Leveraging questionnaire-based physical activity levels and the Goldberg method to evaluate the biological plausibility of self-reported energy intake: a doubly labeled water validation study
Abstract
The Goldberg method is a statistical approach used to identify implausible energy intakes (EI) in nutritional epidemiology. However, estimating physical activity levels (PAL) required for the method, is challenging. We quantified the accuracy of the Goldberg method combined with PAL derived from the Sedentary Time and Activity Reporting Questionnaire (Goldberg-PALSTAR-Q). Total energy expenditure derived from doubly labeled water (TEEDLW) was the comparator. Between 2009 and 2011, men (n = 40) and women (n = 59) completed a 2-week DLW protocol, a food frequency questionnaire, and the STAR-Q. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the Goldberg-PALSTAR-Q were determined. Fifty-eight percent of men and women were classified as EI underreporters by the Goldberg-PALSTAR-Q compared with 60% of men and 56% of women by TEEDLW. Among men, sensitivity, specificity, PPV, NPV, accuracy, and 95% CI were 88% (68%-97%), 87% (61%-98%), 91% (72%-99%), 81% (56%-94%), and 87% (72%-95%), respectively; and among women 79% (62%-90%), 69% (50%-84%), 77% (60%-88%), 72% (52%-86%), and 75% (62%-84%), respectively. In studies where objective EI measures are lacking, the Goldberg method and individual-level questionnaire-derived PALs can provide a viable option in sensitivity analyses exploring the influence of implausible EIs on diet and health-related associations.
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BibTeX
@article{neilson2026leveraging,
title = {{Leveraging questionnaire-based physical activity levels and the Goldberg method to evaluate the biological plausibility of self-reported energy intake: a doubly labeled water validation study}},
author = {Heather K Neilson and Shervin Asgari and Janet A Tooze and Farah Khandwala and Anita Koushik and Rémi Rabasa-Lhoret and Karen A Kopciuk and Ilona Csizmadi},
journal = {American Journal of Epidemiology},
year = {2026},
month = jun,
doi = {10.1093/aje/kwag124},
url = {https://doi.org/10.1093/aje/kwag124},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Leveraging questionnaire-based physical activity levels and the Goldberg method to evaluate the biological plausibility of self-reported energy intake: a doubly labeled water validation study
AU - Heather K Neilson
AU - Shervin Asgari
AU - Janet A Tooze
AU - Farah Khandwala
AU - Anita Koushik
AU - Rémi Rabasa-Lhoret
AU - Karen A Kopciuk
AU - Ilona Csizmadi
PY - 2026
DA - 2026/06/03
JO - American Journal of Epidemiology
DO - 10.1093/aje/kwag124
UR - https://doi.org/10.1093/aje/kwag124
AB - The Goldberg method is a statistical approach used to identify implausible energy intakes (EI) in nutritional epidemiology. However, estimating physical activity levels (PAL) required for the method, is challenging. We quantified the accuracy of the Goldberg method combined with PAL derived from the Sedentary Time and Activity Reporting Questionnaire (Goldberg-PALSTAR-Q). Total energy expenditure derived from doubly labeled water (TEEDLW) was the comparator. Between 2009 and 2011, men (n = 40) and women (n = 59) completed a 2-week DLW protocol, a food frequency questionnaire, and the STAR-Q. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the Goldberg-PALSTAR-Q were determined. Fifty-eight percent of men and women were classified as EI underreporters by the Goldberg-PALSTAR-Q compared with 60% of men and 56% of women by TEEDLW. Among men, sensitivity, specificity, PPV, NPV, accuracy, and 95% CI were 88% (68%-97%), 87% (61%-98%), 91% (72%-99%), 81% (56%-94%), and 87% (72%-95%), respectively; and among women 79% (62%-90%), 69% (50%-84%), 77% (60%-88%), 72% (52%-86%), and 75% (62%-84%), respectively. In studies where objective EI measures are lacking, the Goldberg method and individual-level questionnaire-derived PALs can provide a viable option in sensitivity analyses exploring the influence of implausible EIs on diet and health-related associations.
SN - 0002-9262
SN - 1476-6256
ER -