Objective: Research in industrialised countries has documented a high prevalence of underreported energy intakes associated with characteristics such as obesity. This paper examines the prevalence, patterns and impact of energy under-and overreporting on diet-obesity relationships in a middle-income developing country. Design: A 70-item food-frequency questionnaire was used. Underreporters had reported energy intakes , 1.35 £ basal metabolic rate (BMR), overreporters . 2.4 £ BMR. Multinomial models were used to identify characteristics associated with implausible reporting. Intakes were compared across reporting groups to assess evidence of bias. Associations between diet and obesity were compared with and without adjustment for implausible reporting. Setting: Spanish Town, neighbouring the capital city of Kingston, Jamaica. Subjects: Eight hundred and ninety-one Jamaican adults, aged 25-75 years, were randomly recruited. Results: More women than men (38.6% vs. 22.5%) underreported, but more men overreported energy (23.7% vs. 16.0%). Underreporting was positively associated with obesity, special diets, smoking and age; age was inversely associated with overreporting. Underreporters estimated lower energy from potentially socially undesirable food groups (e.g. snacks) and higher intakes of 'healthy' foods (e.g. fruit) than did plausible reporters. For some of these food groups, significant differences in intakes among normal-weight versus obese subjects observed among plausible reporters were absent when implausible reporters were included. In models of food group -obesity associations, adjusting for implausible energy yielded more credible results that more closely resembled findings in plausible reporters. Conclusions: Energy under-and overreporting are highly prevalent in Jamaica. Adjusting for implausible reporting may help to reduce bias in diet -health outcome associations.

BackgroundThe growing international movement legislating medical marijuana has brought renewed interest to the role of marijuana smoking on fertility potential. Although studies have identified that sperm quality can be compromised by marijuana use, little focus has been placed specifically on those trying to conceive. In this study, we aimed to clarify the impact of marijuana use in semen quality in men being investigated for assisted reproduction.Materials and methodsWe conducted a cross‐sectional study at a university‐based facility in Jamaica. Routine semen analyses were performed on 229 men ages 23–72 years who were new clients. Logistic regression analyses were performed in order to independently predict quantifiable measures of the impact of marijuana use. The main outcome measures were sperm motility, total motile spermatozoa and morphology.ResultsOverall, 47% of the participants reported marijuana use with 21% of these men reporting recent use. Regression analyses showed that recent use and users of large quantities of marijuana were 2.6 times (aOR = 2.6; 95% CI, 1.0–6.8, p = 0.044) and 4.3 times (aOR = 4.3; 95% CI, 1.1–15.9, p = 0.030) at greater risk of being diagnosed with abnormal motility (asthenozoospermia). Additionally, moderate quantity users were 3.4 times (aOR = 3.4; 95% CI, 1.5–7.9, p = 0.004) more likely to be diagnosed with abnormal morphology (teratozoospermia).Discussion and conclusionRecent use of marijuana as well as moderate to large quantities had an impact on sperm motility and morphology in men being investigated for infertility. We recommend therefore that men undergoing fertility investigations be routinely asked about their recreational use of marijuana and in particular recent and heavy users counselled to stop.

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