social Sciences, Umeå University; the Swedish Foundation for Health Care Sciences and Allergy Research; the Health Research Council in the Southeast of Sweden; the Swedish Rheumatism Association; the Swedish Nutrition Foundation; the JC Kempe Memorial Scholarship Fund; the ‘Borgerskapet i Umeå’ Fund, the ‘Uppsala Hemsysterskola’ Fund; Karlshamns AB; Nestlé Sweden AB; Van den Bergh Foods AB.

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Acknowledgements

We express our gratitude to our collaborators, Lena Martinsson, Eva Wolke, Ingela Nilsson, Lena Henningsson, Marianne Olsson, Ann-Louise Karlsson, Mona Bäckström and Gunnel Gustavsson for administrative assistance, information, advice and support to the patients concerning their diet, help with the clinical examinations, and in the handling of blood and urine samples for chemical analysis.We thank Maria Bengtsson and Jenny Wannstedt for performing diet history interviews, Petra Rydén for her help with the processing of food questionnaires, and Anette Jonsäll and Christel Larsson for valuable discussions.We also express our gratitude to all the participants.

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Authors and Affiliations

  1. Department of Food and Nutrition, Umeå University, Umeå, Sweden

    L Hagfors & G Johansson

  2. Department of Human Biology, Maastricht University, Maastricht, The Netherlands

    K Westerterp

  3. Department of Medicine, Visby Hospital, Visby, Sweden

    L Sköldstam

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  1. L Hagfors
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  2. K Westerterp
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  4. G Johansson
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Correspondence to L Hagfors.

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Guarantor: L Hagfors.

Contributors: LH participated in the conception, design, data analysis and the writing of the paper. KW participated in the data analysis and the critical revision of the paper. LS participated in the conception, design and the critical revision of the paper. GJ participated in the conception, design, data analysis and the critical revision of the paper.

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Hagfors, L., Westerterp, K., Sköldstam, L. et al. Validity of reported energy expenditure and reported intake of energy, protein, sodium and potassium in rheumatoid arthritis patients in a dietary intervention study. Eur J Clin Nutr 59, 238–245 (2005). https://doi.org/10.1038/sj.ejcn.1602064

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