Relationship of high energy expenditure and variation in dietary intake with reporting accuracy on 7 day food records and diet histories in a group of healthy adult volunteers Validation of a self-administered food-frequency questionnaire administered in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study: comparison of energy, protein, and macronutrient intakes estimated with the doubly labeled water, urinary nitrogen, and repeated 24-h dietary  Comparison of energy intakes determined by food records and doubly labeled water in women participating in a dietary-intervention trial. Validation of a Smartphone Image-Based Dietary Assessment Method for Pregnant Women Comparison of a web-based food record tool and a food-frequency questionnaire and objective validation using the doubly labelled water technique in a Swedish middle-aged population Biased over- or under-reporting is characteristic of individuals whether over time or by different assessment methods. Validity and reliability of reported dietary intake data. Accuracy of weighed dietary records in studies of diet and health. Assessment of energy intake in women with chronic obstructive pulmonary disease: A doubly labeled water method study Monitoring energy intake: a hand-held personal digital assistant provides accuracy comparable to written records.
Objectives : To assess the accuracy of reporting from both a diet history and food record and identify some of the characteristics of more accurate reporters in a group of healthy adult volunteers for an energy balance study . Design : Prospect i ve measurements in free-living people . Setting : Wollongong , Australia . Subjects : Fifteen healthy volunteers ( seven male , eight female ; aged 22–59 y ; body mass index ( BMI ) 19–33 kg/m2 ) from the local community in the city of Wollongong , Australia . Interventions : Measurement of  energy intake via diet history interview and 7 day food records , total energy expenditure by the doubly labelled water technique over 14 days ,  physical activity  by question naire , and body fat by dual-energy X-ray absorptiometry . Results : Increased misreporting of energy intake was associated with increased energy expenditure ( r=0.90 , P<0.0001 , diet history ; r S=0.79 , P=0.0005 , food records ) but was not associated with age , sex , BMI or body fat . Range in number of recorded dinner foods correlated positively with energy expenditure ( r S=0.63 , P=0.01 ) and degree of misreporting ( r S=0.71 , P=0.003 , diet history ; r S=0.63 , P=0.01 , food records ) . Variation in energy intake at dinner and over the whole day identified by the food records correlated positively with energy expenditure ( r=0.58 , P=0.02 ) and misreporting on the diet history ( r=0.62 , P=0.01 ) . Conclusions : Subjects who are highly active or who have variable dietary and exercise behaviour may be less accurate in reporting dietary intake . Our findings indicate that it may be necessary to screen for these characteristics in studies where accuracy of reporting at an individual level is critical . Sponsorship : The study was supported in part by Australian Research Council funds made available through the University of Wollongong BACKGROUND The validation of dietary assessment instruments is critical in the evaluation of diet as a chronic disease risk factor . OBJECTIVE The objective was to assess the validity of a self-administered food-frequency question naire by comparison with dietary recall , urinary nitrogen excretion , and total energy expenditure data . DESIGN Over a 1-y period , data from twelve 24-h dietary recalls , a food-frequency question naire , and four 24-h urine sample s were obtained from 134 study participants of the European Prospect i ve Investigation into Cancer and Nutrition ( EPIC ) Study in Potsdam , Germany . In a sub study of 28 participants , total energy expenditure from doubly labeled water measurements was assessed . RESULTS Energy-adjusted , deattenuated correlation coefficients between the question naire and the recalls ranged from 0.54 for dietary fiber to 0.86 for alcohol . Cross-classification of quintiles of nutrient intakes from the question naire and recalls indicated severe misclassification to be < 4 % . Reported protein intake correlated with estimated protein excretion ( r = 0.46 ) . Energy intake and total energy expenditure were also significantly correlated ( r = 0.48 ) ; however , all but one subject underreported their energy intake . The magnitude of underreporting varied considerably , by 22 % on average , and increased slightly with increasing energy intake . A