Energy balance measurement: when something is not better than nothing.
Energy intake (EI) and physical activity energy expenditure (PAEE) are key modifiable determinants of energy balance, traditionally assessed by self-report despite its repeated demonstration of considerable inaccuracies. We argue here that it is time to move from the common view that self-reports of EI and PAEE are imperfect, but nevertheless deserving of use, to a view commensurate with the evidence that self-reports of EI and PAEE are so poor that they are wholly unacceptable for scientific research on EI and PAEE. While new strategies for objectively determining energy balance are in their infancy, it is unacceptable to use decidedly inaccurate instruments, which may misguide health-care policies, future research and clinical judgment. The scientific and medical communities should discontinue reliance on self-reported EI and PAEE. Researchers and sponsors should develop objective measures of energy balance.
Infection and Obesity Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA.
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Dhurandhar
Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA.
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Schoeller
Nutrition Obesity Research Center & Office of Energetics, The University of Alabama at Birmingham, Birmingham, AL, USA.
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Brown
Pennington Biomedical Research Center, Baton Rouge, LA, USA.
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Heymsfield
Department of Mathematical Sciences, Montclair State University, Montclair, NJ, USA.
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Thomas
The Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark and Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals-Part of Copenhagen University Hospital, The Capital Region, Denmark.
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Sørensen
Institute of Biological and Environmental Sciences, University of Aberdeen, United Kingdom and Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China.
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Speakman
Nutrition Obesity Research Center, The University of Alabama at Birmingham, Birmingham, AL USA.
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Jeansonne
Nutrition Obesity Research Center, The University of Alabama at Birmingham, Birmingham, AL USA.
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Allison
D000068598:Data Accuracy; D002149:Energy Intake; D004734:Energy Metabolism; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006801:Humans; D009043:Motor Activity; D064887:Observational Studies as Topic; D011050:Policy Making; D015203:Reproducibility of Results; D057566:Self Report