Understanding the Nature of Measurement Error When Estimating Energy Expenditure and Physical Activity via Physical Activity Recall

in Journal of Physical Activity and Health
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Background: The National Health and Nutrition Examination Survey physical activity questionnaire (PAQ) is used to estimate activity energy expenditure (AEE) and moderate to vigorous physical activity (MVPA). Bias and variance in estimates of AEE and MVPA from the PAQ have not been described, nor the impact of measurement error when utilizing the PAQ to predict biomarkers and categorize individuals. Methods: The PAQ was administered to 385 adults to estimate AEE (AEE:PAQ) and MVPA (MVPA:PAQ), while simultaneously measuring AEE with doubly labeled water (DLW; AEE:DLW) and MVPA with an accelerometer (MVPA:A). Results: Although AEE:PAQ [3.4 (2.2) MJ·d−1] was not significantly different from AEE:DLW [3.6 (1.6) MJ·d−1; P > .14], MVPA:PAQ [36.2 (24.4) min·d−1] was significantly higher than MVPA:A [8.0 (10.4) min·d−1; P < .0001]. AEE:PAQ regressed on AEE:DLW and MVPA:PAQ regressed on MVPA:A yielded not only significant positive relationships but also large residual variances. The relationships between AEE and MVPA, and 10 of the 12 biomarkers were underestimated by the PAQ. When compared with accelerometers, the PAQ overestimated the number of participants who met the Physical Activity Guidelines for Americans. Conclusions: Group-level bias in AEE:PAQ was small, but large for MVPA:PAQ. Poor within-participant estimates of AEE:PAQ and MVPA:PAQ lead to attenuated relationships with biomarkers and misclassifications of participants who met or who did not meet the Physical Activity Guidelines for Americans.

Paul and Vella are with the Dept of Movement Sciences, University of Idaho, Moscow, ID. McGrath is with the Dept of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI. Kramer is with the Biometrical Consulting Service, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD. Baer is with the Food Components and Health Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD. Moshfegh is with the Food Surveys Research Group, Beltsville Human Nutrition Research Center, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD.

Paul (dpaul@uidaho.edu) is corresponding author.
  • 1.

    Manini TM, Everhart JE, Patel KV, et al. Daily activity energy expenditure and mortality among older adults. JAMA. 2006;296(2):171–179. PubMed doi:10.1001/jama.296.2.171

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Hu FB, Willett WC, Li T, Stampfer MJ, Colditz GA, Manson JE. Adiposity as compared with physical activity in predicting mortality among women. N Engl J Med. 2004;351(26):2694–2703. PubMed doi:10.1056/NEJMoa042135

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291(10):1238–1245. PubMed doi:10.1001/jama.291.10.1238

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Jakicic JM, Otto AD. Physical activity considerations for the treatment and prevention of obesity. Am J Clin Nutr. 2005;82(1)(suppl):226S–229S. PubMed.

  • 5.

    US Department of Health and Human Services. Physical Activity Guidelines for Americans. Washington, DC: US Department of Health and Human Services; 2008:vi–vii.

    • Search Google Scholar
    • Export Citation
  • 6.

    Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40(1):181–188. PubMed doi:10.1249/mss.0b013e31815a51b3

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Matthews CE, Moore SC, George SM, Sampson J, Bowles HR. Improving self-reports of active and sedentary behaviors in large epidemiologic studies. Exerc Sport Sci Rev. 2012;40(3):118–126. PubMed.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Ainsworth BE, Caspersen CJ, Matthews CE, Masse LC, Baranowski T, Zhu W. Recommendations to improve the accuracy of estimates of physical activity derived from self report. J Phys Act Health. 2012;9(suppl1):76–84. doi:10.1123/jpah.9.s1.s76

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Neilson HK, Robson PJ, Friedenreich CM, Csizmadi I. Estimating activity energy expenditure: how valid are physical activity questionnaires? Am J Clin Nutr. 2008;87(2):279–291. PubMed.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Esliger DW, Tremblay MS. Physical activity and inactivity profiling: the next generation. Can J Public Health. 2007;98(suppl 2):S195–S207.

  • 11.

    Schoeller DA. Measurement of energy expenditure in free-living humans by using doubly labeled water. J Nutr. 1988;118(11):1278–1289. PubMed doi:10.1093/jn/118.11.1278

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Speakman JR. The history and theory of the doubly labeled water technique. Am J Clin Nutr. 1998;68(4):932S–938S. PubMed doi:10.1093/ajcn/68.4.932S

  • 13.

    Plasqui G, Bonomi AG, Westerterp KR. Daily physical activity assessment with accelerometers: new insights and validation studies. Obes Rev. 2013;14(6):451–462. PubMed doi:10.1111/obr.12021

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Prince SA, Adamo KB, Hamel ME, Hardt J, Connor Gorber S, Tremblay M. A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review. Int J Behav Nutr Phys Act. 2008;5:56. PubMed doi:10.1186/1479-5868-5-56

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Paul DR, Kramer M, Stote KS, Baer DJ. Determinants of variance in the habitual physical activity of overweight adults. J Phys Act Health. 2015;12(5):680–685. PubMed doi:10.1123/jpah.2013-0269

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Melanson EL Jr, Freedson PS. Physical activity assessment: a review of methods. Crit Rev Food Sci Nutr. 1996;36(5):385–396. PubMed doi:10.1080/10408399609527732

