Cathie Sudlow and colleagues describe the UK Biobank, a large population-based prospective study, established to allow investigation of the genetic and non-genetic determinants of the diseases of middle and old age.

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UK biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age

The intent of this chapter is to enhance understanding of various dietary assessment methods so that the most appropriate method for a particular need is chosen. This review focuses only on individual level food intake assessment. It is intended to serve as a resource for those who wish to assess diet in a research study using individual measurements for group level analysis. The chapter reviews major dietary assessment methods, their advantages and disadvantages, and validity; describes which dietary assessment methods are appropriate for different types of studies and populations; and discusses specific issues that relate to all methods.

Dietary Assessment Methodology

Objective To investigate the association of grip strength with disease specific incidence and mortality and whether grip strength enhances the prediction ability of an established office based risk score. Design Prospective population based study. Setting UK Biobank. Participants 502 293 participants (54% women) aged 40-69 years. Main outcome measures All cause mortality as well as incidence of and mortality from cardiovascular disease, respiratory disease, chronic obstructive pulmonary disease, and cancer (all cancer, colorectal, lung, breast, and prostate). Results Of the participants included in analyses, 13 322 (2.7%) died over a mean of 7.1 (range 5.3-9.9) years’ follow-up. In women and men, respectively, hazard ratios per 5 kg lower grip strength were higher (all at P Conclusion Higher grip strength was associated with a range of health outcomes and improved prediction of an office based risk score. Further work on the use of grip strength in risk scores or risk screening is needed to establish its potential clinical utility.

https://www.bmj.com/content/bmj/361/bmj.k1651.full.pdf

Associations of grip strength with cardiovascular, respiratory, and cancer outcomes and all cause mortality: prospective cohort study of half a million UK Biobank participants

UK Biobank is a very large prospective study which aims to provide a resource for the investigation of the genetic, environmental and lifestyle determinants of a wide range of diseases of middle age and later life. Between 2006 and 2010, over 500,000 men and women aged 40 to 69 years were recruited and extensive data on participants' lifestyles, environment, medical history and physical measures, along with biological samples, were collected. The health of the participants is now being followed long-term, principally through linkage to a wide range of health-related records, with validation and characterisation of health-related outcomes. Further enhancements are also underway to improve phenotype characterisation, including internet-based dietary assessment, biomarker measurements on the baseline blood samples and, in sub-samples of the cohort, physical activity monitoring and proposals for extensive brain and body imaging. UK Biobank is now available for use by all researchers, without exclusive or preferential access, for any health-related research that is in the public interest. The open-access nature of the resource will allow researchers from around the world to conduct research that leads to better strategies for the prevention, diagnosis and treatment of a wide range of life-threatening and disabling conditions.

UK Biobank: Current status and what it means for epidemiology

Introduction: The use of innovative technologies is deemed to improve dietary assessment in various research settings. However, their relative merits in nutritional epidemiological studies, which require accurate quantitative estimates of the usual intake at individual level, still need to be evaluated. 
Objective: To report on the inventory of available innovative technologies for dietary assessment and to critically evaluate their strengths and weaknesses as compared with the conventional methodologies (i.e. Food Frequency Questionnaires, food records, 24-hour dietary recalls) used in epidemiological studies. 
Methods: A list of currently available technologies was identified from English-language journals, using PubMed and Web of Science. The search criteria were principally based on the date of publication (between 1995 and 2011) and pre-defined search keywords. 
Results: Six main groups of innovative technologies were identified ('Personal Digital Assistant-', 'Mobile-phone-', 'Interactive computer-', 'Web-', 'Camera- and tape-recorder-' and 'Scan- and sensor-based' technologies). Compared with the conventional food records, Personal Digital Assistant and mobile phone devices seem to improve the recording through the possibility for 'real-time' recording at eating events, but their validity to estimate individual dietary intakes was low to moderate. In 24-hour dietary recalls, there is still limited knowledge regarding the accuracy of fully automated approaches; and methodological problems, such as the inaccuracy in self-reported portion sizes might be more critical than in interview-based applications. In contrast, measurement errors in innovative web-based and in conventional paper-based Food Frequency Questionnaires are most likely similar, suggesting that the underlying methodology is unchanged by the technology. 
Conclusions: Most of the new technologies in dietary assessment were seen to have overlapping methodological features with the conventional methods predominantly used for nutritional epidemiology. Their main potential to enhance dietary assessment is through more cost- and time-effective, less laborious ways of data collection and higher subject acceptance, though their integration in epidemiological studies would need additional considerations, such as the study objectives, the target population and the financial resources available. However, even in innovative technologies, the inherent individual bias related to self-reported dietary intake will not be resolved. More research is therefore crucial to investigate the validity of innovative dietary assessment technologies.

