Self-reported energy intake and energy expenditure in elderly women

Under-reporting of energy intake in elderly Australian women is associated with a higher body mass index

OBJECTIVES

Identify the extent of under-reporting of energy intake and the characteristics associated with implausible intakes in elderly women.

DESIGN

Dietary intake was assessed using a 3-day weighed food record. Protein intake was validated by 24-hour urinary nitrogen. To examine under-reporting, participants were grouped according to their energy intake and compared to the Goldberg cut-off equation. Logistic regression was performed to assess the influence of body mass index (BMI) and social-demographic factors on under-reporting.

SETTING

Community dwelling elderly women from Perth, Western Australia.

PARTICIPANTS

217 elderly women aged 70-80 years.

RESULTS

Under-reporters had a higher physical activity level (p<0.001) compared with acceptable-reporters. The under-reporters also had a higher body weight (p=0.006), body mass index (BMI) (p=0.001), waist (p=0.011), hip circumference (p<0.001), whole body fat mass (p<0.001) and percentage body fat (p<0.001) than acceptable-reporters. Under-reporters had a significantly lower intakes of protein, fat, carbohydrate and alcohol (p<0.001) and fewer reported food items, compared with acceptable reporters. However, 24-hour urinary nitrogen was only marginally different between the two groups (p=0.053). Participants with a higher BMI were more likely to under-report their energy intake (BMI=25-29.9: odds ratio=2.98[95% CI=1.46-6.09]; BMI≥30: 5.84[2.41-14.14]).

CONCLUSION

Under-reporting energy intake in elderly women was associated with a higher BMI, body fat and higher self-reported physical activity levels. A higher BMI (≥25) appears to be most significant factor in determining if elderly women will underreport their food intake and may be related to body image. These results have implications for undertaking surveys of food intake in elderly women.

Underreporting of food intake among Mexican/Mexican-American Women: rates and correlates

BACKGROUND

Under-reporters are those individuals who report a dietary intake level that is not biologically plausible given their physiological status and physical activity level. Underreporting of food intake threatens the validity of dietary assessment; yet, little is known about the prevalence or correlates of underreporting in the Mexican/Mexican-American community.

OBJECTIVE

To examine underreporting rates and correlates among Mexican/Mexican-American women using dietary data based on repeated 24-hour recalls and the Goldberg equation.

DESIGN

Cross-sectional study of baseline data collected as part of a larger randomized controlled trial through structured interviews and anthropometric measurements.

SUBJECTS/SETTING

A random sample of 357 Mexican/Mexican-American women, ranging in age from 21 to 67 years, living in south San Diego near the United States/Mexico border.

STATISTICAL ANALYSES PERFORMED

Age, income level, education level, and weight status, all correlates of underreporting in samples of non-Hispanic white participants, were examined as potential correlates of underreporting among Mexican/Mexican-American women using binary logistic regression. Acculturation was examined to determine if it accounted for additional variance in underreporting. Finally, multivariate analyses using backward stepwise regression were conducted to determine which correlates remained significant in the final model.

RESULTS

Rates of underreporting varied across the five detection methods employed, from 11.9% (n=42) to 81.3% (n=286). Obese weight status was the only significant correlate across all five underreporting detection methods and remained significant in the final model. Using backward stepwise regression, the final model showed weight status to be a significant correlate of underreporting both at the overweight (P<0.05) and obese levels (P<0.01). In addition, Anglo orientation score (P<0.05) remained significant in the final model, as well as the age group of 51 years or older (P<0.05).

CONCLUSIONS

Consistent with previous studies, under-reporters in this Mexican/Mexican-American sample were more likely to be overweight or obese, and were older. They also were more likely to identify with the dominant Anglo culture. Additional studies are needed to further examine underreporting error in dietary assessment among Latinos, and to determine whether the effects of acculturation on underreporting are found in other Latino subgroups.

Racial differences in correlates of misreporting of energy intake in adolescent females

OBJECTIVE

To determine the extent of misreporting of energy intake (EI) and its anthropometric, demographic, and psychosocial correlates in a bi-racial cohort of young women.

RESEARCH METHODS AND PROCEDURES

This was a cross-sectional study of 60 black and 60 white young women, 18 to 21 years old, enrolled in a longitudinal study. Total energy expenditure was assessed using doubly labeled water. Self-reported EI was obtained from 3-day food records. BMI was computed from height and weight. Fat mass was assessed by DXA. Multivariate analyses examined racial differences on the extent of misreporting and its effect on other potential correlates of misreporting. Race-specific step-wise linear regression analysis was performed to examine the effect of BMI, parental education, and drive for thinness on misreporting of EI.

RESULTS

More white women tended to under-report EI than black women (22% vs. 13%, p = 0.07). In black women, under-reporting was significantly (p = 0.01) associated with drive for thinness score but was only marginally (p = 0.1) associated with BMI. Each point increase in drive for thinness score was associated with under-reporting by 40 kcal/d. In white women, under-reporting was significantly (p = 0.03) associated with higher parental education by 440 kcal/d and also only marginally (p = 0.09) with BMI.

DISCUSSION

This tendency for under-reporting of EI limits the use of self-reported EI in studying energy balance in free-living subjects. Most black and almost all white women in their late teens significantly under-reported their EI, whereas under-reporting was not as evident among lean young black women.