Short- and long-term reliability of adult recall of vegetarian dietary patterns in the Adventist Health Study-2 (AHS-2)

Past dietary patterns may be more important than recent dietary patterns in the aetiology of chronic diseases because of the long latency in their development. We developed an instrument to recall vegetarian dietary patterns during the lifetime and examined its reliability of recall over 5·3 and 32·6 years on average. The short-term/5-year recall ability study (5-RAS) was done using 24 690 participants from the cohort of the Adventist Health Study-2 (mean age 62·2 years). The long-term/33-year recall ability study (33-RAS) included an overlap population of 1721 individuals who joined the Adventist Health Study-1 and Adventist Health Study-2 (mean age 72·5 years). Spearman correlation coefficients for recall of vegetarian status were 0·78 and 0·72 for the 5-RAS and 33-RAS, respectively, when compared with 'reference' data. For both time periods sensitivity and positive predictive values were highest for the lacto-ovo-vegetarian and non-vegetarian patterns (vegans, lacto-ovo-vegetarians, pesco-vegetarians, semi-vegetarians and non-vegetarians). In the 5-RAS analyses, male, non-black, younger, and more educated participants, lifetime Adventists, and those with more stability of consumption of animal products generally showed higher recall ability. Somewhat similar tendencies were shown for the 33-RAS analyses. Our findings show that the instrument has higher reliability for recalled lacto-ovo-vegetarian and non-vegetarian than for vegan, semi- and pesco-vegetarian dietary patterns in both short- and long-term recalls. This is in part because these last dietary patterns were greatly contaminated by recalls that correctly would have belonged in the adjoining category that consumed more animal products.