Accuracy of reporting food energy intake: influence of ethnicity and body weight status in South African women (original) (raw)
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American Journal of Clinical Nutrition
Desire for weight change and level of dietary consciousness may severely bias reported food intake in dietary surveys. We evaluated to what degree under-and overreporting of energy intake (EI) was related to lifestyle, sociodemographic variables, and attitudes about body weight and diet in a nationwide dietary survey. Data were gathered by a self-administered quantitative food-frequency questionnaire distributed to a representative sample of men and women aged 16-79 y in Norway, of whom 3144 subjects (63%) responded. Reported EI was related to estimated basal metabolic rate (BMR) based on self-reported body weight, age, and sex. An EI:BMR < 1.35 was considered to represent underreporting and an EI:BMR ≥ 2.4 as overreporting of EI. Fewer men than women underreported EI (38% compared with 45%). The fraction of overreporters did not differ significantly between sexes (7% of the men compared with 5% of the women). A large proportion of underreporters was obese (9%) and wanted to reduce their weight (41%). Few overreporters were obese and 12% wanted to increase their weight. Underreporters consumed fewer foods rich in fat and sugar than did the other subjects. Multiple regression analysis showed that desire for weight change and physical activity score were significantly correlated with both EI and EI:BMR when adjusted for sociodemographic and lifestyle variables. Our findings indicated that attitudes about one's own body weight influenced reported EI. These attitudes are important in the interpretation of dietary data because many of the subjects (> 30%) wanted to change their body weight. Am J Clin Nutr 1998;68:266-74.
Cadernos de Saúde Pública, 2015
The purpose of the present study was to identify energy intake (EI) underreporting and to estimate the impact of using a population specific equation for the basal metabolic rate (BMR) in a probability sample of adults from Niterói, Rio de Janeiro State, Brazil. A sample of 1,726 subjects participated in the study. EI was assessed by a 24-hour dietary recall and EI/BMR was computed with BMR estimated using internationally recommended equations as well as specific equations developed for the adult population of Niterói. Mean EI was 1,570.9 and 2,188.8kcal.day-1 for women and men, respectively. EI decreased with increasing age in both men and women. BMR estimated by the Brazilian equation was significantly lower than the values estimated by the international equation for all age, sex and nutritional status groups. In general, EI underreporting was found in at least 50% of the population, higher in women, and increased with increasing age and body mass index (BMI). The results of the p...
Total daily energy expenditure in black and white, lean and obese South African women
European Journal of Clinical Nutrition, 2009
Background/Objectives: In South Africa (SA), the prevalence of obesity in women is 56%, with black women being most at risk (62%). Studies in the United States have demonstrated ethnic differences in resting (REE) and total daily energy expenditure (TDEE) between African American (AA) and their white counterparts. We investigated whether differences in EE exist in black and white SA women, explaining, in part, the ethnic obesity prevalence differences. Subjects/Methods: We measured REE, TDEE and physical activity EE (PAEE) in lean (BMI o25 kg m À2 ) and obese (BMI 430 kg m À2 ) SA women (N ¼ 44, 30±6 year). REE, TDEE, PAEE and total awake EE were measured during a 21 h stay in a respiration chamber. Results: Black and white subjects within obese and lean groups were not significantly different for age, mass, BMI and % body fat. However, fat-free mass (kg FFM) was consistently lower in the black women (Po0.01) in both weight groups. After adjusting EE measurements for differences in FFM, REE was not significantly different for either body weight or ethnicity, although 24 h TDEE (kJ) was significantly greater in the obese women (Po0.01) and white women (Po0.05). Total awake non-PAEE was not significantly different for either groups, while total awake time was only significantly lower for the lean groups (Po0.01). Total PAEE (kJ min À1 ) was significantly lower in the lean (Po0.001) and black groups (Po0.01).
2008
Objective Underreporting of energy intake is prevalent in food surveys, but there is controversy about which dietary assessment method provides greater underreporting rates. Our objective is to compare validity of self-reported energy intake obtained by three dietary assessment methods with total energy expenditure (TEE) obtained by doubly labeled water (DLW) among Brazilian women. Design We used a cross-sectional study. Subjects/setting Sixty-five females aged 18 to 57 years (28 normal-weight, 10 overweight, and 27 obese) were recruited from two universities to participate. Main outcome measures TEE determined by DLW, energy intake estimated by three 24-hour recalls, 3-day food record, and a food frequency questionnaire (FFQ). Statistical analyses performed Regression and analysis of variance with repeated measures compared TEE and energy intake values, and energy intake-to-TEE ratios and energy intakeϪTEE values between dietary assessment methods. Bland and Altman plots were provided for each method. 2 test compared proportion of underreporters between the methods. Results Mean TEE was 2,622 kcal (standard deviation [SD]ϭ490 kcal), while mean energy intake was 2,078 kcal (SDϭ430 kcal) for the diet recalls; 2,044 kcal (SDϭ479 kcal) for the food record and 1,984 kcal (SDϭ832 kcal) for the FFQ (all energy intake values significantly differed from TEE; PϽ0.0001). Bland and Altman plots indicated great dispersion, negative mean differences between measurements, and wide limits of agreement. Obese subjects underreported more than normal-weight subjects in the diet recalls and in the food records, but not in the FFQ. Years of education, income and ethnicity were associated with reporting accuracy. Conclusions The FFQ produced greater under-and overestimation of energy intake. Underreporting of energy intake is a serious and prevalent error in dietary selfreports provided by Brazilian women, as has been described in studies conducted in developed countries.
