Factors associated with low reported energy intake in the elderly.
BACKGROUND
Underreporting of dietary intake can be estimated by the Energy Ratio (ER) between reported energy intake (EI) and calculated total energy expenditure (TEE). The gap between EI and TEE is usually attributed to underreporting. In elderly populations, compromised dietary intake and health status may offer alternative explanations to this gap.


OBJECTIVE
This study aimed to characterize "underreporting" of dietary intake and low energy reporters (LER) among the elderly.


METHODS
Participants aged 65 years and over, were recruited using random population sampling of the Negev population. Data were collected using the 24-h recall method with additional demographic and age-specific health questionnaires. ER was calculated using the ratio between reported energy intake and calculated TEE computed by the Schofield formula. LER were defined as those with reported energy intake of less than 0.8 calculated BMR using the Schofield formula.


RESULTS
We restricted our analysis to 191 elderly aged 65-74 y and 177 aged 75 y and older who reported their diet to be "as usual." In univariate analyses, BMI < 22, better health status, use of fewer than four medications and good reported appetite were significantly related to higher ER. No difference was shown in ER by gender, level of education, and family status. Weight loss superior 5 kg was associated with low ER (p = 0.049). In a linear regression model, low ER (indicating "underreporting") was significantly associated with higher activity level and use of over four medications. Using a dichotomous approach, Low Energy Reporters (LER) used a higher number of medications, ate fewer food items per day and suffered from poorer appetite.


CONCLUSIONS
In the elderly, ER < 1 may indicate underreporting in dietary intake, and indeed, is frequent among the obese. Nonetheless, among the elderly, ER < 1 may reflect truly low caloric intake. Our results suggest that, to some degree, health status variables are associated with decreased ER, supporting a true caloric deprivation state.
Shahar
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The S. Daniel Abraham International Center for Health and Nutrition, Ben-Gurion University of the Negev, POB 653, Beer-Sheva 84105 Israel. Dshahar@bgumail.bgu.ac.il
Shai
I
I
Vardi
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H
Fraser
D
D
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000886:Anthropometry; D001067:Appetite Depressants / Q000008:administration & dosage; D015992:Body Mass Index; D004032:Diet; D064420:Drug-Related Side Effects and Adverse Reactions; D002149:Energy Intake; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008297:Male; D011939:Mental Recall; D009765:Obesity / Q000523:psychology; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D012044:Regression Analysis; D012650:Self Disclosure; D011795:Surveys and Questionnaires
D001067:Appetite Depressants; D004364:Pharmaceutical Preparations