Original Article

Journal of Human Hypertension (2017) 31, 462–473; doi:10.1038/jhh.2016.98; published online 16 February 2017

Applying recovery biomarkers to calibrate self-report measures of sodium and potassium in the Hispanic Community Health Study/Study of Latinos

Y Mossavar-Rahmani1, D Sotres-Alvarez2, W W Wong3, C M Loria4, M D Gellman5, L Van Horn6, M H Alderman1, J M Beasley7, C M Lora8, A M Siega-Riz9, R C Kaplan1 and P A Shaw10

  1. 1Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
  2. 2Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
  3. 3USDA/ARS, Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
  4. 4Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
  5. 5Department of Psychology, University of Miami, Coral Gables, FL, USA
  6. 6Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
  7. 7Department of Medicine, New York University, New York, NY, USA
  8. 8Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
  9. 9Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
  10. 10Department of Biostatistics & Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

Correspondence: Dr Y Mossavar-Rahmani, Division of Health Promotion & Nutrition Research, Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Belfer Building 1312, Bronx, New York 10461, USA. E-mail: yasmin.mossavar-rahmani@einstein.yu.edu

Received 20 September 2016; Revised 30 November 2016; Accepted 12 December 2016
Advance online publication 16 February 2017



Measurement error in assessment of sodium and potassium intake obscures associations with health outcomes. The level of this error in a diverse US Hispanic/Latino population is unknown. We investigated the measurement error in self-reported dietary intake of sodium and potassium and examined differences by background (Central American, Cuban, Dominican, Mexican, Puerto Rican and South American). In 2010–2012, we studied 447 participants aged 18–74 years from four communities (Miami, Bronx, Chicago and San Diego), obtaining objective 24-h urinary sodium and potassium excretion measures. Self-report was captured from two interviewer-administered 24-h dietary recalls. Twenty percent of the sample repeated the study. We examined bias in self-reported sodium and potassium from diet and the association of mismeasurement with participant characteristics. Linear regression relating self-report with objective measures was used to develop calibration equations. Self-report underestimated sodium intake by 19.8% and 20.8% and potassium intake by 1.3% and 4.6% in men and women, respectively. Sodium intake underestimation varied by Hispanic/Latino background (P<0.05) and was associated with higher body mass index (BMI). Potassium intake underestimation was associated with higher BMI, lower restaurant score (indicating lower consumption of foods prepared away from home and/or eaten outside the home) and supplement use. The R2 was 19.7% and 25.0% for the sodium and potassium calibration models, respectively, increasing to 59.5 and 61.7% after adjusting for within-person variability in each biomarker. These calibration equations, corrected for subject-specific reporting error, have the potential to reduce bias in diet–disease associations within this largest cohort of Hispanics in the United States.

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