British Journal of Nutrition, 2019
Low-income women are the group with the highest levels of obesity worldwide. In low-income settings, the use of predictive equations, which yield a measure of the individuals’ BMR, is a feasible approach to estimate the individuals’ total energy expenditure (TEE), using the factorial method (calculated-TEE = BMR × physical activity level), an important step of the obesity nutritional care. The present study aimed to identify the predictive equation that, in conjunction with metabolic equivalents of tasks (MET) data from accelerometers, yields the calculated-TEE with better agreement compared with the TEE measured by doubly labelled water (TEE-DLW). Forty-five women aged 19–45 years, with excess weight and mothers of undernourished children, were included. They received DLW to determine TEE (14 d); at the same time, they used triaxial accelerometers (7 d) to estimate their MET. The Bland–Altman method, paired-sample t tests, concordance correlation coefficient and root-mean-square error were used to assess the agreement. Maximum allowed differences were defined as 24 %, based on the within-variance coefficient of the energy intake of the sample. Eleven equations were studied. The calculated-TEE obtained by five equations showed non-significant bias: Dietary Reference Intake (Institute of Medicine (2005) Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids), FAO/WHO/UNU ((2001) Food and Nutrition Technical Report Series), Harris & Benedict ((1919) Proc Natl Acad Sci USA4, 370–373), Henry & Rees ((1991) Eur J Clin Nutr45, 177–185) and Schofield ((1985) Hum Nutr Clin Nutr39, 5–41). The mean percentage differences were –1·5, –0·8, 2·2, –2·2 and 2·0 %, respectively. Considering all parameters, FAO/WHO/UNU ((2001) Food and Nutrition Technical Report Series) equation performed slightly better than the others; nevertheless, no equation in conjunction with the estimated-MET showed a calculated-TEE with its CI for the Bland–Altman limits of agreement inside the pre-defined acceptable range.
An estimation of periconceptional under-reporting of dietary energy intake
Journal of public health (Oxford, England), 2014
The purpose of this cross-sectional study was to examine periconceptional misreporting of energy intake (EI) using the Willet food frequency questionnaire (WFFQ). Women were recruited in the first trimester. Women completed a semi-quantitative WFFQ. Maternal body composition was measured using eight-electrode bioelectrical impedance analysis. Under-reporters were those whose ratio of EI to their calculated basal metabolic rate fell below the calculated plausible threshold for their physical activity category. The mean age was 30.1 ± 5.3 years (n = 524). The mean body mass index (BMI) was 25.4 ± 5.6 kg/m(2), and 16.6% were obese (BMI ≥ 30.0 kg/m(2)). Under-reported EI was observed in 122 women (23.3%) with no over-reporters in the sample. Under-reporters were younger (P < 0.001), less likely to have a normal BMI (P = 0.002) and more likely to be obese (P < 0.001) than plausible reporters. Under-reporters had higher percentage of body-fat and lower percentage of body fat-free ma...
Energy requirements in nonobese men and women: results from CALERIE
American Journal of Clinical Nutrition, 2014
Background: The energy intake necessary to maintain weight and body composition is called the energy requirement for weight maintenance and can be determined by using the doubly labeled water (DLW) method. Objective: The objective was to determine the energy requirements of nonobese men and women in the Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy 2 study. Design: Energy requirements were determined for 217 healthy, weight-stable men and women [aged .21 to ,50 y; 70% female, 77% white; body mass index (BMI; in kg/m 2 ) 22 to ,28; 52% overweight] over 28 d with 2 consecutive 14-d DLW assessments in addition to serial measures of body weight and fat-free mass and fat mass by dual-energy X-ray absorptiometry. Energy intake and physical activity were also estimated by self-report over $6 consecutive d in each DLW period. Results: Total daily energy expenditure (TDEE) was consistent between the 2 DLW studies (TDEE1: 2422 6 404 kcal/d; TDEE2: 2465 6 408 kcal/d; intraclass correlation coefficient = 0.90) with a mean TDEE of 2443 6 397 kcal/d that was, on average, 20% (580 kcal/d) higher in men than in women (P , 0.0001). The regression equation relating mean TDEE to demographics and weight was as follows: TDEE (kcal/d) = 1279 + 18.3 (weight, kg) + 2.3 (age, y) 2 338 (sex: 1 = female, 0 = male); R 2 = 0.57. When body composition was included, TDEE (kcal/d) = 454 + 38.7 (fat-free mass, kg) 2 5.4 (fat mass, kg) + 4.7 (age in y) + 103 (sex: 1 = female, 0 = male); R 2 = 0.65. Individuals significantly underreported energy intake (350 kcal/d; 15%), and underreporting by overweight individuals (w400 kcal/d; 16%) was greater (P , 0.001) than that of normal-weight individuals (w270 kcal/d; 12%). Estimates of TDEE from a 7-d physical activity recall and measured resting metabolic rate also suggested that individuals significantly underreported physical activity (w400 kcal/d; 17%; P , 0.0001). Conclusion: These new equations derived over 1 mo during weight stability can be used to estimate the free-living caloric requirements of nonobese adults. This trial was registered at clinicaltrials.gov as NCT00427193.
