Discrepancy between Self-Reported and Actual Caloric Intake and Exercise in Obese Subjects

Lichtman, Steven W.; Pisarska, Krystyna; Berman, Ellen Raynes; Pestone, Michele; Dowling, Hillary J.; Offenbacher, Esther G.; Weisel, Hope; Heshka, Stanley; Matthews, Dwight E.; Heymsfield, Steven B.

doi:10.1056/nejm199212313272701

Cited by 1,134 publications

(633 citation statements)

References 26 publications

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“…First, both occupational and domestic activity data rely on selfreport, which can lead to recall bias. Studies have shown that overweight individuals tend to over-report their physical activity (Lichtman et al, 1992;Buchowski et al, 1999); however, the majority of this work has not been done in populations from lower-income developing countries where the stigma with being overweight is much less established. Nonetheless, if this were the case in these data, overreporting of activity data would only serve to attenuate the estimates by misclassifying overweight individuals as being more active than they truly are.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal relationships between occupational and domestic physical activity patterns and body weight in China

Monda

Zhai³

et al. 2007

Eur J Clin Nutr

146

114

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Objectives: To examine the longitudinal relationship between occupational and domestic sources of physical activity and body weight in a sample of Chinese adults. Methods: Population-based longitudinal observational study of Chinese adults (4697 women and 4708 men) aged 18-55 from the 1991, 1993, 1997, and 2000 waves of the China Health and Nutrition Survey. Measured height and weight and detailed self-reported energy expenditure from multiple occupational and domestic sources were assessed over a 9-year period. Longitudinal relationships were modeled using linear random effects models. Results: Increased occupational physical activity resulted in overall lower body weight for both men and women (b-coefficients (95% confidence interval (CI)) for high levels: À0.46 (À0.76, À0.15) for men, À0.36 (À0.62, À0.10) for women, and increased domestic physical activity resulted in overall lower body weight in men (b-coefficient (95% CI): À0.40 (À0.62, À0.18)). Conclusions: Physical activity that occurs in the occupational and domestic sectors is often overlooked; yet our research suggests they have important effects on body weight in Chinese adults. As China continues to urbanize, energy expenditure from these sources is decreasing, and our results point out the need to explore these types of physical activity more broadly across the world as potential sources of weight gain.

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Section: Discussionmentioning

confidence: 99%

Longitudinal relationships between occupational and domestic physical activity patterns and body weight in China

Monda

Zhai³

et al. 2007

Eur J Clin Nutr

146

114

View full text Add to dashboard Cite

show abstract

“…The problem has been identi®ed by several external markers of intake: ®rst, comparisons between self-reported energy intake and the energy intake required to maintain body weight in longterm metabolic studies (Lichtman et al, 1992;Mertz et al, 1991); second, comparisons between reported nitrogena protein intake and 24-h urinary nitrogen excretion where the 24-h urine collection has been validated by the PABA-CHEK technique (Bingham & Cummings, 1983;Bingham et al, 1995;Bingham & Cummings, 1985;Isaksson, 1980); third, comparisons between reported energy intake (EI) and energy expenditure measured by the doubly labelled water technique (EE) (Bandini et al, 1987;Black et al, 1993;Livingstone et al, 1992;Prentice et al, 1986a;Westerterp et al, 1986).…”

Section: Introductionmentioning

confidence: 99%

The sensitivity and specificity of the Goldberg cut-off for EI:BMR for identifying diet reports of poor validity

2000

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Objective: To explore the speci®city and sensitivity of the Goldberg cut-off for EI : BMR for identifying diet reports of poor validity as compared with the direct comparison of energy intake with energy expenditure measured by doubly-labelled water. Design: Twenty-two studies with measurements of total energy expenditure by doubly-labelled water (EE), basal metabolic rate (BMR) and energy intake (EI) provided the database (n 429). The ratio EI : EE provided the baseline de®nition of under-(UR), acceptable-(AR) and over-reporters (OR), respectively EI : EE`0.76, 0.76 ± 1.24 and b 1.24. Four strategies for identifying under-and over-reporters using the Goldberg cut-off were explored. Sensitivity of the cut-off was calculated as the proportion of UR correctly identi®ed and speci®city as the proportion of non-UR correctly identi®ed. Results: UR, AR and OR (by EI : EE) were 34, 62 and 4% respectively of all subjects. When a single Goldberg cut-off for the physical activity level (PAL) of 1.55 was used, for men and women respectively the sensitivity was 0.50 and 0.52 and the speci®city 1.00 and 0.99. Using a cut-off for higher PAL traded speci®city for sensitivity. Using the cut-off for a PAL of 1.95, sensitivity was 0.76 and 0.85 and the speci®city 0.87 and 0.78 for men and women respectively. Using cut-offs for mean age ± sex speci®c PAL did not improve sensitivity. When subjects were assigned to low, medium and high activity levels and cut-offs for three different PALs used, sensitivity improved to 0.74 and 0.67 without loss of speci®city (0.97 and 0.98), for men and women respectively. If activity levels for men were applied to the womens' data, sensitivity improved to 0.72. Conclusion: To identify diet reports of poor validity using the Goldberg cut-off for EI : BMR, information is needed on each subject's activity level.

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“…Findings thus far have shown overweight and higher physical activity to be associated with greater under-reporting of energy intake (Lichtman et al, 1992;Prentice et al, 1986;Lansky & Brownell, 1982;Edwards et al, 1993). One investigator (Lichtman et al, 1992) recently noted that`the mechanisms responsible [for the consistent under-report] are not well understood'.…”

Section: Introductionmentioning

confidence: 99%

“…The ®rst domain would be based on physiological characteristics, such as age and body composition as previously reported in the literature. These variables would be used to control for previously reported factors that were associated with underreporting (Lichtman et al, 1992;Bandini et al, 1990;Prentice et al, 1986;Lansky & Brownell, 1982;Pannemans & Westerterp, 1993). The second domain of factors would be psychological indicators that are directly related to concerns about diet and body weight (Wear & Pratz 1987;Gross et al, 1986;Welch et al, 1990;Ruderman 1986;Klesges et al, 1991).…”

Section: Introductionmentioning

confidence: 99%

The association of energy intake bias with psychological scores of women

et al. 1999

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Objective: Assess the association between reporting bias of dietary energy intake and the behavioral and psychological pro®les in women. Design: At baseline a series of questionnaires were administered to 37 women, (the Marlowe-Crowne Social Desirability Scale, Weinberger Adjustment Inventory (WAI), the Eating Disorder Inventory (EDI), the Restraint Scale and Sorensen-Stunkard's silhouettes). Subjects received training on how to record dietary records. Subjects recorded three days of dietary records to measure energy intake (EI) during a study to determine total energy expenditure (TEE) using doubly labeled water. Reporting accuracy (RA EIaTEE 6 100) was determined for each subject. Statistical analysis of the data used a mixed effects model accounting for within subject variability to determine if the psychological scores were associated with reporting accuracy. Setting and subject: Women were recruited with local advertisements in Tucson, Arizona. The women had a mean ( AE 1 s.d.) age of 43.6 AE 9.3 yrs, body mass index (BMI) of 28.7 AE 8.5 kgam 2 and total body fat (%TBF) of 31.9 AE 7.3%. Results: Age and %TBF were signi®cantly and inversely associated with RA. Furthermore, Social Desirability was negatively associated with RA. Body dissatisfaction and associating a smaller body size than one's own as being more healthy were also associated with a lower RA. Conclusions: These results suggest that Social Desirability and self image of body shape are associated with RA. Modi®cations in subject training may reduce the effect of these factors on RA. Sponsorship: This project was supported by a grant from the National Institute of Diabetes, Digestive and

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Discrepancy between Self-Reported and Actual Caloric Intake and Exercise in Obese Subjects

Abstract: The failure of some obese subjects to lose weight while eating a diet they report as low in calories is due to an energy intake substantially higher than reported and an overestimation of physical activity, not to an abnormality in thermogenesis.

Cited by 1,134 publications

References 26 publications

Longitudinal relationships between occupational and domestic physical activity patterns and body weight in China

Longitudinal relationships between occupational and domestic physical activity patterns and body weight in China

The sensitivity and specificity of the Goldberg cut-off for EI:BMR for identifying diet reports of poor validity

The association of energy intake bias with psychological scores of women

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