Misreport of energy intake assessed with food records and 24-h recalls compared with total energy expenditure estimated with DLW.
The accuracy of dietary assessment methods has rarely been validated using precise techniques. The objective of this work was to evaluate the validity of energy intake (EI) estimated with food records (FRs) and 24-h recalls (24hRs) against total energy expenditure (EE) estimated by the doubly labeled water (DLW) method. In addition, the magnitude of EI under-reporting was assessed along with its associated characteristics.



The studied group included 83 adults between 20 and 60 years of age who were recruited from a population-based sample. Within-person variation-adjusted means of EI estimated from two FRs and three 24hRs were compared with EE estimated using the DLW method multiple-point protocol. The Wilcoxon signed-rank test was used to assess the differences between EI and EE, whereas Bland-Altman and survival-agreement plots assessed the agreement between the estimates.



The mean EE (2540 kcal) was greater than the mean reported EI for both dietary assessment methods (FR: 1774 kcal; 24hR: 1658 kcal, P<0.01). The frequency of under-reporting was lower (20%) for EI estimated with the 24hR than that estimated with the FR (32%). Men presented lower magnitude of under-reported EI than women did. For women, differences between EI and EE were lower with FR than with 24hR. Overall, FR and 24hR showed similar performance. The mean under-reported EI was ~30% for both methods.



Irregular meal habits, smoking and low education were associated with the under-report of EI. Both FR and 24hR are subjected to bias suggesting the need of refining the procedures applied in dietary assessment methods.
Department of Social and Applied Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
T S
TS
Lopes
Institute of Collective Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
R R
RR
Luiz
Department of Nutritional Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
D J
DJ
Hoffman
Division of General Internal and Geriatric Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
E
E
Ferriolli
Division of General Internal and Geriatric Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
K
K
Pfrimer
Laboratory of Physiology of Nutrition and Development, Department of Physiological Sciences, Biomedical Center, Institute of Biology, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
A S
AS
Moura
Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
R
R
Sichieri
Department of Social and Applied Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
R A
RA
Pereira
D000328:Adult; D015982:Bias; D003430:Cross-Sectional Studies; D017666:Deuterium Oxide / Q000378:metabolism*; D015930:Diet Records; D002149:Energy Intake; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009751:Nutritional Requirements; D011237:Predictive Value of Tests; D055815:Young Adult
D017666:Deuterium Oxide