Underreporting of energy intake in Brazilian women varies according to dietary assessment: a cross-sectional study using doubly labeled water (original) (raw)

Characterizing energy intake misreporting and its effects on intake estimations, in the Portuguese adult population

Public Health Nutrition

Objective:The aim of the current study was to evaluate energy intake misreporting prevalence, its associated factors and its effects on nutrient intake, in the Portuguese population aged from 18 to 84 years.Design:Cross-sectional study.Setting:Portugal.Subjects:Adults participants from the National Food, Nutrition and Physical Activity Survey, IAN-AF, 2015–2016, who provided two complete 24 h dietary recall and complete covariate information.Results:Under, plausible and over-reporters were identified according to the Goldberg method. Total misreporting prevalence was 29·9 %, being 28·5 % of under-reporting and 1·4 % of over-reporting. The current study found higher odds of being classified as an under-reporter especially in participants with higher BMI and in those who self-reported health perception status as non-favourable. Energy intake estimation increases by 853.5 kJ/d (204 kcal/d) when misreporters are excluded, and the same tendency is observed for macro and micronutrients. I...

Participant characteristics associated with errors in self-reported energy intake from the Women's Health Initiative food-frequency questionnaire

The American Journal of Clinical Nutrition, 2002

Background: Errors in self-reported dietary intake threaten inferences from studies relying on instruments such as food-frequency questionnaires (FFQs), food records, and food recalls. Objective: The objective was to quantify the magnitude, direction, and predictors of errors associated with energy intakes estimated from the Women's Health Initiative FFQ. Design: Postmenopausal women (n = 102) provided data on sociodemographic and psychosocial characteristics that relate to errors in self-reported energy intake. Energy intake was objectively estimated as total energy expenditure, physical activity expenditure, and the thermic effect of food (10% addition to other components of total energy expenditure). Results: Participants underreported energy intake on the FFQ by 20.8%; this error trended upward with younger age (P = 0.07) and social desirability (P = 0.09) but was not associated with body mass index (P = 0.95). The correlation coefficient between reported energy intake and total energy expenditure was 0.24; correlations were higher among women with less education, higher body mass index, and greater fat-free mass, social desirability, and dissatisfaction with perceived body size (all P < 0.10). Conclusions: Energy intake is generally underreported, and both the magnitude of the error and the association of the self-reporting with objectively estimated intake appear to vary by participant characteristics. Studies relying on self-reported intake should include objective measures of energy expenditure in a subset of participants to identify person-specific bias within the study population for the dietary self-reporting tool; these data should be used to calibrate the self-reported data as an integral aspect of diet and disease association studies.

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...

Johansson L, Solvoll K, Gunn-Elin AB, Drevon CA. Under- and overreporting of energy intake related to weight status and lifestyle in a nationwide sample. Am J Clin Nutr 68, 266-274

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.

Validity of energy intake reports in relation to dietary patterns

Journal of Health, Population and Nutrition, 2014

The role of under- and overreporting of energy intake in determining the dietary patterns is yet unclear, especially in the Middle Eastern countries. This study identifies the prevalence of misreporting among Tehranian women aged 18-45 years and to compare the dietary intake patterns of plausible and all energy reporters. Dietary intakes and anthropometric data were collected. FitMate metabolic analyzer and Goldberg equation were used in determining the under/overreporting of energy intake. Underreporters were more likely to be overweight and older compared to plausible reporters. Three dietary patterns emerged for all reporters, and two were identified for plausible reporters. Using only plausible reporters to determine dietary patterns was not similar to using all reporters. The proportion of underreporters was 59.3% in the mixture cluster, 30.4% in the unhealthy cluster, and 35.3% in the healthy cluster (p < 0.05). Underreporting of energy intake is not uniformly distributed a...

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.

