Validity of an online 24-hour recall tool (myfood24) for dietary assessment in population studies: comparison with biomarkers and standard interviews

Background: Online dietary assessment tools can reduce administrative costs and facilitate repeated dietary assessment during follow-up in large-scale studies. However, information on bias due to measurement error of such tools is limited. We developed an online 24-hour recall (myfood24) and compared its performance with a traditional interviewer-administered multiple-pass 24-hour recall, assessing both against biomarkers. Methods: Metabolically stable adults were recruited and completed the new online dietary recall, an interviewer-based multiple pass recall and a suite of reference measures. Longer-term dietary intake was estimated from up to 3 x 24-hour recalls taken 2 weeks apart. Estimated intake of protein, potassium and sodium were compared with urinary biomarker concentrations. Estimated total sugar intake was compared with a predictive biomarker and estimated energy intake compared with energy expenditure measured by accelerometry and calorimetry. Nutrient intakes were also compared to those derived from an interviewer-administered multiple-pass 24-hour recall. Results: Biomarker samples were received from 212 participants on at least one occasion. Both self-reported dietary assessment tools led to attenuation compared to biomarkers. The online tools resulted in attenuation factors around 0.2 to 0.3 and partial correlation coefficients reflecting ranking intakes, of approximately 0.3 to 0.4. This was broadly similar to the more administratively burdensome interviewer-based tool. Other nutrient estimates derived from myfood24 were around 10-20% lower than from the interviewer-based tool, with wide limits of agreement. Intra-class correlation coefficients were approximately 0.4 to 0.5 indicating consistent moderate agreement. Conclusions: Our findings show that, whilst results from both measures of self-reported diet are attenuated compared to biomarker measures, the myfood24 online 24-hour recall is comparable to the more time-consuming and costly interviewer-based 24-hour recall across a range of measures.