similar pattern of underreporting was observed when energy intakes from the 24-h dietary recalls were compared with total energy expenditure . CONCLUSIONS These data indicate an acceptable relative validity of the food-frequency question naire in this study population . Compared with measurements of total energy expenditure and protein excretion , however , only moderate agreement with both the food-frequency question naire and the 24-h dietary recalls was observed The accuracy of estimates of usual energy intake derived from food records in participants of a long-term dietary-intervention trial was studied in a subset of 29 women aged 48.7+/-5.0 y and weighing 61.9+/-6.5 kg . This sample was similar to the population in the whole trial ( n=715 ) , from which it was selected in terms of age , weight , body mass index ( BMI ) , and reported energy and fat intakes . During the validation study , reported energy intake was derived from 7 consecutive days of food records , and total energy expenditure was measured by the doubly labeled water method over 13 d.  Reported energy intake ( 6.98+/-1.58 MJ/d ) was significantly lower than energy expenditure ( 9.00+/-2.08MJ/d ) and represented 79.8+/-17.6 % of expenditure . The correlation between reported energy intake and expenditure was 0.46 ( P=0.01 , 95 % CI : 0.15 , 0.71 ) . Body weight , BMI , height , length of time in the dietary trial , and percentage of energy from fat and carbohydrate were not significantly associated with the accuracy of reporting . These results indicate that energy intake derived from food records is an imprecise measure that substantially underestimates energy intake in middle-aged women participating in a long-term dietary-intervention trial Image-based dietary records could lower participant burden associated with traditional prospect i ve methods of dietary assessment . They have been used in children , adolescents and adults , but have not been evaluated in pregnant women . The current study evaluated relative validity of the  DietBytes image-based dietary assessment method  for assessing energy and nutrient intakes .  Pregnant women collected image-based dietary records ( via a smartphone application ) of all food , drinks and supplements consumed over three non-consecutive days . Intakes from the image-based method were compared to intakes collected from three 24-h recalls , taken on r and om days ; once per week , in the weeks following the image-based record . Data were analyzed using nutrient analysis software . Agreement between methods was ascertained using Pearson correlations and Bl and -Altman plots . Twenty-five women ( 27 recruited , one withdrew , one incomplete ) , median age 29 years , 15 primiparas , eight Aboriginal Australians , completed image-based records for analysis . Significant correlations between the two methods were observed for energy , macronutrients and fiber ( r = 0.58–0.84 , all p < 0.05 ) , and for micronutrients both including ( r = 0.47–0.94 , all p < 0.05 ) and excluding ( r = 0.40–0.85 , all p < 0.05 ) supplements in the analysis . Bl and -Altman plots confirmed acceptable agreement with no systematic bias . The DietBytes method demonstrated acceptable relative validity for assessment of nutrient intakes of pregnant women Two web-based dietary assessment tools have been developed for use in large-scale studies : the Riksmaten method ( 4-d food record ) and MiniMeal-Q ( food-frequency method ) . The aim of the present study was to examine the ability of these methods to capture energy intake against objective ly measured total energy expenditure ( TEE ) with the doubly labelled water technique ( TEEDLW ) , and to compare reported energy and macronutrient intake . This study was conducted within the pilot study of the Swedish CArdioPulmonary bioImage Study ( SCAPIS ) , which included 1111 r and omly selected men and women aged 50–64 years from the Gothenburg general population . Of these , 200 were enrolled in the SCAPIS diet sub study .  