Under-reporting of energy intake affects estimates of nutrient intakes

Asia Pacific journal of clinical nutrition, 2006

Under-reporting of energy intake is a common problem in nutritional epidemiological studies. The aim of the present study was to determine the effect of under-reporting of energy intake on the estimates of nutrient intakes. In this cross-sectional study, 901 subjects aged >16 y were randomly selected from participants of the Tehran Lipid and Glucose Study. Dietary intake was assessed by means of two 24-hour dietary recalls. Basal metabolic rate (BMR) was determined according to age, sex and weight. The ratio of energy intake (EI) to BMR was calculated. Under-reporting of energy intake was defined as EI:BMR< 1.35 and normal-reporting of dietary intake as EI:BMR = 1.35-2.39. To obtain energy-adjusted amounts of macro- and micronutrients, the residual method was used. Under-reporting of energy intake was revealed in 31% of the subjects and was more common among females (40%) than males (19%, P <0.01). The mean age of females who under-reported was significantly lower than the ...

Sociodemographic, lifestyle, mental health and dietary factors associated with direction of misreporting of energy intake

2011

Objective: To estimate the extent of under-and over-reporting, to examine associations with misreporting and sociodemographic and lifestyle characteristics and mental health status and to identify differential reporting in micro-and macronutrient intake and quality of diet. Design: A health and lifestyle questionnaire and a semi-quantitative FFQ were completed as part of the 2007 Survey of Lifestyle, Attitudes and Nutrition. Energy intake (EI) and intake of micro-and macronutrients were determined by applying locally adapted conversion software. A dietary score was constructed to identify healthier diets. Accuracy of reported EI was estimated using the Goldberg method. ANOVA, x 2 tests and logistic regression were used to examine associations. Setting: Residential households in Ireland. Subjects: A nationally representative sample of 7521 adults aged 18 years or older. Results: Overall, 33?2 % of participants were under-reporters while 11?9 % were over-reporters. After adjustment, there was an increased odds of under-reporting among obese men (OR 5 2?01, 95 % CI 1?46, 2?77) and women (OR 5 1?68, 95 % CI 1?23, 2?30) compared to participants with a healthy BMI. Older age, low socioeconomic status and overweight/obesity reduced the odds of over-reporting. Among under-reporters, the percentage of EI from fat was lower and overall diet was healthier compared to accurate and over-reporters. The reported usage of salt, fried food consumption and snacking varied significantly by levels of misreporting. Conclusions: Patterns in differential reporting were evident across sociodemographic, lifestyle and mental health factors and diet quality. Consideration should be given to how misreporting affects nutrient analysis to ensure sound nutritional policy.

Validity of self-reported energy intake in lean and obese young women, using two nutrient databases, compared with total energy expenditure assessed by doubly labeled water

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.

Misreporting of Energy Intake in Older People: Comparison of Two Dietary Assessment Methods

Journal of Nutrition in Gerontology and Geriatrics, 2018

Accurate assessment of dietary intake is essential in clinical practice and research. While energy intake (EI) misreporting has been extensively studied in the general population, relatively little is known about misreporting among older people. This cross-sectional study used clinical data routinely collected in 127 participants, aged 70-96 years, from the Toulouse Frailty Clinic. EI was assessed by diet history interview and three-day food record. Misreporters were identified with the Goldberg cutoff method, using the Harris-Benedict equation to estimate total energy expenditure. The response rate was 66% for three-day food record and 93% for diet history interviews. EI from diet history interviews (1799 ± 416 kcal/day) was significantly higher than from food records (1400 ± 381 kcal/ day; p < 0.001) and closest to total energy expenditure (1758 ± 437 kcal/day; (p > 0.05). Thirty percent of participants were identified as underreporters with three-day food records vs. 9% with diet history interviews. Overreporters were found with diet history interviews only (11% of participants). In older people, the diet history interview has the advantage of obtaining a higher response rate and a lower underreporting rate, compared to three-day food record. Nevertheless, with this method, overreporting was observed and interpreting results should be done with caution.