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Zulfarina MS, Sharif R, Sharkawi AM, Mokhtar SA, Shuid AN, Naina-Mohamed I. Quality of energy intake in Malaysian adolescents: prevalence, characteristics, determinants and impact of implausible reporters. Public Health Nutr 2023; 26:122-131. [PMID: 35321764 PMCID: PMC11077444 DOI: 10.1017/s1368980022000726] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 03/09/2022] [Accepted: 03/21/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Misreporting of energy intake (EI) in nutritional epidemiology is common and even severe among adolescents. Thus, the current study aims to examine the presence, bias and impact introduced by implausible reporters. DESIGN Cross-sectional. SETTING Central and eastern regions of Peninsular Malaysia. PARTICIPANTS A stratified random sampling was employed to select 917 secondary school-going adolescents (aged 15-17 years). RESULTS The prevalence of under-reporters was 17·4 %, while no over-reporters were identified. Under-reporters had higher body composition and lower dietary intakes (except for vitamin C, Cr and Fl) compared with plausible reporters (P < 0·05). Adolescents with overweight and obesity had a higher odds of under-reporting compared with under-/normal weight adolescents (P < 0·001). In model 3, the highest regression coefficient (R2 = 0·404, P < 0·001) was obtained after adjusting for reporting status. CONCLUSIONS Overweight and obese adolescents were more likely to under-report their food intake and consequently affect nutrient intakes estimates. Future analyses that include nutrient intake data should adjust for reporting status so that the impact of misreporting on study outcomes can be conceded and consequently improve the accuracy of dietary-related results.
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Affiliation(s)
- Mohamed S Zulfarina
- Pharmacoepidemiology Unit, Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur56000, Malaysia
| | - Razinah Sharif
- Nutritional Science Program and Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abd Aziz, Kuala Lumpur, Malaysia
| | - Ahmad Mohd Sharkawi
- Pharmacoepidemiology Unit, Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur56000, Malaysia
| | - Sabarul Afian Mokhtar
- ProVice-Chancellor Office, Health Campus, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia
| | - Ahmad Nazrun Shuid
- Department of Pharmacology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, Sungai Buloh, Malaysia
| | - Isa Naina-Mohamed
- Pharmacoepidemiology Unit, Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur56000, Malaysia
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Suissa K, Benedetti A, Henderson M, Gray-Donald K, Paradis G. The Cardiometabolic Risk Profile of Underreporters of Energy Intake Differs from That of Adequate Reporters among Children at Risk of Obesity. J Nutr 2019; 149:123-130. [PMID: 30602028 PMCID: PMC6351144 DOI: 10.1093/jn/nxy209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 08/07/2018] [Indexed: 11/13/2022] Open
Abstract
Background Misreporting of energy intake (EI) in nutritional epidemiology is a concern because of information bias, and tends to occur differentially in obese compared with nonobese subjects. Objective We examined characteristics of misreporters within a cohort of children with a parental history of obesity and the bias introduced by underreporting. Methods The QUebec Adipose and Lifestyle InvesTigation in Youth (QUALITY) cohort included 630 Caucasian children aged 8-10 y at recruitment with ≥1 obese parent [body mass index (BMI; in kg/m2) >30 or waist circumference >102 cm (men), >88 cm (women)] and free of diabetes or severe illness. Children on antihypertensive medications or following a restricted diet were excluded. Child and parent characteristics were measured directly or by questionnaire. Three 24-h dietary recalls were administered by phone by a dietitian. Goldberg's cutoff method identified underreporters (URs). Logistic regression identified correlates of URs. We compared coefficients from linear regressions of BMI after 2 y on total EI at baseline 1) in all participants; 2) in adequate reporters (ARs) (excluding URs); 3) in all participants statistically adjusted for underreporting; 4) excluding URs using individual physical activity level (PAL)-specific cutoffs; and 5) in all participants statistically adjusted for underreporting using PAL-specific cutoffs. Results We identified 175 URs based on a calculated cutoff of 1.11. URs were older, had a higher BMI z score, and had poorer cardiometabolic health indicators. Parents of URs had a lower family income and higher BMI. Child BMI z score (OR: 3.07; 95% CI: 2.38, 3.97) and age (OR: 1.46/y; 95% CI: 1.14, 1.87/y) were the strongest correlates of underreporting. The association between BMI and total EI was null in all participants but became significantly positive after excluding URs (ß = 0.62/1000 kcal; 95% CI: 0.33, 0.92/1000 kcal) and after adjustment for URs (ß = 0.85/1000 kcal; 95% CI: 0.55, 1.06/1000 kcal). Conclusions URs in 8- to 10-y-old children differed from ARs. Underreporting biases measurement of nutritional exposures and the assessment of exposure-outcome relations. Identifying URs and using an appropriate correction method is essential.
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Affiliation(s)
- Karine Suissa
- Epidemiology, Biostatistics, and Occupational Health McGill University, Montreal, Quebec, Canada
| | - Andrea Benedetti
- Epidemiology, Biostatistics, and Occupational Health McGill University, Montreal, Quebec, Canada,Medicine, McGill University, Montreal, Quebec, Canada,Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Mélanie Henderson
- Research Center of Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada,Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Katherine Gray-Donald
- School of Dietetics and Human Nutrition, McGill University, Montreal, Quebec, Canada (retired)
| | - Gilles Paradis
- Epidemiology, Biostatistics, and Occupational Health McGill University, Montreal, Quebec, Canada,Address correspondence to GP (e-mail: )
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Younger and older ages and obesity are associated with energy intake underreporting but not overreporting in Japanese boys and girls aged 1-19 years: the National Health and Nutrition Survey. Nutr Res 2016; 36:1153-1161. [DOI: 10.1016/j.nutres.2016.09.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 08/18/2016] [Accepted: 09/08/2016] [Indexed: 12/21/2022]
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Mchiza Z, Goedecke J, Lambert E. Accuracy of reporting food energy intake: influence of ethnicity and body weight status in South African women. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2016. [DOI: 10.1080/16070658.2010.11734286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Prevalence and characteristics of misreporting of energy intake in US children and adolescents: National Health and Nutrition Examination Survey (NHANES) 2003–2012. Br J Nutr 2015; 115:294-304. [DOI: 10.1017/s0007114515004304] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AbstractUsing data from the National Health and Nutrition Examination Survey (NHANES) 2003–2012, we investigated the prevalence and characteristics of under- and over-reporting of energy intake (EI) among 14 044 US children and adolescents aged 2–19 years. For the assessment of EI, two 24-h dietary recalls were conducted with the use of the US Department of Agriculture Automated Multiple-Pass Method. Under-, plausible and over-reporters of EI were identified using two methods: based on the 95 % confidence limits (1) for agreement between the ratio of EI:BMR and a physical activity level for sedentary lifestyle (1·55) and (2) of the expected ratio of EI:estimated energy requirement (EER) of 1·0. BMR was calculated using Schofield’s equations. EER was calculated using equations from the US Dietary Reference Intakes, assuming ‘low active’ level of physical activity. The risk of being an under- or over-reporter compared with a plausible reporter was analysed using multiple logistic regression. Percentages of under-, plausible and over-reporters were 13·1, 81·5 and 5·4 %, respectively, based on EI:BMR and 18·8, 72·3 and 8·8 %, respectively, based on EI:EER. Under-reporting was associated with older age, non-Hispanic blacks (compared with non-Hispanic whites) and overweight and obesity (compared with normal weight). Over-reporting was associated with younger age, lower family poverty income ratio, normal weight and the first survey cycle. Similar findings were obtained when analysing only the first 24-h recall data from NHANES 1999–2012 (n 22 949). In conclusion, we found that EI misreporting remains prevalent and differential in US children and adolescents.
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Fakhouri THI, Jahren AH, Appel LJ, Chen L, Alavi R, Anderson CAM. Serum carbon isotope values change in adults in response to changes in sugar-sweetened beverage intake. J Nutr 2014; 144:902-5. [PMID: 24717368 PMCID: PMC4018953 DOI: 10.3945/jn.113.186213] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Serum carbon isotope values [13C-to-12C serum carbon isotope ratio (δ(13)C)], which reflect consumption of corn- and cane-based foods, differ between persons consuming high and low amounts of sugar-sweetened beverages (SSBs). In this study, we determined whether serum δ(13)C changes in response to change in SSB intake during an 18-mo behavioral intervention trial. Data were from a subset of 144 participants from the PREMIER trial, a completed behavioral intervention (Maryland, 1998-2004). SSB intake was assessed using 2 24-h dietary recall interviews. Blinded serum samples were assayed for δ(13)C by natural abundance stable isotope mass spectroscopy. Multiple linear regression models with generalized estimating equations and robust variance estimation were used. At baseline, mean SSB intake was 13.8 ± 14.2 fl oz/d, and mean δ(13)C serum value was -19.3 ± 0.6 units per mil (designated ‰). A reduction of 12 oz (355 mL)/d SSB (equivalent to 1 can of soda per day) was associated with 0.17‰ (95% CI: 0.08‰, 0.25‰ P < 0.0001) reduction in serum δ(13)C values over 18 mo (equivalent to a 1% reduction in δ(13)C from baseline). After adjusting for potential confounders, a reduction of 12 oz/d SSB (equivalent to 1 can of soda per day), over an 18-mo period, was associated with 0.12‰ (95% CI: 0.01‰, 0.22‰ P = 0.025) reduction in serum δ(13)C. These findings suggest that serum δ(13)C can be used as a measure of dietary changes in SSB intake.
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Affiliation(s)
| | - A. Hope Jahren
- School of Earth and Ocean Science and Technology, University of Hawaii, Honolulu, HI
| | - Lawrence J. Appel
- Department of Epidemiology and,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | - Liwei Chen
- Program of Epidemiology, Louisiana State University School of Public Health, New Orleans, LA; and
| | - Reza Alavi
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | - Cheryl A. M. Anderson
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA,To whom correspondence should be addressed. E-mail:
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Hare ME, Sherrill-Mittleman D, Klesges RC, Lanctot JQ, Klesges LM. Energy underreporting in African-American girls: a longitudinal analysis. Child Obes 2012. [PMID: 23181921 PMCID: PMC3647539 DOI: 10.1089/chi.2011.0117] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The objective of this study was to determine the longitudinal prevalence and predictors of dietary underreporting in African-American preadolescent girls and the association of baseline dietary underreporting with changes in BMI over a 2-year period as part of the Girls health Enrichment Multi-site Studies (GEMS). METHODS Energy was summarized at baseline, 12 months, and 24 months and computed as a 3-day average of 24-hour dietary recalls. Physical activity was assessed by accelerometer, basal metabolic rate was estimated using the World Health Organization's prediction equation, and caloric underreporting was based on the Goldberg equation. RESULTS We classified 48% of the girls at baseline as underreporters; with underreporting increasing over time (61% at 12 months; 66% at 24 months). Intervention treatment assignment did not affect the prevalence of underreporting over time. The consistency of underreporting (or not) stayed stable over time. Across all three time points, a higher BMI predicted underreporting. Baseline dietary underreporting and baseline BMI were found to be the major predictors of change in BMI, whereas baseline dietary variables did not predict change in BMI. CONCLUSIONS Dietary underreporting was extremely common in this sample of AA preadolescent girls and predictive of change in BMI. Given the magnitude and consistency of dietary underreporting along with the fact that no dietary variables predicted change in BMI, measurement of dietary intake in preadolescents, even with sophisticated measurement methodologies, appears biased. The best use of dietary recalls may not be to estimate dietary intake but rather to determine underreporting.
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Affiliation(s)
- Marion E. Hare
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN.,Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN
| | | | - Robert C. Klesges
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN.,Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
| | - Jennifer Q. Lanctot
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN
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Prevalence and determinants of misreporting among European children in proxy-reported 24 h dietary recalls. Br J Nutr 2012; 109:1257-65. [PMID: 22863030 DOI: 10.1017/s0007114512003194] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Dietary assessment is strongly affected by misreporting (both under- and over-reporting), which results in measurement error. Knowledge about misreporting is essential to correctly interpret potentially biased associations between diet and health outcomes. In young children, dietary data mainly rely on proxy respondents but little is known about determinants of misreporting here. The present analysis was conducted within the framework of the multi-centre IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study and is based on 6101 children aged 2-9 years with 24 h dietary recall (24-HDR) and complete covariate information. Adapted Goldberg cut-offs were applied to classify the 24-HDR as 'over-report', 'plausible report' or 'under-report'. Backward elimination in the course of multi-level logistic regression analyses was conducted to identify factors significantly related to under- and over-reporting. Next to characteristics of the children and parents, social factors and parental concerns/perceptions concerning their child's weight status were considered. Further selective misreporting was addressed, investigating food group intakes commonly perceived as more or less socially desirable. Proportions of under-, plausible and over-reports were 8.0, 88.6 and 3.4 %, respectively. The risk of under-reporting increased with age (OR 1.19, 95 % CI 1.05, 1.83), BMI z-score of the child (OR 1.23, 95 % CI 1.10, 1.37) and household size (OR 1.12, 95 % CI 1.01, 1.25), and was higher in low/medium income groups (OR 1.45, 95 % CI 1.13, 1.86). Over-reporting was negatively associated with BMI z-scores of the child (OR 0.78, 95 % CI 0.69, 0.88) and higher in girls (OR 1.70, 95 % CI 1.27, 2.28). Further social desirability and parental concerns/perceptions seemed to influence the reporting behaviour. Future studies should involve these determinants of misreporting when investigating diet-disease relationships in children to correct for the differential reporting bias.
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Characteristics of under- and over-reporters of energy intake among Japanese children and adolescents: The Ryukyus Child Health Study. Nutrition 2012; 28:532-8. [DOI: 10.1016/j.nut.2011.08.011] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Revised: 08/20/2011] [Accepted: 08/20/2011] [Indexed: 11/17/2022]
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Thomas JG, Bond DS, Sarwer DB, Wing RR. Technology for behavioral assessment and intervention in bariatric surgery. Surg Obes Relat Dis 2011; 7:548-57. [PMID: 21514246 PMCID: PMC3422738 DOI: 10.1016/j.soard.2011.02.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Revised: 02/24/2011] [Accepted: 02/28/2011] [Indexed: 10/18/2022]
Abstract
Patients' behaviors have a substantial effect on postoperative outcomes after bariatric surgery. Thus, studying patients' behaviors is essential to learning how to optimize postoperative outcomes. To be most effective, this research should use the best tools available for assessing patient behavior. However, the traditional methods of behavioral assessment (e.g., questionnaires and clinical interviews) rely primarily on patients' retrospective self-report, which is often inaccurate. Despite their significant shortcomings, these types of assessments continue to predominate. However, technological advances now allow for much greater accuracy in the assessment of patient behaviors by way of devices, such as accelerometers and palmtop computers. Accelerometers allow for patients' physical activity to be measured objectively in great detail, in real-time, in the patients' natural environment. Ecologic momentary assessment using a palmtop computer or mobile telephone allows the assessment of important behaviors, such as eating and activity behaviors, to be measured, with many of the same advantages. Furthermore, new computer-assisted technologies are in development that will further facilitate behavioral assessment. Technology also has the potential to play an important role in the delivery of behavioral interventions aimed at bariatric surgery patients, given that Internet-based treatments have already proved effective for nonoperative weight loss and are often highly cost-effective and easily disseminable. Future research should evaluate the efficacy of these programs for bariatric patients.
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Affiliation(s)
- J Graham Thomas
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control and Diabetes Research Center, Providence, Rhode Island, USA.
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Noel SE, Mattocks C, Emmett P, Riddoch CJ, Ness AR, Newby PK. Use of accelerometer data in prediction equations for capturing implausible dietary intakes in adolescents. Am J Clin Nutr 2010; 92:1436-45. [PMID: 20881064 PMCID: PMC2980968 DOI: 10.3945/ajcn.2010.29386] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Reporting errors have been quantified in epidemiologic studies by comparing reported intakes with predicted energy requirements (pERs). Several studies lacking measures of physical activity level (PAL) assigned low-active levels to obtain pERs. OBJECTIVE We applied objective physical activity measures to current methods to quantify dietary reporting errors and compared associations with anthropometric and dietary variables among plausible and implausible reporters. DESIGN This study included 2868 adolescents with an average age of 13 y. Three-day dietary records, accelerometers, and dual-energy X-ray absorptiometry were used to assess diet, activity, and body composition, respectively. Three variations of physical activity coefficients were used: 1) assigning low physical activity coefficients (PA(low)), 2) calculating PAL values (PA(PAL)), and 3) applying minutes of moderate-to-vigorous physical activity (PA(MVPA)). RESULTS Of the total participants, 51.5%, 51.8%, and 37.1% of the PA(low), PA(PAL), and PA(MVPA) groups, respectively, were classified as underreporters, and 40.8%, 37.9%, and 42.4% of the respective groups were classified as plausible reporters. Underreporters had a higher body mass index, body fat, and waist circumference than did plausible reporters (P < 0.001 for all). Overreporters had a lower weight and body fat than did plausible reporters (P < 0.001 for all). Underreporters reported lower dairy and calcium intakes than did plausible reporters; the results were attenuated with adjustment for total energy. CONCLUSION Accounting for objective physical activity measures to quantify reporting errors resulted in different and potentially more reasonable proportions of implausible reporters.
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Affiliation(s)
- Sabrina E Noel
- Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA.
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Forrestal SG. Energy intake misreporting among children and adolescents: a literature review. MATERNAL AND CHILD NUTRITION 2010; 7:112-27. [PMID: 20735731 DOI: 10.1111/j.1740-8709.2010.00270.x] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
While adults' energy intake misreporting is a well-documented phenomenon, relatively little is known about the nature and extent of misreporting among children and adolescents. Children's and adolescents' dietary reporting patterns are likely to be distinct because of their ongoing cognitive and social development. These developmental differences present unique challenges to aspects of dietary reporting, such as food knowledge, portion size estimation and response editing. This review of 28 articles describes energy intake misreporting among children and adolescents. Like adults, children and adolescents tended to underreport energy, with the largest biases observed with food records. Even when mean reported energy intake was close to its expected value, approximately half of all individuals were classified as misreporters, and overreporting appeared to be more common than it is among adults. Associations between numerous characteristics and misreporting were explored in the literature, with the most consistent findings for age and adiposity. Two predictors for adults, gender and social desirability, were not consistent factors among children and adolescents. The review concludes by highlighting knowledge gaps and recommendations for future research and practice.
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Affiliation(s)
- Sarah G Forrestal
- Community Health Sciences Division, University of Illinois at Chicago School of Public Health, Chicago, Illinois 60612, USA.