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Tucker JM, Welk GJ, Beyler NK. Physical activity in U.S.: adults compliance with the Physical Activity Guidelines for Americans. Am J Prev Med. 2011;40(4):454–461. PubMed doi:10.1016/j.amepre.2010.12.016

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Csizmadi I, Neilson HK, Kopciuk KA, et al. The Sedentary Time and Activity Reporting Questionnaire (STAR-Q): reliability and validity against doubly labeled water and 7-day activity diaries. Am J Epidemiol. 2014;180(4):424–435. PubMed doi:10.1093/aje/kwu150

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Neuhouser ML, Di C, Tinker LF, et al. Physical activity assessment: biomarkers and self-report of activity-related energy expenditure in the WHI. Am J Epidemiol. 2013;177(6):576–585. PubMed doi:10.1093/aje/kws269

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Besson H, Brage S, Jakes RW, Ekelund U, Wareham NJ. Estimating physical activity energy expenditure, sedentary time, and physical activity intensity by self-report in adults. Am J Clin Nutr. 2010;91(1):106–114. PubMed doi:10.3945/ajcn.2009.28432

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Bull FC, Maslin TS, Armstrong T. Global physical activity questionnaire (GPAQ): nine country reliability and validity study. J Phys Act Health. 2009;6(6):790–804. PubMed doi:10.1123/jpah.6.6.790

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Leenders NY, Sherman WM, Nagaraja HN, Kien CL. Evaluation of methods to assess physical activity in free-living conditions. Med Sci Sports Exerc. 2001;33(7):1233–1240. PubMed doi:10.1097/00005768-200107000-00024

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    De Vera MA, Ratzlaff C, Doerfling P, Kopec J. Reliability and validity of an internet-based questionnaire measuring lifetime physical activity. Am J Epidemiol. 2010;172(10):1190–1198. PubMed doi:10.1093/aje/kwq273

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Craig CL, Marshall AL, Sjostrom M, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–1395. PubMed doi:10.1249/01.MSS.0000078924.61453.FB

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    van Poppel MN, Chinapaw MJ, Mokkink LB, van Mechelen W, Terwee CB. Physical activity questionnaires for adults: a systematic review of measurement properties. Sports Med. 2010;40(7):565–600. PubMed doi:10.2165/11531930-000000000-00000

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Winkler E, Waters L, Eakin E, Fjeldsoe B, Owen N, Reeves M. Is measurement error altered by participation in a physical activity intervention? Med Sci Sports Exerc. 2013;45(5):1004–1011. PubMed doi:10.1249/MSS.0b013e31827ccf7d

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Zheng C, Beresford SA, Van Horn L, et al. Simultaneous association of total energy consumption and activity-related energy expenditure with risks of cardiovascular disease, cancer, and diabetes among postmenopausal women. Am J Epidemiol. 2014;180(5):526–535. PubMed doi:10.1093/aje/kwu152

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Westerterp KR. Assessment of physical activity: a critical appraisal. Eur J Appl Physiol. 2009;105(6):823–828. PubMed doi:10.1007/s00421-009-1000-2

  • 29.

    Moshfegh AJ, Rhodes DG, Baer DJ, et al. The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes. Am J Clin Nutr. 2008;88(2):324–332. PubMed

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Schoeller DA, Tylavsky FA, Baer DJ, et al. QDR 4500A dual-energy X-ray absorptiometer underestimates fat mass in comparison with criterion methods in adults. Am J Clin Nutr. 2005;81(5):1018–1025. PubMed

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Paul DR, Novotny JA, Rumpler WV. Effects of the interaction of sex and food intake on the relation between energy expenditure and body composition. Am J Clin Nutr. 2004;79(3):385–389. PubMed doi:10.1093/ajcn/79.3.385

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Food and Nutrition Board. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: National Academies Press; 2005:157–158.

    • Search Google Scholar
    • Export Citation
  • 33.

    Paul DR, Kramer M, Stote KS, et al. Estimates of adherence and error analysis of physical activity data collected via accelerometry in a large study of free-living adults. BMC Med Res Methodol. 2008;8:38. PubMed doi:10.1186/1471-2288-8-38

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34.

    Gordon B, Chen S, Durstine JL. The effects of exercise training on the traditional lipid profile and beyond. Curr Sports Med Rep. 2014;13(4):253–259. PubMed doi:10.1249/JSR.0000000000000073

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Loney T, Standage M, Thompson D, Sebire SJ, Cumming S. Self-report vs. objectively assessed physical activity: which is right for public health? J Phys Act Health. 2011;8(1):62–70. PubMed doi:10.1123/jpah.8.1.62

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Tooze JA, Troiano RP, Carroll RJ, Moshfegh AJ, Freedman LS. A measurement error model for physical activity level as measured by a questionnaire with application to the 1999-2006 NHANES questionnaire. Am J Epidemiol. 2013;177(11):1199–1208. PubMed doi:10.1093/aje/kws379

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Schatzkin A, Subar AF, Moore S, et al. Observational epidemiologic studies of nutrition and cancer: the next generation (with better observation). Cancer Epidemiol Biomarkers Prev. 2009;18(4):1026–1032. PubMed doi:10.1158/1055-9965.EPI-08-1129

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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