title: Low energy reporting related to lifestyle, clinical, and psychosocial factors in a randomly selected population sample of Greek adults: the ATTICA Study.
abstract: OBJECTIVE
  Aim of the present study was to identify potential dietary, lifestyle, psychosocial and clinical correlates of underreporting in a population-based sample.
  
  
  METHODS
  Following a random multistage sampling, 1514 men (46+/-13 years old) and 1528 women (45+/-13 years old) from the Attica area, in Greece, participated in this study. All participants underwent a standard assessment procedure that included clinical, psychosocial and lifestyle parameters. Food consumption was assessed through a validated semi-quantitative food frequency questionnaire. The ratio of energy intake to estimated basal metabolic rate (EI/BMR) and the Goldberg cut-off points were used for the classification of subjects as low energy reporters (LERs) and non-LERs.
  
  
  RESULTS
  LERs represented 12.2% of the sample. This percentage was higher in obese subjects compared to overweight or normal weight (20.6 % vs. 9.9 % vs. 10.6 %, p = 0.05), as well as in women compared to men (14.6% vs. 9.9%, p<0.001). Data analysis was stratified by gender, since a significant interaction was observed between gender and LER group on several dietary parameters. Female LERs had higher Med Diet Score compared to non-LERs (30.6 +/- 8.2, 95%CI 30.2-31.04 vs. 26.9 +/- 6.3, 95%CI 26.05-27.7, p<0.001). Multiple regression analysis revealed that lower EI/BMR values were associated with younger age (p<0.001), higher BMI (p<0.001), presence of diabetes mellitus (p=0.012) and lower depression score (p=0.056) in women, whereas with younger age (p<0.001), higher BMI (p<0.001), higher education level (p=0.046) and higher anxiety score (p=0.08) in men.
  
  
  CONCLUSIONS
  Several psychosocial and clinical characteristics operate in low energy reporting in both genders. Nutrition-related professionals should be aware of these gender-specific trends in dietary assessment procedures.
authors: Department of Nutrition and Dietetics, Harokopio University, El. Venizelou 70, Athens 17671, Greece. myiannak@hua.gr
authors: Mary
authors: M
authors: Yannakoulia
authors: Demosthenes B
authors: DB
authors: Panagiotakos
authors: Christos
authors: C
authors: Pitsavos
authors: Eirini
authors: E
authors: Bathrellou
authors: Christina
authors: C
authors: Chrysohoou
authors: Yannis
authors: Y
authors: Skoumas
authors: Christodoulos
authors: C
authors: Stefanadis
mesh_terms: D017677:Age Distribution; D001481:Basal Metabolism / Q000502:physiology*; D015992:Body Mass Index; D003863:Depression; D004032:Diet; D004522:Educational Status; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D006115:Greece; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009765:Obesity / Q000523:psychology; D012650:Self Disclosure; D017678:Sex Distribution; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires