Dietary methods research in the third National Health and Nutrition Examination Survey: underreporting of energy intake

Briefel, Ronette; Sempos, Christopher T.; McDowell, Margaret; Chien, Sandy; Alaimo, Katherine

doi:10.1093/ajcn/65.4.1203s

Cited by 447 publications

(377 citation statements)

References 18 publications

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“…While the associations that have been found certainly appear probable, they need to be con®rmed in more representative groups of under-reporters. For example, the present analysis did not ®nd a higher proportion of underreporters among women or older persons, contrary to the ®ndings of some studies that have compared Low Energy Reporters with`others' (Briefel et al, 1997;Fogelholm et al, 1996;Heywood et al, 1993). It remains unclear whether men under-report to a lesser degree than women, or whether they under-report to the same degree but from a higher energy requirement and therefore fewer fall below a single cut-off applied across all subjects.…”

Section: Discussioncontrasting

confidence: 99%

“…This classi®cation of individuals has then been used to explore parameters associated with under-reporting (e.g. Ballard-Barbash et al, 1996;Briefel et al, 1997;Fogelholm et al, 1996;Gnardellis et al, 1998;Haraldsdo Âttir & Sandstro Èm, 1994;Klesges et al, 1995;Ko Èrtzinger et al, 1997;Lafay et al, 1997;Price et al, 1997;Pryer et al, 1997;Rutishauser et al, 1994), or to adjust data prior to analysis (e.g. Flynn et al, 1996;Heitmann et al, 1996;Pryer et al, 1995;Stallone et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

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The sensitivity and specificity of the Goldberg cut-off for EI:BMR for identifying diet reports of poor validity

2000

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Objective: To explore the speci®city and sensitivity of the Goldberg cut-off for EI : BMR for identifying diet reports of poor validity as compared with the direct comparison of energy intake with energy expenditure measured by doubly-labelled water. Design: Twenty-two studies with measurements of total energy expenditure by doubly-labelled water (EE), basal metabolic rate (BMR) and energy intake (EI) provided the database (n 429). The ratio EI : EE provided the baseline de®nition of under-(UR), acceptable-(AR) and over-reporters (OR), respectively EI : EE`0.76, 0.76 ± 1.24 and b 1.24. Four strategies for identifying under-and over-reporters using the Goldberg cut-off were explored. Sensitivity of the cut-off was calculated as the proportion of UR correctly identi®ed and speci®city as the proportion of non-UR correctly identi®ed. Results: UR, AR and OR (by EI : EE) were 34, 62 and 4% respectively of all subjects. When a single Goldberg cut-off for the physical activity level (PAL) of 1.55 was used, for men and women respectively the sensitivity was 0.50 and 0.52 and the speci®city 1.00 and 0.99. Using a cut-off for higher PAL traded speci®city for sensitivity. Using the cut-off for a PAL of 1.95, sensitivity was 0.76 and 0.85 and the speci®city 0.87 and 0.78 for men and women respectively. Using cut-offs for mean age ± sex speci®c PAL did not improve sensitivity. When subjects were assigned to low, medium and high activity levels and cut-offs for three different PALs used, sensitivity improved to 0.74 and 0.67 without loss of speci®city (0.97 and 0.98), for men and women respectively. If activity levels for men were applied to the womens' data, sensitivity improved to 0.72. Conclusion: To identify diet reports of poor validity using the Goldberg cut-off for EI : BMR, information is needed on each subject's activity level.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The sensitivity and specificity of the Goldberg cut-off for EI:BMR for identifying diet reports of poor validity

2000

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“…This procedure, known as the Goldberg cut-off technique, has demonstrated a widespread tendency to underestimation in large national dietary surveys from several countries as well as in many smaller surveys (Heywood et al, 1993;Fogelholm et al, 1996;Briefel et al, 1997;Lafay et al, 1997;Price et al, 1997;Pryer et al, 1997;Rothenberg et al, 1997;Voss et al, 1998). However, this technique was devised to evaluate the overall bias towards under-reporting at the group level.…”

Section: Introductionmentioning

confidence: 99%

An evaluation of the sensitivity and specificity of energy expenditure measured by heart rate and the Goldberg cut-off for energy intake: basal metabolic rate for identifying mis-reporting of energy intake by adults and children: a retrospective analysis

et al. 2003

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Objective: To identify adults and children as under-(UR), acceptable (AR), or over-reporters (OR) of energy intake (EI) using energy expenditure measured by doubly labelled water (DLW) (EE DLW ), and to use this as a reference to determine the sensitivity and specificity of (i) EE measured by heart rate (EE HR ), and (ii) the Goldberg cut-off technique for classifying subjects into the same categories. Design: Retrospective analysis of a dataset comprising concurrent measurements of EE DLW , EE HR , basal metabolic rate (BMR), and EI by weighed record (EI WR ) on 14 adults and 36 children. EI by diet history (EI DH ) was also measured in the children only. EI WR :EE DLW provided the reference definition of subjects as UR, AR or OR. Three strategies for classifying mis-reporters based on EE HR and Goldberg cut-offs were then explored. Sensitivity and specificity were calculated respectively as the proportion of UR and non-UR correctly identified.Results: Approximately 80% of all subjects were AR. For EI WR and EI DH respectively, the sensitivity of EE HR was 0.50 and 1.00, and specificity was 0.98 and 1.00. Although designating subjects as having low, medium or high activity levels (EE HR :BMR meas ) and calculating cut-offs based on appropriate WHO physical activity level PALs did not change sensitivity, specificity dropped to 0.98 (EI WR ) and 0.97 (EI DH ). Cut-offs based on a PAL of 1.55 reduced sensitivity to 0.33 (EI WR ) and 0.00 (EI DH ), but specificity remained unchanged. The sensitivity of all cut-offs based on physical activity level (PALs) for EI WR was 0.50 (adults) and 0.25 (children). Conclusions: If the precision of EE HR was improved, it may be useful for identifying mis-reporters of EI.

