title: Influence of body composition on the accuracy of reported energy intake in children.
abstract: OBJECTIVE
  Mis-reporting dietary intake is a substantial barrier to understanding the role of dietary behavior in disease. Work with adults indicates that heavier individuals under-report dietary intake and that under-reporting may be macronutrient-specific. Whether weight status and macronutrient intake influence the accuracy of dietary reports among children, however, is less clear. This research evaluated children's dietary reporting accuracy as a function of their relative weight, body composition, and macronutrient intake.
  
  
  METHODS
  Participants included 146 4- to 11-year-old children. Reported energy intake was determined by interviewing children in the presence of parents, using three multiple pass, 24-hour recalls. Children were classified as having had an under-reported, accurately reported, or over-reported dietary intake relative to total energy expenditure, as measured by doubly labeled water. Reporting accuracy was examined as a function of children's body weight, body composition (using dual energy x-ray absorptiometry), and macronutrient intake.
  
  
  RESULTS
  Average reported intake was, on average, 14% greater than children's estimated expenditure (p < 0.01). Reporting accuracy varied as a function of children's relative weight and body composition; under-reporting tended to occur among heavier children, having the highest body fat content (p < 0.0001) and relative weight (p < 0.0001).
  
  
  CONCLUSIONS
  These findings suggest that weight status influences the accuracy of dietary reports made by children and their parents. More research is needed to address possible psychological and social factors that introduce bias in reporting children's dietary data.
authors.affiliation: Department of Human Development and Family Studies, Pennsylvania State University, University Park, USA.
authors.forename: J O
authors.initials: JO
authors.lastname: Fisher
authors.forename: R K
authors.initials: RK
authors.lastname: Johnson
authors.forename: C
authors.initials: C
authors.lastname: Lindquist
authors.forename: L L
authors.initials: LL
authors.lastname: Birch
authors.forename: M I
authors.initials: MI
authors.lastname: Goran
mesh_terms: D015502:Absorptiometry, Photon; D001823:Body Composition; D002648:Child; D002675:Child, Preschool; D015930:Diet Records; D002149:Energy Intake; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D011939:Mental Recall; D015596:Nutrition Assessment; D012680:Sensitivity and Specificity