Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Epidemiology

Checking for completeness of 24-h urine collection using para-amino benzoic acid not necessary in the Observing Protein and Energy Nutrition study

European Journal of Clinical Nutrition volume 67, pages 863–867 (2013)Cite this article

Subjects

Abstract

Background/Objectives:

The orally administered para-amino benzoic acid (PABA) is known to have near 100% excretion in urine and is used as a measure of 24-h urine collection completeness (referred to as PABAcheck). The purpose was to examine the effect of including urine collections deemed incomplete based on PABAcheck in a dietary measurement error study.

Subjects/Methods:

The Observing Protein and Energy Nutrition (OPEN) study was conducted in 1999–2000 and included 484 men and women aged 40–69 years. A food frequency questionnaire and 24-h dietary recalls were evaluated using recovery biomarkers that included urinary nitrogen and potassium from two 24-h urine collections. Statistical modeling determined the measurement error properties of dietary assessment instruments. In the original analyses, PABAcheck was used as a measure of complete urine collection; incomplete collections were either excluded or adjusted to acceptable levels. The OPEN data were reanalyzed including all urine collections and by using criteria based on self-reported missing voids to assess the differences.

Results:

Means and coefficients of variation for biomarker-based protein and potassium intakes, and measurement error model-based correlations and attenuation factors were similar regardless of whether PABAcheck or missed voids were considered.

Conclusion:

PABAcheck may not be required in large population-based biomarker studies. However, until there are more analyses evaluating the necessity of a PABAcheck, it is recommended that PABA be given to all participants, but not necessarily analyzed. Then, PABAcheck could be used selectively as a marker of completeness among the collections in which low levels of biomarker are detected or for which noncompliance is suspected.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Kaaks RJ . Biochemical markers as additional measurements in studies of the accuracy of dietary questionnaire measurements: conceptual issues. Am J Clin Nutr 1997; 65: 1232S–1239S.

    Article  CAS  Google Scholar 

  2. Bingham S . Biomarkers in nutritional epidemiology. Public Health Nutr 2002; 5: 821–827.

    Article  Google Scholar 

  3. Huse DM, Nelson RA, Briones ER, Hodgson PA . Urinary nitrogen excretion as objective measure of dietary intake. Am J Clin Nutr 1974; 27: 771–773.

    Article  CAS  Google Scholar 

  4. Isaksson B . Urinary nitrogen output as validity test in dietary surveys. Am J Clin Nutr 1980; 33: 4–5.

    Article  CAS  Google Scholar 

  5. Bingham SA, Cummings JH . Urine nitrogen as an independent validatory measure of dietary intake: a study of nitrogen balance in individuals consuming their normal diet. Am J Clin Nutr 1985; 42: 1276–1289.

    Article  CAS  Google Scholar 

  6. Subar AF, Kipnis V, Troiano RP, Midthune D, Schoeller DA, Bingham S et al. Using intake biomarkers to evaluate the extent of dietary misreporting in a large sample of adults: The OPEN Study. Am J Epidemiol 2003; 158: 1–13.

    Article  Google Scholar 

  7. Kipnis V, Subar AF, Midthune D, Freedman LS, Ballard-Barbash R, Troiano RP et al. The structure of dietary measurement error: results of the OPEN biomarker study. Am J Epidemiol 2003; 158: 14–21.

    Article  Google Scholar 

  8. Neuhouser ML, Tinker L, Shaw PA, Schoeller D, Bingham SA, Van Horn L et al. Use of recovery biomarkers to calibrate nutrient consumption self-reports in the Women’s Health Initiative. Am J Epidemiol 2008; 67: 1247–1259.

    Article  Google Scholar 

  9. Preis SR, Spiegelman D, Zhao BB, Moshfegh A, Baer DJ, Willett WC . Application of repeat-measure biomarker measurement error model to 2 validation studies: examination of the effect of within-person variation in biomarker measurements. Am J Epidemiol 2011; 173: 683–694.

    Article  Google Scholar 

  10. Crispin SP, de Vries JHM, Geelen A, Souverein OW, Hulshof PJM, Lafay L et al. Two non-consecutive 24-h recalls using EPIC-Soft software are sufficiently valid for comparing protein and potassium intake between five European centers—results from the European Food Consumption Validation (EFCOVAL) study. Br J Nutr 2011; 105: 447–458.

    Article  Google Scholar 

  11. Tasevska N, Runswick SA, Bingham SA . Urinary potassium is as reliable as urinary nitrogen for use as a recovery biomarker in dietary studies of free living individuals. J Nutr 2006; 136: 1334–1340.

    Article  Google Scholar 

  12. Bingham SA, Cummings JH . 4 amino benzoic acid as a marker for the assessment of completeness of 24 h urine collections. Clin Sci 1983; 64: 629–635.

    Article  CAS  Google Scholar 

  13. Roberts SB, Morrow FD, Evans WJ, Shepard DC, Dallal GE, Meredith CN et al. Use of p-aminobenzoic acid to monitor compliance with prescribed dietary regimens during metabolic balance studies in man. Am J Clin Nutr 1990; 51: 385–388.