European Journal of Clinical Nutrition, 2001
Objective: To compare self-reported total energy intake (TEI) estimated using two databases with total energy expenditure (TEE) measured by doubly labeled water in physically active lean and sedentary obese young women, and to compare reporting accuracy between the two subject groups. Design: A cross-sectional study in which dietary intakes of women trained in diet-recording procedures were analyzed using the Minnesota Nutrition Data System (NDS; versions 2.4=6A=21, 2.6=6A=23 and 2.6=8.A=23) and Nutritionist III (N3; version 7.0) software. Reporting accuracy was determined by comparison of average TEI assessed by an 8 day estimated diet record with average TEE for the same period. Results: Reported TEI differed from TEE for both groups irrespective of nutrient database (P < 0.01). Measured TEE was 11.10 AE 2.54 and 11.96 AE 1.21 MJ for lean and obese subjects, respectively. Reported TEI, using either database, did not differ between groups. For lean women, TEI calculated by NDS was 7.66 AE 1.73 MJ and by N3 was 8.44 AE 1.59 MJ. Corresponding TEI for obese women were 7.46 AE 2.17 MJ from NDS and 7.34 AE 2.27 MJ from N3. Lean women under-reported by 23% (N3) and 30% (NDS), and obese women under-reported by 39% (N3) and 38% (NDS). Regardless of database, lean women reported higher carbohydrate intakes, and obese women reported higher total fat and individual fatty acid intakes. Higher energy intakes from mono-and polyunsaturated fatty acids were estimated by NDS than by N3 in both groups of women (P 0.05). Conclusions: Both physically active lean and sedentary obese women under-reported TEI regardless of database, although the magnitude of under-reporting may be influenced by the database for the lean women.
Selective underreporting of energy intake in women: Magnitude, determinants, and effect of training
Objective The aim of this study was to quantify underreporting of energy intake in Brazilian women; identify underreporting determinants; find out if underreporting was selective and; test if a motivational multimethod training, in combination with providing the subjects some results from the prior recording period, was able to reduce underreporting. Design Energy intake (EI) was assessed by a 7-day diet record. Energy expenditure (EE) was calculated by heart rate monitoring. EI:EE ratio lower than one in subjects who did not lose weight in one month was considered underreporting. Underreporting was correlated with anthropometric, behavioral, and psychological parameters. Food and nutrient consumption was compared between underreporters and non-underreporters. A focus group investigated the main causes of underreporting. Subjects were told that the earlier food records' results were unrealistic and submitted to a motivational training. Then, they were reevaluated for underreporting. Subjects Subjects were recruited by advertisements for a physical activity program. Thirty-eight healthy women, 13 normal-weight (34%), 13 overweight (34%), and 12 obese (32%), enrolled in the study. Three subjects (2 normalweight and 1 obese) (8%) withdrew. Statistical analyses performed Analysis of variance, paired t tests, and simple linear regression. Results Seventeen women (49%) underreported their EI by 21%. A significant negative correlation was found between social desirability and EI:EE. Undereating, errors in portion sizes estimation and the inconvenience of having to record everything that was eaten seemed to explain underreporting. Mean portion sizes did not differ for underreporters and nonunderreporters. Fewer self-reported years of education was correlated with underreporting only among normal-weight women. Training and confrontation with earlier results reduced underreporting rate to 33%, but did not affect macronutrient densities. Applications/conclusions Subjects tended to report their intake in a socially desirable way, by eating or reporting less frequently foods considered unhealthful or fattening, like sweets and fried foods. Inclusion of social desirability score as a covariate in studies that rely on self-reports of food intake may be useful. A motivational training program, developed in such a way that subjects are comfortable reporting intake of foods considered socially undesirable, in combination with confrontation with earlier results of dietary assessment and use of portion size measurement aids, can be used to attenuate underreporting.