Known factors associated with under-reporting energy intake (EI) include anthropometry, energy expenditure, psychological factors, smoking, and gender. There is insufficient information on the association between chronic disease status and under-reporting EI. Using NHANES III data from non-pregnant adults aged 20 years, reported EI was estimated from a single 24-hour dietary recall and compared with estimated basal metabolic rate (BMR est ) among 1503 diabetics and 17,010 non-diabetics. Multiple linear regression and logistic regression were performed to compare underreporting between diabetics and non-diabetics, and if it was associated with a hemoglobin A1c within diabetics.Using EI:BMR est < 0.9, male and female diabetics were 2.1 and 3.4 times as likely to under report EI compared to nondiabetics after controlling for weight, age, education, usual intake level, physical activity, tobacco and alcohol use. This greater under-reporting by diabetics could bias the association between diet and disease toward the null in epidemiological studies.Data examining the relationship between under-reporting EI and diabetic status are limited. One small study found under-reporting more prevalent among young type 1 diabetics [18]. No large studies have examined if an association between diabetic status and under-reporting exists.The current research was conducted using data from NHANES III to examine if an association between self-
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