Evaluation of food and nutrient intake assessment using concentration biomarkers in European adolescents from the Healthy Lifestyle in Europe by Nutrition in Adolescence study

Accurate food and nutrient intake assessment is essential for investigating diet-disease relationships. The purpose of the present study was to evaluate food and nutrient intake assessment obtained from a FFQ and 24-hour recalls (mean of two recalls) respectively, and compared with concentration biomarkers. Biomarkers included were vitamin C, β-carotene, eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA), vitamin B12 (cobalamin and holo-transcobalamin) and folate (erythrocyte folate and plasmafolate). For the food intake assessment evaluation 390 European adolescents were included while 697 for the nutrient intake assessment evaluation. Except for DHA+EPA status versus fish intake, highest correlations were found between food consumption frequencies and mean food intakes (r=0.51 for fruits and r=0.29 for vegetables). Correlations were higher between frequency of food consumption and concentration biomarkers than between mean food intake and concentration biomarkers, especially for EPA+DHA (r=0.35 vs. r=0.27). Most correlations were higher among girls than boys. For boys, highest validity coefficients were found for frequency of fruit consumption (0.88) and for DHA+EPA biomarker (%) (0.71). In girls the highest validity coefficients were found for fruit consumption frequency (0.76), vegetable consumption frequency (0.74), mean fruit intake (0.90) and DHA+EPA biomarker (%) (0.69). After exclusion of underreporters correlations slightly improved. Correlations between usual food intakes, adjusted for food consumption frequency, and concentration biomarkers were higher than correlations between mean food intakes and concentration biomarkers. In conclusion, two non-consecutive 24-hour recalls in combination with a FFQ seem to be appropriate to rank subjects according to their usual food intake. Exclusion of underreporters might be beneficial.Accurate food and nutrient intake assessment is essential for investigating diet-disease relationships. The purpose of the present study was to evaluate food and nutrient intake assessment obtained from a FFQ and 24-hour recalls (mean of two recalls) respectively, and compared with concentration biomarkers. Biomarkers included were vitamin C, β-carotene, eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA), vitamin B12 (cobalamin and holo-transcobalamin) and folate (erythrocyte folate and plasmafolate). For the food intake assessment evaluation 390 European adolescents were included while 697 for the nutrient intake assessment evaluation. Except for DHA+EPA status versus fish intake, highest correlations were found between food consumption frequencies and mean food intakes (r=0.51 for fruits and r=0.29 for vegetables). Correlations were higher between frequency of food consumption and concentration biomarkers than between mean food intake and concentration biomarkers, especially for EPA+DHA (r=0.35 vs. r=0.27). Most correlations were higher among girls than boys. For boys, highest validity coefficients were found for frequency of fruit consumption (0.88) and for DHA+EPA biomarker (%) (0.71). In girls the highest validity coefficients were found for fruit consumption frequency (0.76), vegetable consumption frequency (0.74), mean fruit intake (0.90) and DHA+EPA biomarker (%) (0.69). After exclusion of underreporters correlations slightly improved. Correlations between usual food intakes, adjusted for food consumption frequency, and concentration biomarkers were higher than correlations between mean food intakes and concentration biomarkers. In conclusion, two non-consecutive 24-hour recalls in combination with a FFQ seem to be appropriate to rank subjects according to their usual food intake. Exclusion of underreporters might be beneficial.A