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This Article Full Text (Publish Ahead of Print[PDF]) Supplemental data All Versions of this Article: 89/6/1744    most recent ajcn.2008.26752v1 Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Singh, R. Articles by Weaver, C. M Search for Related Content PubMed PubMed Citation Articles by Singh, R. Articles by Weaver, C. M Agricola Articles by Singh, R. Articles by Weaver, C. M

Comparison of self-reported, measured, metabolizable energy intake with total energy expenditure in overweight teens^1,2,3

¹ From the Departments of Foods and Nutrition (RS, BRM, YH, DT, WWC, and CMW) and Statistics (BAC), Purdue University, West Lafayette, IN; the Department of Nutritional Science, University of Wisconsin, Madison, WI (DAS); and the School of Public Health, Curtin University of Technology, Perth, Australia (DAK).

² Supported by the National Institutes of Health (grant no. 1 R 01 DK 066108). The doubly labeled water measurements were supported by the National Dairy Council.

³ Address reprint requests and correspondence to CM Weaver, Purdue University, Foods and Nutrition, 700 West State Street, West Lafayette, IN 47907-2059. E-mail: weavercm{at}purdue.edu.

ABSTRACT

Background: The accuracy of dietary energy assessment tools is critical to understanding the role of diet in the increasing rate of obesity.

Objectives: The purposes of our study in overweight adolescent boys and girls were 1) to assess the energy reporting bias of diet records against the referent of total energy expenditure (TEE) and 2) to compare the methods of determining energy needs by using measured metabolizable energy intake (MEI) and TEE.

Design: Twenty girls [12–15 y, body mass index (in kg/m²) = 33.0 ± 5] and 14 boys (12–14 y, body mass index = 27.4 ± 4) participated in 2- to 3-wk metabolic balance studies. TEE was measured by using doubly labeled water (TEE_DLW), and MEI was measured by bomb calorimetry of composite daily diet, urine, and fecal collections. Food records were collected before each study.

Results: Food records underreported TEE_DLW by 35 ± 20%. Underreporting of energy intake was correlated with all macronutrient intake concentrations (g or kcal) (P < 0.0001). A multiple regression model showed that 86.4% of the variance in underreporting error was explained by dietary fat (g), BMI, and sex. The intrasubject CV was 3.9% for TEE_DLW and 9.9% for MEI. MEI for weight stability (MEI_wtstb) averaged 99 ± 11% of TEE.

Conclusions: The increased underreporting of dietary intake with increasing body weight in teens may explain in part previous reports noting that there has been an increased incidence of obesity, although energy intakes have not appeared to increase. MEI_wtstb and TEE_DLW gave similar estimates of energy needs. This trial was registered at clinicaltrials.gov as NCT 00592137.

Received for publication July 25, 2008. Accepted for publication March 9, 2009.