Concurrent comparison of energy intake and expenditure among adults in Butajira District, Ethiopia

Abstract

Objective: To estimate and compare dietary energy intake (DEI) and total energy expenditure (TEE) among adults, using questionnaires. Design: Comparative, cross-sectional study. Setting: Community-based, at the demographic surveillance site (DSS) in Butajira District of Ethiopia. Subjects: A total of 619 adults, 18-64 years of age, were randomly selected from among the urban and rural population of Butajira using the DSS sampling frame. Habitual dietary intake and physical activity were assessed using questionnaires. BMR was estimated using a regression equation, and TEE was calculated from BMR and the metabolic energy equivalent task (MET) and duration of reported activities. Physical activity level (PAL) was calculated as TEE/BMR, while food intake level (FIL) was calculated as DEI/BMR. The mean DEI:TEE ratio was used to evaluate reported DEI at the population level, while individual misreporters were identified by applying the Goldberg cut-off points at three levels of PAL. Results: Based on the Goldberg method, 57 % of the study participants were identified as acceptable reporters of DEI, among whom mean TEE was 8?21 (95 % CI 8?01, 8?42) MJ (1963 (95 % CI 1914, 2012) kcal), mean DEI was 8?13 (95 % CI 7?93, 8?34) MJ (1944 (95 % CI 1895) kcal) and mean DEI:TEE was 1?01 (95 % CI 0?99, 1?04). Conclusion:The dietary history and physical activity questionnaires provide comparable estimates of mean energy intake and expenditure at a population level. Acceptable reporters have to be identified in order to obtain better estimates. Questionnaire-based estimates of energy intake should not be interpreted without an inherent system of comparison or validation. Keywords Dietary energy intake Total energy expenditurePhysical activity level ButajiraPoor diet and physical inactivity are widely prevalent risk factors of chronic diseases such as CVD and diabetes (1) . However, accurate and reliable measurement of dietary intake and physical activity at the population level is challenging, particularly in developing countries (2,3) . Various techniques, employing questionnaires, records or objective measurements, have been applied for the assessment of dietary intake and physical activity. However, only a few, such as the doubly labelled water (DLW) method (4) , have proved sufficiently precise and unbiased for the estimation of energy expenditure and for the validation of dietary energy intake (DEI) (5,6) . Although the DLW method provides an accurate estimation of the mean DEI and physical activity level (PAL), its use in large epidemiological surveys is limited owing to scarcity of the stable isotope and its inhibitory cost (7) .Dietary intake is reported inaccurately, most often under-reported (8) . The DLW method has been used to measure energy expenditure and validate energy intake calculated from food records, diet recalls or diet histories in several studies (9)(10)(11)(12) , thereby revealing a substantial bias towards underestimation of reported energy intake. Under-reporting of energy expenditure is said t...

Nutritional status and dietary intake of urban residents in Gondar, Northwest Ethiopia

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The Usefulness of an Accelerometer for Monitoring Total Energy Expenditure and Its Clinical Application for Predicting Body Weight Changes in Type 2 Diabetic Korean Women

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A frequency questionnaire to estimate free-living physical activity among Tunisian preadolescent and adolescent children

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