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Use of a triaxial accelerometer to validate reported food intakes^1,2

¹ From the Departments of Human Biology and Methodology and Statistics, Maastricht University, Maastricht, Netherlands.

Background: An easy and cheap method for validating reported energy intake (EI) is needed.

Objective: Reported EI was compared with calculated energy expenditure (EE_calc) and with energy expenditure measured by the doubly labeled water method (EE_DLW).

Design: EE was calculated on the basis of basal metabolic rate (BMR) measured with the ventilated-hood technique and physical activity (PA) measured with a triaxial accelerometer (EE_VH+PA) and on the basis of BMR estimated by using World Health Organization equations and PA (EE_WHO+PA): EE_calc = -1.259 + 1.55 x BMR + 0.076 x counts/min (r² = 0.90, P = 0.0001). Subjects [n = 12 men and 12 women aged 60 ± 3 y; body mass index (in kg/m²): 26 ± 4] reported their food intakes for 7 d and EE_DLW, EE_VH+PA, and EE_WHO+PA were assessed over the same 7 d.

Results: Reported EI (9.0 ± 2.1 MJ/d) was lower (P < 0.0001) than were EE_DLW (11.3 ± 2.3 MJ/d), EE_VH+PA (10.8 ± 1.7 MJ/d), and EE_WHO+PA (10.8 ± 1.8 MJ/d). Underreporting was 19.4 ± 14.0%, 16.7 ± 13.6%, and 16.4 ± 15.5% on the basis of EE_DLW, EE_VH+PA, and EE_WHO+PA, respectively. The difference of 2.7 ± 8.0% between EE_DLW and EE_VH+PA was not related to the average of both percentages and was not significantly different from zero. The percentage of underreporting calculated with EE_WHO+PA was not significantly different from that calculated with EE_DLW.

Conclusions: The use of a combination of BMR (measured or estimated) and PA is a good method for validating reported EI. There was no significant difference between the percentage of underreporting calculated with EE_VH+PA, EE_WHO+PA, or EE_DLW.

Key Words: Energy intake • energy expenditure • triaxial accelerometer • doubly labeled water • basal metabolic rate • physical activity • elderly • underreporting • underrecording

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