Markers of the Validity of Reported Energy Intake

Abstract

Energy intake (EI) is the foundation of the diet, because all other nutrients must be provided within the quantity of food needed to fulfill the energy requirement. Thus if total EI is underestimated, it is probable that the intakes of other nutrients are also underestimated. Under conditions of weight stability, EI equals energy expenditure (EE). Because at the group level weight may be regarded as stable in the timescale of a dietary assessment, the validity of reported EI can be evaluated by comparing it with either measured EE or an estimate of the energy requirement of the population. This paper provides the first comprehensive review of studies in which EI was reported and EE was measured using the doubly labeled water technique. These conclusively demonstrate widespread bias to the underestimation of EI. Because energy requirements of populations or individuals can be conveniently expressed as multiples of the basal metabolic rate (BMR), EE:BMR, reported EI may also be expressed as EI:BMR for comparison. Values of EI:BMR falling below the 95% confidence limit of agreement between these two measures signify the presence of underreporting. A formula for calculating the lower 95% confidence limit was proposed by Goldberg et al. (the Goldberg cutoff). It has been used by numerous authors to identify individual underreporters in different dietary databases to explore the variables associated with underreporting. These studies are also comprehensively reviewed. They explore the characteristics of underreporters and the biases in estimating nutrient intake and in describing meal patterns associated with underreporting. This review also examines some of the problems for the interpretation of data introduced by underreporting and particularly by variable underreporting across subjects. Future directions for research are identified.

Eating patterns and dietary composition in relation to BMI in younger and older adults

“…Some reasons that our findings conflict with those of previous studies are that we took into account all eating occasions at one time in our statistical models, and we excluded subjects with physiologically implausible reports of energy intake from our analysis. 22 It has been demonstrated unequivocally that overweight and obese subjects are more likely to provide physiologically implausible reports of energy intake than normal weight subjects, 23,24,41,65,66 typically under-reporting energy intake by 30-50%. Older persons may also under-report energy intake.…”

Monetary costs of dietary energy reported by young Japanese women: association with food and nutrient intake and body mass index

“…To minimise the influence of dietary underreporting, we used energy-adjusted values. Studies have consistently shown that underreporting is more prevalent among people with higher BMI 30,31 , and that energydense, nutrient-dilute and low-cost foods such as fat and oils, sugar and confectioneries are more likely to be selectively underreported 30,32 . However, as mentioned above, exclusion of energy underreporters identified by the Goldberg cut-off method 21,23 did not change the results materially, which may support the robustness of the findings in the present study.…”

Validation of self-reported energy intake by a self-administered diet history questionnaire using the doubly labeled water method in 140 Japanese adults

“…Dietary assessment questionnaires have been developed for assessing habitual dietary intake and for ranking subjects according to their dietary intake. However, they cannot entirely avoid reporting errors (Barrett-Connor, 1991), including not only random but also systematic errors (Black and Cole, 2001;Livingstone and Black, 2003), due to the fact that they are self-reported.…”