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Review and evaluation of innovative technologies for measuring diet in nutritional epidemiology

Objectives: To describe the development of the Oxford WebQ, a web-based 24h dietary assessment tool developed for repeated administration in large prospective studies; and to report the preliminary assessment of its performance for estimating nutrient intakes. Design: We developed the Oxford WebQ by repeated testing until it was sufficiently comprehensive and easy to use. For the latest version, we compared nutrient intakes from volunteers who completed both the Oxford WebQ and an interviewer-administered 24h dietary recall on the same day. Setting: Oxford, UK. Subjects: A total of 116 men and women. Results: The WebQ took a median of 12? 5( interquartile range: 10?8‐16?3) min to self-complete and nutrient intakes were estimated automatically. By contrast, the interviewer-administered 24h dietary recall took 30min to complete and 30min to code. Compared with the 24h dietary recall, the mean Spearman’s correlation for the 21 nutrients obtained from the WebQ was 0?6, with the majority between 0? 5a nd 0?9. The mean differences in intake were less than 610% for all nutrients except for carotene and vitamins B12 and D. On rare occasions a food item was reported in only one assessment method, but this was not more frequent or systematically different between the methods. Conclusions: Compared with an interviewer-based 24h dietary recall, the WebQ captures similar food items and estimates similar nutrient intakes for a single day’s dietary intake. The WebQ is self-administered and nutrients are estimated automatically, providing a low-cost method for measuring dietary intake in large-scale studies.

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Development and evaluation of the Oxford WebQ, a low-cost, web-based method for assessment of previous 24 h dietary intakes in large-scale prospective studies.

Changes in nitrate concentration in groundwater from wells in Prince Edward Island, Canada were investigated over time using two datasets. Temporal trends in groundwater nitrate concentrations were assessed annually during 1981–1996 (1,299 observations), and both seasonally and monthly during 1988–1991 (1,868 observations). Data were analysed using linear mixed models with random effects and correlation structures. The average nitrate concentration in the monthly dataset was 3.99 mg/L as NO3–N, with January, May, and November concentrations being higher (p = 0.018). A seasonal effect was present when season was combined with land use type in an interaction term (p = 0.004). Wells located in agricultural areas had greater nitrate concentrations than urban areas, which in turn, had greater values than low human-impact areas. Row-cropped areas had higher groundwater nitrate concentrations in the summer, whereas manure storage areas were higher in the spring and autumn. Nitrate in groundwater in areas with low human impact and with centralized sewage disposal infrastructure remained relatively low and stable throughout the seasons. There was no significant annual trend (p = 0.954), but for individual sites, 9.6% significantly increased in nitrate concentration over time, and 6.6% significantly decreased over time.

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Victoria S. Benson

Papers

Development and evaluation of the Oxford WebQ, a low-cost, web-based method for assessment of previous 24 h dietary intakes in large-scale prospective studies.

Temporal analysis of groundwater nitrate concentrations from wells in Prince Edward Island, Canada: application of a linear mixed effects model