Underreporting of energy intake in four populations of African origin.
OBJECTIVE
To investigate the frequency of dietary underreporting in four African populations in different geographic and cultural settings.


METHODS
Seven-hundred and forty three men and women from rural Cameroon, 1042 men and women from urban Cameroon, 857 men and women from Jamaica and 243 male and female African Caribbeans from the UK. Subjects who reported dieting or weight control were excluded.


METHODS
Habitual dietary intake was estimated with a quantitative food frequency questionnaire, developed specifically for each country. Underreporting was defined using three cut-off levels for energy intake/estimated basic metabolic rate (EI/BMRest), based on age, sex and weight, in each site.


RESULTS
The EI/BMRest was highest in rural Cameroonian men at 3.07 (95% confidence interval: 2.97, 3.17) and women at 2.84 (2.74, 2.94), intermediate in urban Cameroon and Jamaica and lowest in the UK men and women at 1.44 (1.26, 1.62) and 1.41 (1.21, 1.61). This trend existed even after adjustment for age, BMI and education (P for trend<0.0001). The trend in the frequency of underreporting using the lowest cut-off level for EI/BMRest of 1.15 was 6% and 6% in rural Cameroon for women and men, respectively, 4% and 5% in urban Cameroon, 24% and 19% in Jamaica and 28% and 39% in the UK. With higher cut off levels this trend was similar.


CONCLUSIONS
The results suggest that the frequency of dietary underreporting differs between societies and that Westernization may be one of the factors underlying this phenomenon.
INSERM, Unit 258, Université Paris-Sud, Villejuif, France.
L I
LI
Mennen
M
M
Jackson
J
J
Cade
J C
JC
Mbanya
L
L
Lafay
S
S
Sharma
S
S
Walker
S
S
Chungong
R
R
Wilks
B
B
Balkau
T
T
Forrester
J K
JK
Cruickshank
D000328:Adult; D000349:Africa / Q000208:ethnology; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D000368:Aged; D001481:Basal Metabolism; D044383:Black People; D015992:Body Mass Index; D002163:Cameroon / Q000453:epidemiology; D017691:Caribbean Region / Q000208:ethnology; D003431:Cross-Cultural Comparison; D004522:Educational Status; D002149:Energy Intake; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D007563:Jamaica / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012424:Rural Population; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D014505:Urban Population