Dietary Underreporting by Obese Individuals--is It Specific or Non-specific?

Overview

Journal BMJ

Specialty General Medicine

Date 1995 Oct 14

PMID 7580640

Citations 160

Authors

B L Heitmann

L Lissner

Affiliations

Soon will be listed here.

Abstract

Objective: To examine the distribution of patterns of macronutrient density in relation to obesity.

Design: Cross sectional.

Setting: Denmark.

Subjects: 323 men and women aged 35-65 years, selected randomly from a larger population sample of Danish adults.

Main Outcome Measure: Bias in dietary reporting of energy and protein intake in relation to percentage body fat, assessed by comparison of data from an interview on dietary intake with data estimated from 24 hour nitrogen output, validated by administering p-aminobenzoic acid, and estimated 24 hour energy expenditure.

Results: Degree of obesity was positively associated with underreporting of total energy and protein, whereas compared with total energy reported, protein was overreported by the obese subjects.

Conclusion: Errors in dietary reporting of protein seem to occur disproportionately with respect to total energy, suggesting a differential reporting pattern of different foods. Although, on average, all subjects showed a greater underreporting of energy than of protein, this was most common in the obese subjects. Snack-type foods may be preferentially forgotten when obese people omit food items in dietary reporting. These results seem to agree with the general assumption that obese people tend to underreport fatty foods and foods rich in carbohydrates rather than underreport their total dietary intake. These results may have implications for the interpretation of studies of diet and comorbidities related to obesity.

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References

Jackson A . Does the Nutrition Society serve the needs of its overseas members?. Proc Nutr Soc. 1991; 50(1):1-7. DOI: 10.1079/pns19910003. View

Heitmann B . Body fat in the adult Danish population aged 35-65 years: an epidemiological study. Int J Obes. 1991; 15(8):535-45. View

Black A, Goldberg G, Jebb S, Livingstone M, Cole T, Prentice A . Critical evaluation of energy intake data using fundamental principles of energy physiology: 2. Evaluating the results of published surveys. Eur J Clin Nutr. 1991; 45(12):583-99. View

Heitmann B . The effects of gender and age on associations between blood lipid levels and obesity in Danish men and women aged 35-65 years. J Clin Epidemiol. 1992; 45(7):693-702. DOI: 10.1016/0895-4356(92)90046-p. View

Drewnowski A, Kurth C, Holden-Wiltse J, Saari J . Food preferences in human obesity: carbohydrates versus fats. Appetite. 1992; 18(3):207-21. DOI: 10.1016/0195-6663(92)90198-f. View

Lichtman S, Pisarska K, Berman E, Pestone M, Dowling H, Offenbacher E . Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. N Engl J Med. 1992; 327(27):1893-8. DOI: 10.1056/NEJM199212313272701. View

Lissner L, Lindroos A . Is dietary underreporting macronutrient-specific?. Eur J Clin Nutr. 1994; 48(6):453-4. View

Summerbell C, Moody R, Shanks J, Stock M, Geissler C . Sources of energy from meals versus snacks in 220 people in four age groups. Eur J Clin Nutr. 1995; 49(1):33-41. View

Rutishauser I . Is dietary underreporting macronutrient specific?. Eur J Clin Nutr. 1995; 49(3):219-20. View

10.

Isaksson B . Urinary nitrogen output as a validity test in dietary surveys. Am J Clin Nutr. 1980; 33(1):4-5. DOI: 10.1093/ajcn/33.1.4. View

11.

Bingham S, Cummings J . The use of 4-aminobenzoic acid as a marker to validate the completeness of 24 h urine collections in man. Clin Sci (Lond). 1983; 64(6):629-35. DOI: 10.1042/cs0640629. View

12.

Bingham S, Cummings J . Urine nitrogen as an independent validatory measure of dietary intake: a study of nitrogen balance in individuals consuming their normal diet. Am J Clin Nutr. 1985; 42(6):1276-89. DOI: 10.1093/ajcn/42.6.1276. View

13.

Prentice A, Black A, Coward W, Davies H, Goldberg G, Murgatroyd P . High levels of energy expenditure in obese women. Br Med J (Clin Res Ed). 1986; 292(6526):983-7. PMC: 1339917. DOI: 10.1136/bmj.292.6526.983. View

14.

Garby L, Garrow J, Jorgensen B, Lammert O, Madsen K, Sorensen P . Relation between energy expenditure and body composition in man: specific energy expenditure in vivo of fat and fat-free tissue. Eur J Clin Nutr. 1988; 42(4):301-5. View

15.

Lissner L, Habicht J, Strupp B, Levitsky D, Haas J, Roe D . Body composition and energy intake: do overweight women overeat and underreport?. Am J Clin Nutr. 1989; 49(2):320-5. DOI: 10.1093/ajcn/49.2.320. View

16.

Livingstone M, Prentice A, Strain J, Coward W, Black A, Barker M . Accuracy of weighed dietary records in studies of diet and health. BMJ. 1990; 300(6726):708-12. PMC: 1662510. DOI: 10.1136/bmj.300.6726.708. View

17.

Hulten B, Bengtsson C, Isaksson B . Some errors inherent in a longitudinal dietary survey revealed by the urine nitrogen test. Eur J Clin Nutr. 1990; 44(3):169-74. View

18.

Heitmann B . Prediction of body water and fat in adult Danes from measurement of electrical impedance. A validation study. Int J Obes. 1990; 14(9):789-802. View

19.

Jensen K, Jorgensen T . Incidence of gallstones in a Danish population. Gastroenterology. 1991; 100(3):790-4. DOI: 10.1016/0016-5085(91)80027-7. View

20.

Schoeller D . How accurate is self-reported dietary energy intake?. Nutr Rev. 1990; 48(10):373-9. DOI: 10.1111/j.1753-4887.1990.tb02882.x. View