TEEDLW was measured in a sub sample ( n 40 ) . Compared with TEEDLW , both methods underestimated energy intake : −2·5 ( sd 2·9 ) MJ with the Riksmaten method ; −2·3 ( sd 3·6 ) MJ with MiniMeal-Q. Mean reporting accuracy was 80 and 82 % , respectively . The correlation between reported energy intake and TEEDLW was r 0·4 for the Riksmaten method ( P < 0·05 ) and r 0·28 ( non-significant ) for MiniMeal-Q. Women reported similar average intake of energy and macronutrients in both methods whereas men reported higher intakes with the Riksmaten method . Energy-adjusted correlations ranged from 0·14 ( polyunsaturated fat ) to 0·77 ( alcohol ) . Bl and –Altman plots showed acceptable agreement for energy and energy-adjusted protein and carbohydrate intake , whereas the agreement for fat intake was poorer . According to energy intake data , both methods displayed similar precision on energy intake reporting . However , MiniMeal-Q was less successful in ranking individuals than the Riksmaten method . The development of methods to achieve limited under-reporting is a major challenge for future research Seven studies with repeated measurements of energy intake and /or nitrogen intake were examined to determine whether misreporting is characteristic of some persons or occurs r and omly . Four of the studies were vali date d by doubly labeled water measurements of energy expenditure . Reporting validity was expressed as the ratio of energy intake to energy expenditure . Ratios were consistently below the expected value of 1.0 for some subjects and consistently above 1.0 for others , indicating characteristic reporting validity within subjects . Two year-long studies provided 4 to 12 measurements and a total number of days sufficient to measure individual habitual intake . Subjects  mean energy intake to basal metabolic rate ( BMR ) ratios were < 1.35 in 45 % and 47 % and < 1.35 at every measurement in 25 % of subjects . This indicated persistent underreporting over time , because 1.35 x BMR is the minimum energy expenditure compatible with a normally active lifestyle . Three of the studies used more than 1 assessment method ( vali date d by doubly labeled water and /or urinary nitrogen excretion ) . There was a tendency for persons determined to be underreporters by 1 method to be also underreporters when tested by other methods . We conclude that biased over- or underreporting is characteristic of some persons . Thus , repeat measurements do not necessarily provide valid measures of individual intake , extreme intakes may reflect under- and overreporting rather than true low or high intakes , and subjects most prone to reporting bias may be repeatedly misclassified in quantiles of the distribution . This presents a challenge to dietitians nutritionists , and statisticians both for the design of surveys and the h and ling of flawed data OBJECTIVE To compare two training techniques for validity and reliability of dietary instruments and the measurement of total energy expenditure ( TEE ) to determine whether technique could influence the accuracy of food portion estimates . DESIGN Adult women were r and omized into a control group and an experimental group for comparison of training technique . SETTING University and research center . SUBJECTS Five hundred women were screened using the Three-Factor Eating Question naire to identify restrained eaters or disinhibitors . Other criteria for selection included good health ; absence of thyroid , respiratory , or other diseases ; normal menstrual cycles ; between the ages of 18 and 50 years . Forty-nine were recruited , with an attrition rate of 10 % for a total sample of 44 subjects . INTERVENTION The control group ( n = 26 ) was trained with food models and the experimental group ( n = 18 ) was trained with a combination of food models and life-sized food photographs . All subjects completed two 24-hour recalls and 14 consecutive days of food records . TEE was measured by the doubly-labeled water method . MAIN OUTCOME MEASURES Training would improve the accuracy of food portion estimates . STATISTICAL ANALYSES PERFORMED Analysis of variance , the paired t test , Pearson 's correlation coefficient , and Wilcoxon 's ranking test . RESULTS The mean reported intake between instruments was found to be reliable ; however , the comparison with TEE was underreported by 21.4 % and was thus nonvalid . Training technique made no difference in validity or reliability . Both training techniques improved the accuracy of food portion estimates ; however , improvement was enhanced with food photographs . APPLICATIONS/ CONCLUSION The findings indicate that training can improve food portion estimates , and dietary instruments may provide reliable but nonvalid results OBJECTIVE --To provide an independent evaluation of seven day weighed dietary records , which are currently accepted as the most accurate technique for assessing habitual dietary intake in studies investigating the links between diet and health . DESIGN --Subjects who had previously participated in the Northern Irel and diet and health study were reselected by stratified r and om sampling to represent the range of energy intakes in the study as