Literature DB >> 23701939

Energy adjustment of nutrient intakes is preferable to adjustment using body weight and physical activity in epidemiological analyses.

Jinnie J Rhee1, Eunyoung Cho2, Walter C Willett1.   

Abstract

OBJECTIVE: Adjustment for body weight and physical activity has been suggested as an alternative to adjusting for reported energy intake in nutritional epidemiology. We examined which of these approaches would yield stronger correlations between nutrients and their biomarkers.
DESIGN: A cross-sectional study in which dietary fatty acids, carotenoids and retinol were adjusted for reported energy intake and, separately, for weight and physical activity using the residual method. Correlations between adjusted nutrients and their biomarkers were examined.
SETTING: USA.
SUBJECTS: Cases and controls from a nested case-control study of erythrocyte fatty acids and CHD (n 442) and of plasma carotenoids and retinol and breast cancer (n 1254).
RESULTS: Correlations between intakes and plasma levels of trans-fatty acids were 0·30 (energy-adjusted) and 0·16 (weight- and activity-adjusted); for erythrocyte levels, the corresponding correlations were 0·37 and 0·25. Energy-adjusted intakes of linoleic acid and α-linolenic acid were more strongly correlated with their respective biomarkers than weight- and activity-adjusted intakes, but the differences were not significant except for linoleic acid (erythrocyte). Weight- and activity-adjusted DHA intake was slightly more strongly correlated with its plasma biomarker than energy-adjusted intake (0·37 v. 0·34). Neither method made a difference for DHA (erythrocyte), carotenoids and retinol.
CONCLUSIONS: The effect of energy adjustment depends on the nutrient under investigation, and adjustment for energy calculated from the same questionnaire used to estimate nutrient intakes improves the correlation of some nutrients with their biomarkers appreciably. For the nutrients examined, adjustment using weight and physical activity had at most a small effect on these correlations.

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Year:  2013        PMID: 23701939      PMCID: PMC3884063          DOI: 10.1017/S1368980013001390

Source DB:  PubMed          Journal:  Public Health Nutr        ISSN: 1368-9800            Impact factor:   4.022


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