Repeatability and measurement error in the assessment of choline and betaine dietary intake: the Atherosclerosis Risk in Communities (ARIC) Study

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  • Bidulescu, Aurelian
    • Other Affiliation: Cardiovascular Research Institute and Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, USA
  • Chambless, Lloyd E
    • Affiliation: Gillings School of Global Public Health, Department of Biostatistics
  • Siega-Riz, Anna Maria
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
  • Zeisel, Steven H.
    • Affiliation: Gillings School of Global Public Health, Department of Nutrition
  • Heiss, Gerardo
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
Abstract
  • Abstract Background The repeatability of a risk factor measurement affects the ability to accurately ascertain its association with a specific outcome. Choline is involved in methylation of homocysteine, a putative risk factor for cardiovascular disease, to methionine through a betaine-dependent pathway (one-carbon metabolism). It is unknown whether dietary intake of choline meets the recommended Adequate Intake (AI) proposed for choline (550 mg/day for men and 425 mg/day for women). The Estimated Average Requirement (EAR) remains to be established in population settings. Our objectives were to ascertain the reliability of choline and related nutrients (folate and methionine) intakes assessed with a brief food frequency questionnaire (FFQ) and to estimate dietary intake of choline and betaine in a bi-ethnic population. Methods We estimated the FFQ dietary instrument reliability for the Atherosclerosis Risk in Communities (ARIC) study and the measurement error for choline and related nutrients from a stratified random sample of the ARIC study participants at the second visit, 1990–92 (N = 1,004). In ARIC, a population-based cohort of 15,792 men and women aged 45–64 years (1987–89) recruited at four locales in the U.S., diet was assessed in 15,706 baseline study participants using a version of the Willett 61-item FFQ, expanded to include some ethnic foods. Intraindividual variability for choline, folate and methionine were estimated using mixed models regression. Results Measurement error was substantial for the nutrients considered. The reliability coefficients were 0.50 for choline (0.50 for choline plus betaine), 0.53 for folate, 0.48 for methionine and 0.43 for total energy intake. In the ARIC population, the median and the 75th percentile of dietary choline intake were 284 mg/day and 367 mg/day, respectively. 94% of men and 89% of women had an intake of choline below that proposed as AI. African Americans had a lower dietary intake of choline in both genders. Conclusion The three-year reliability of reported dietary intake was similar for choline and related nutrients, in the range as that published in the literature for other micronutrients. Using a brief FFQ to estimate intake, the majority of individuals in the ARIC cohort had an intake of choline below the values proposed as AI.
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  • Article
Rights statement
  • In Copyright
Rights holder
  • Aurelian Bidulescu et al.; licensee BioMed Central Ltd.
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Journal title
  • Nutrition Journal
Journal volume
  • 8
Journal issue
  • 1
Page start
  • 14
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1475-2891
Bibliographic citation
  • Nutrition Journal. 2009 Feb 20;8(1):14
Publisher
  • BioMed Central Ltd
Access right
  • Open Access
Date uploaded
  • August 23, 2012

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file details 1475-2891-8-14.pdf 2019-05-06 Public Download
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file details Measurement error model and variance-covariance matrix. The description provided represents the algorithms used to construct the measurement error mixed model and to obtain the variance-covariance matrix for the related dietary nutrients. 2019-05-06 Public Download