assessed by the seven day weighed dietary record . SETTING --Northern Irel and . SUBJECTS--31 Free living adults ( 16 men and 15 women ) . MAIN OUTCOME MEASURES --Energy intake as measured by the  seven day weighed dietary record  and total energy expenditure estimated concurrently by the doubly labelled water technique . RESULTS --Average recorded energy intakes were significantly lower than measured expenditure in the group overall ( 9.66 MJ/day v 12.15 MJ/day , 95 % confidence interval 1.45 to 3.53 MJ/day ) . Among those in the upper third of energy intakes the mean ( SE ) ratio of intake to expenditure was close to 1.0 , indicating accurate records ( men 1.01 ( 0.11 ) , women 0.96 ( 0.08 ] . In the middle and lower thirds the ratios for men were only 0.74 ( 0.05 ) and 0.70 ( 0.07 ) respectively and for women 0.89 ( 0.07 ) and 0.61 ( 0.07 ) . CONCLUSIONS --These results show a serious bias in reporting habitual energy intake . If substantiated they may have wide implication s for the interpretation of many nutritional studies Objectives To maintain energy balance , reliable methods for assessing energy intake and expenditure should be used in patients with chronic obstructive pulmonary disease ( COPD ) . The purpose of this study was to vali date the diet history and 7-day food diary methods of assessing energy intake ( EI ) using total energy expenditure ( TEE ) with the doubly labeled water ( DLW ) method ( TEEDLW ) as the criterion method in outpatient women with COPD . Methods EI was assessed by  diet history ( EIDH ) and a 7-day food diary ( EIFD ) in 19 women with COPD , using TEEDLW as the criterion method . The three methods were compared using intra-class correlation coefficients ( ICC ) and Bl and -Altman analyses . The participants were classified according to their reporting status ( EI/TEE ) as valid-reporters 0.79–1.21 , under-reporters < 0.79 or over-reporters > 1.21 . Results Diet history underestimated reported EI by 28 % , and 7-day food diary underestimated EI by approximately 20 % compared with TEEDLW . The ICC analysis showed weak agreement between TEEDLW and EIDH ( ICC=-0.01 ; 95%CI-0.10 to 0.17 ) and between TEEDLW and EIFD ( ICC=0.11 ; 95%CI -0.16 to 0.44 ) . The Bl and -Altman plots revealed a slight systematic bias for both methods . For diet history , six women ( 32 % ) were identified as valid-reporters , and for the 7-day food diary , twelve women ( 63 % ) were identified as valid-reporters . The accuracy of reported EI was only related to BMI . Conclusion The diet history and 7-day food diary methods underestimated energy intake in women with COPD compared with the DLW method . Individuals with higher BMI s are prone to underreporting . Seven-day food diaries should be used with caution in assessing EI in women with COPD New approaches to assess energy intake ( EI ) may have advantages over traditional written methods , but validity of these emerging method ologies must be demonstrated . This exploratory study compared EI obtained using a h and -held personal digital assistant ( PDA ) and traditional written records with total energy expenditure measured by doubly labeled water ( TEE(DLW ) ) . Twenty-six volunteers ( aged 23+/-4 years , body mass index [ calculated as kg/m(2 ) ] 24+/-2 ) participated in a r and omized ( either PDA or written record  group ) and matched ( for sex , age , and body mass index ) study for 7 consecutive days between June 2005 and April 2006 to record EI . Group comparisons were made with t and Mann-Whitney U tests . Bl and -Altman plots were used to compare limits of agreement between methods . Volunteers remained weight stable during the study period ( 0.2+/-0.8 kg ; P>0.05 ) . Reported EI by written record and PDA were similar to TEE(DLW ) ; 105 % vs 92 % of TEE(DLW ) , respectively ( P>0.05 ) . There was a significant relationship between reported EI by PDA and TEE(DLW ) ( r=0.60 , P<0.05 ) , but not for written record ( r=0.45 , P>0.05 ) . Limits of agreement indicated both written record and PDA had large variability ( range 1,394 to -1,472 kcal/day ) . Findings suggest the bias in using a PDA is similar to that observed when using a written record for estimation of EI in weight-stable volunteers
Accuracy in quantifying energy intake ( EI ) using common dietary assessment methods is crucial for interpreting the relationship between diet and chronic disease .
The aim of this systematic review was to evaluate the validity of dietary assessment methods used to estimate the EI of adults in comparison to total energy expenditure ( TEE ) measured by doubly labeled water ( DLW ) .