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Can adverse effects of dietary fat intake be overestimated as a consequence of dietary fat underreporting?

Published online by Cambridge University Press:  02 January 2007

Berit Lilienthal Heitmann  and
Lauren Lissner
Berit Lilienthal Heitmann*
Affiliation:
Research Unit for Dietary Studies and Danish Epidemiology Science Centre, Institute of Preventive Medicine, Copenhagen University Hospital, DK-1399 Copenhagen K, Denmark Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark
Lauren Lissner
Affiliation:
Department of Internal Medicine, Sahlgrenska University Hospital, Gothenborg University, Gothenborg, Sweden
*
*Corresponding author: Email [email protected]
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Abstract

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Objective

To describe the consequences of systematic reporting bias by the obese for diet–disease relationships.

Design

The present report used 24-hour urinary nitrogen and estimates of 24-hour energy expenditure to assess error in diet reporting, and examined the consequence of accounting for this error for associations between dietary fat intake and serum low-density lipoprotein (LDL)-cholesterol.

Setting

Sub-study to the Danish MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) project, carried out in 1987–1988.

Subjects

A random sub-sample of the adult Danish male population (n = 152).

Results

Correcting dietary fat for underreporting error weakened, rather than strengthened, the association between dietary fat intake and LDL-cholesterol by reducing the slope of the regression from β = 3.4, P = 0.02 to β = 2.7, P = 0.04.

Conclusion

This example illustrates that systematic underreporting of dietary fat by high-risk groups such as the obese may produce an overestimated association. These results imply that previous epidemiological studies showing a positive association between percentage of energy from fat and other health outcomes, e.g. cancer and heart disease, may have overestimated the negative effects of a high-fat diet. If we were able to correctly assess dietary fat intake in general populations, recommendations for fat intake may be more liberal than the 30% suggested today. Improved assessment of fat intake in epidemiological studies is necessary for future development of evidence-based recommendations for diet and health.

Keywords

Fat intakeObesityBiasEpidemiology
Type
Research Article
Information
Public Health Nutrition , Volume 8 , Issue 8 , December 2005 , pp. 1322 - 1327
Copyright
Copyright © The Authors 2005

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