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“…In 63 % of groups mean EI was more than 10 % below mean EE and in only one group was it more than 10 % above EE. Comparisons of EI expressed as a multiple of BMR (EI : BMR) with the physical activity level (PAL) for a sedentary lifestyle have confirmed the widespread tendency to underestimation of EI in large national dietary surveys from several countries (Heywood et al 1993;Klesges et al 1995;Ballard-Barbash et al 1996;Fogelholm et al 1996;Briefel et al 1997;Lafay et al 1997;Price et al 1997;Pryer et al 1997;Rothenberg et al 1997;Braam et al 1998;Gnardellis et al 1998;Voss et al 1998) and also many smaller studies. Mean reported EI : BMR values were predominantly in the range of 1⋅2-1⋅5, whereas DLW studies suggest that EE is greater than 1⋅55 × BMR in all age groups except those aged over 75 years .…”

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confidence: 85%

Validation of dietary intakes measured by diet history against24 h urinary nitrogen excretion and energy expenditure measuredby the doubly-labelled water method in middle-aged women

Black¹,

Welch²,

Bingham³

2000

Br J Nutr

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A diet history method for estimating energy and N intakes was validated against 24 h urinary N excretion and energy expenditure measured by the doubly-labelled water (DLW) method. Fortyeight women aged 50-65 years were studied over 1 year. Weighed diet records from 4 d and two 24 h urine collections, for measurement of urinary N excretion, were obtained in each of four seasons. At the end of the year, a diet history was obtained, BMR was measured by whole-body calorimetry, and, in sixteen women, total energy expenditure (EE) was measured by DLW. Energy intake (EI) and N intake (NI) were calculated using food tables. Using weighed records and diet history respectively mean NI were 11⋅21 (SD 2⋅09) g and 11⋅47 (SD 2⋅40) g (NS) and EI were 8⋅08 (SD 1⋅54) MJ and 8⋅20 (SD 1⋅86) MJ (NS). Mean urine N : NI and EI : BMR values indicated bias to under-reporting by weighed record and diet history techniques in some individuals, but there was no significant difference between these measures at the group level. The Pearson correlation coefficient (r) for urine N v. NI was 0⋅81 for the weighed record and 0⋅38 for the diet history. The correlation of EE v. EI was r 0⋅48 for weighed record and r 0⋅11 for diet history. In this study the diet history gave the same estimate of mean intake, but the weighed record appeared to perform better in ranking individuals. Diet history: Diet record: ValidationThe diet history method of assessing dietary intake is favoured for two reasons. First, as a retrospective questionnaire method, it places less burden on subjects than do prospective diet records. Second, it is believed to obtain a better measure of long-term habitual intake than diet records, which, of necessity, record intake on a limited number of days. The debate over the respective merits of the weighed diet record and the diet history is a long one and many studies over several decades have compared their relative validity. On balance the diet history tends to obtain higher mean energy intakes (EI) (see reviews by Bingham, 1987;Black et al. 1991). However, without external validation such studies have been unable to reach a firm conclusion as to which, if either, is valid in absolute terms.A valid dietary assessment should give an estimate of mean intake that is close to the true intake and also be able to rank individuals correctly for intake within acceptable limits of precision. The two requirements do not necessarily go together. For example, a dataset of valid 24 h recalls would give a valid estimate of mean intake but could not rank individuals correctly for habitual intake. A diet record of sufficient length to measure habitual intake might rank individuals correctly but give an invalid estimate of mean intake due to systematic bias across all subjects. If random errors are large and if systematic bias is variable across individuals, then ranking will also be poor. Studies of relative validity indicate whether one method gives a higher intake than another, and comparison with expected energy requirements can help determine ...

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Dietary methods research in the third National Health and Nutrition Examination Survey: underreporting of energy intake

Cited by 447 publications

References 18 publications

The sensitivity and specificity of the Goldberg cut-off for EI:BMR for identifying diet reports of poor validity

The sensitivity and specificity of the Goldberg cut-off for EI:BMR for identifying diet reports of poor validity

An evaluation of the sensitivity and specificity of energy expenditure measured by heart rate and the Goldberg cut-off for energy intake: basal metabolic rate for identifying mis-reporting of energy intake by adults and children: a retrospective analysis

Validation of dietary intakes measured by diet history against24 h urinary nitrogen excretion and energy expenditure measuredby the doubly-labelled water method in middle-aged women

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