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Gábor A, Kovács V, Fajcsák Z, Martos É. From guidelines to practice — Nutritional habits of Hungarian elite athletes compared with the data from the 3rdNational Dietary Survey. ACTA ALIMENTARIA 2010. [DOI: 10.1556/aalim.39.2010.1.3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Underreporting of Energy Intake in Brazilian Women Varies According to Dietary Assessment: A Cross-Sectional Study Using Doubly Labeled Water. ACTA ACUST UNITED AC 2008; 108:2031-40. [DOI: 10.1016/j.jada.2008.09.012] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2007] [Accepted: 06/25/2008] [Indexed: 11/22/2022]
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Lanctot JQ, Klesges RC, Stockton MB, Klesges LM. Prevalence and characteristics of energy underreporting in African-American girls. Obesity (Silver Spring) 2008; 16:1407-12. [PMID: 18388890 DOI: 10.1038/oby.2008.222] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To determine the frequency and characteristics of energy intake underreporting in African-American preadolescent girls as part of the Girls health Enrichment Multi-site Studies (GEMS). METHODS AND PROCEDURES Energy intake was summarized using the Nutrition Data System for Research software and computed as a 3-day average of 24-h dietary recalls. Physical activity was assessed by an accelerometer, basal metabolic rate (BMR) was estimated using the World Health Organization's prediction equation, and underreporting of caloric intake was based on the Goldberg equation. RESULTS Using a conservative criterion for determining energy underreporting, we classified 54.8% of the girls as underreporters; 45.2% were classified as plausible reporters. Factors related to underreporting included higher BMI (beta = -0.506, P < or = 0.001), older age (beta = -0.159, P = 0.001), greater unhealthy eating behaviors (beta = -0.118, P = 0.025), and higher self-efficacy for diet (beta = -0.098, P = 0.033). DISCUSSION Underreporting of dietary intake, specifically energy, is common in African-American preadolescent girls and can be partially explained by weight status and psychosocial variables. The extent of dietary underreporting in specific and high-risk populations is largely unknown and could be evaluated by routinely including a report of such an index in future research studies.
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Affiliation(s)
- Jennifer Q Lanctot
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
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Klesges RC, Obarzanek E, Klesges LM, Stockton MB, Beech BM, Murray DM, Lanctot JQ, Sherrill-Mittleman DA. Memphis Girls health Enrichment Multi-site Studies (GEMS). Contemp Clin Trials 2008; 29:42-55. [PMID: 17588824 DOI: 10.1016/j.cct.2007.05.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2006] [Revised: 04/23/2007] [Accepted: 05/04/2007] [Indexed: 10/23/2022]
Abstract
Obesity prevalence is increasing in the U.S., especially among children and minority populations. This report describes the design and baseline data of the ongoing Girls health Enrichment Multi-site Studies (GEMS) trial (Memphis site), which is testing the efficacy of a 2-year family-based intervention to reduce excessive increase in body mass index (BMI). This randomized, controlled trial conducted at community centers in Memphis, Tennessee requires major measurements at baseline and at 12 and 24 months post-randomization. The participants are healthy African-American girls and one parent/caregiver of each girl. Participating girls are of ages 8-10 years, with BMI>or=25th percentile of the CDC 2000 growth charts or with one overweight or obese parent/caregiver (BMI>or=25 kg/m(2)). The active intervention is designed to prevent excessive weight gain by promoting healthy eating habits and increasing physical activity. An alternative intervention (comparison group) promotes general self-esteem and social efficacy. The main outcome measure is the difference between the two treatment groups in the change in BMI at 2 years. Three hundred and three girls have been randomly assigned to receive the test intervention (n=153) or the alternative intervention (n=150). The two groups do not differ in baseline characteristics. At the time of enrollment, the mean age was 9 years, the mean BMI was 22 kg/m(2) (mean BMI percentile=77 th), and 41% were overweight (BMI>/=95th percentile using CDC 2000 growth charts). Participants' intake of fruits and vegetables (1.3 serving/day) and fats (36% kcal), and their participation in moderate-to-vigorous physical activity (20 min/day), did not meet national recommendations. The GEMS obesity prevention intervention targets improved diet and increased physical activity to reduce excessive weight gain in healthy African-American girls of ages 8-10.
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Affiliation(s)
- Robert C Klesges
- Department of Preventive Medicine, University of Tennessee Center for Health Sciences and St. Jude Children's Research Hospital, Memphis, TN, USA
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