title: Underreporting of energy intake and associated factors in a Latino population at risk of developing type 2 diabetes.
abstract: The objective of this study was to examine the extent of underreporting of total energy intake and associated factors in a low-income, low-literacy, predominantly Caribbean Latino community in Lawrence, MA. Two hundred fifteen Latinos participated in a diabetes prevention study, for which eligibility included a >or=30% risk of developing diabetes in 7.5 years. Dietary self-reported energy intake was assessed using three randomly selected days of 24-hour diet recalls. Basal metabolic rate (BMR) was estimated using the Mifflin-St Jeor equation. Underreporting was determined by computing a ratio of energy intake to BMR, with a ratio of 1.55 expected for sedentary populations. Linear regression analyses were used to identify factors associated with underreporting (energy intake:BMR ratio). The population was predominately women (77%), middle-aged (mean 52+/-11 years), obese (78% had a body mass index >or=30); low-literate (62% < high school education), unemployed (57% reported no job), married or living with partner (52%), and some had a family history of diabetes (37% had siblings with diabetes). Reported total daily energy intake was 1,540+/-599 kcal, whereas estimated BMR was 1,495.7+/-245.1 kcal/day. When multiplied by an activity factor (1.20 for sedentariness), expected energy intake was 1,794+/-294.0 per day, indicating underreporting by an average of 254 kcal/day. Mean energy intake:BMR was 1.03+/-0.37, and was lower for participants with higher body mass index, siblings with diabetes, sedentary lifestyle, and those who were unemployed. Energy intake underreporting is prevalent in this low-income, low-literacy Caribbean Latino population. Future studies are needed to develop dietary assessment measures that minimize underreporting in this population.
authors.affiliation: University of Massachusetts Medical School, Division of Preventive and Behavioral Medicine, 55 Lake Ave N, Shaw Bldg, Worcester, MA 01655, USA. Barbara.Olendzki@umassmed.edu
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Olendzki
authors.forename: Yunsheng
authors.initials: Y
authors.lastname: Ma
authors.forename: James R
authors.initials: JR
authors.lastname: Hébert
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Pagoto
authors.forename: Philip A
authors.initials: PA
authors.lastname: Merriam
authors.forename: Milagros C
authors.initials: MC
authors.lastname: Rosal
authors.forename: Ira S
authors.initials: IS
authors.lastname: Ockene
mesh_terms: D000328:Adult; D000368:Aged; D001481:Basal Metabolism / Q000502:physiology*; D015992:Body Mass Index; D017691:Caribbean Region / Q000208:ethnology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology; D004522:Educational Status; D004651:Employment; D002149:Energy Intake / Q000502:physiology*; D015444:Exercise / Q000502:physiology; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D008019:Life Style; D016014:Linear Models; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D012650:Self Disclosure