    Article  Google Scholar 

  14. Leclerq C, Maiani G, Polito A, Ferro-Luzzi A . Use of PABA test to check completeness of 24-h urine collections in elderly subjects. Nutrition 1991; 7: 350–354.

    Google Scholar 

  15. Jakobsen J, Pedersen AN, Ovesen L . Para-aminobenzoic acid (PABA) used as a marker for completeness of 24 h urine: effects of age and dosage scheduling. Eur J Clin Nutr 2003; 57: 138–142.

    Article  CAS  Google Scholar 

  16. Arab L, Tseng C-H, Ang A, Jardack P . Validity of a multipass, web-based 24-hour self-administered recall for assessment of total energy intake in blacks and whites. Am J Epidemiol 2011; 174: 1256–1265.

    Article  Google Scholar 

  17. Subar AF, Thompson FE, Kipnis V, Midthune D, Hurwitz P, McNutt S et al. Comparative validation of the Block, Willett, and National Cancer Institute food frequency questionnaires: the Eating at America's Table Study. Am J Epidemiol 2001; 154: 1089–1099.

    Article  CAS  Google Scholar 

  18. Raper N, Perloff B, Ingwersen L, Steinfeldt L, Anand J . An overview of USDA’s Dietary Intake Data System. J Food Comp Anal 2004; 17: 545–555.

    Article  Google Scholar 

  19. Bingham SA, Williams DRR, Cole TJ, Price CP, Cummings JH . Reference values for analytes of 24 h urine samples known to be complete. Ann Clin Biochem 1988; 25: 610–619.

    Article  CAS  Google Scholar 

  20. Johansson G, Bingham S, Vahter M . A method to compensate for incomplete 24 h urine collections in nutritional epidemiology studies. Public Health Nutr 1999; 2: 587–591.

    Article  CAS  Google Scholar 

  21. Jakobsen J, Ovesen L, Fagt S, Pederson AN . Para-aminobenzoic acid used as a marker for completeness of 24 h urine: assessment of control limits for a specific HPLC method. Eur J Clin Nutr 1997; 51: 514–519.

    Article  CAS  Google Scholar 

  22. Berg JD, Chesner I, Lawson N . Practical Assessment of the NBT-PABA pancreatic function test using HPLC determination of p-aminobenzoic acid in urine. Ann Clin Biochem 1985; 22: 586–590.

    Article  CAS  Google Scholar 

  23. Freedman LS, Midthune D, Carroll RJ, Krebs-Smith S, Subar AF, Troiano RP et al. Adjustments to improve the estimation of usual dietary intake distributions in the population. J Nutr 2004; 134: 1836–1843.

    Article  CAS  Google Scholar 

  24. Schatzkin A, Kipnis V, Carroll RJ, Midthune D, Subar AF, Bingham S et al. A comparison of a food frequency questionnaire with a 24-hour recall for use in an epidemiological cohort study: results from the biomarker-based Observing Protein and Energy Nutrition (OPEN) study. Int J Epidemiol 2003; 32: 1054–1062.

    Article  Google Scholar 

  25. Carroll RJ, Midthune D, Freedman LS, Kipnis V . Seemingly unrelated measurement error models, with application to nutritional epidemiology. Biometrics 2006; 62: 75–84.

    Article  Google Scholar 

  26. Freedman LS, Schatzkin A, Midthune D, Kipnis V . Dietary measurement error in nutritional cohort studies. J Natl Cancer Inst 2011; 103: 1086–1092.

    Article  Google Scholar 

Download references

Acknowledgements

This work was funded by the US National Cancer Institute.

Author information

Authors and Affiliations

  1. Division of Cancer Control and Population Sciences, US National Cancer Institute, Bethesda, MD, USA

    A F Subar & N Tasevska

  2. Division of Cancer Prevention, US National Cancer Institute, Bethesda, MD, USA

    D Midthune & V Kipnis

  3. Gertner Institute for Epidemiology and Public Health Policy, Sheba Medical Center, Tel Hashomer, Israel

    L S Freedman

Authors
  1. A F Subar
    View author publications

    Search author on:PubMed Google Scholar

  2. D Midthune
    View author publications

    Search author on:PubMed Google Scholar

  3. N Tasevska
    View author publications

    Search author on:PubMed Google Scholar

  4. V Kipnis
    View author publications

    Search author on:PubMed Google Scholar

  5. L S Freedman
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to A F Subar.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Subar, A., Midthune, D., Tasevska, N. et al. Checking for completeness of 24-h urine collection using para-amino benzoic acid not necessary in the Observing Protein and Energy Nutrition study. Eur J Clin Nutr 67, 863–867 (2013). https://doi.org/10.1038/ejcn.2013.62

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/ejcn.2013.62

Keywords

This article is cited by

Search

Advanced search

Quick links