Energy balance measurement: when something is not better than nothing

Abstract

Energy intake (EI) and physical activity energy expenditure (PAEE) are key modifiable determinants of energy balance, traditionally assessed by self-report despite its repeated demonstration of considerable inaccuracies. We argue here that it is time to move from the common view that self-reports of EI and PAEE are imperfect, but nevertheless deserving of use, to a view commensurate with the evidence that self-reports of EI and PAEE are so poor that they are wholly unacceptable for scientific research on EI and PAEE. While new strategies for objectively determining energy balance are in their infancy, it is unacceptable to use decidedly inaccurate instruments, which may misguide health care policies, future research, and clinical judgment. The scientific and medical communities should discontinue reliance on self-reported EI and PAEE. Researchers and sponsors should develop objective measures of energy balance.

Nausea and vomiting in early pregnancy: Effects on food intake and diet quality

“…FFQs have also demonstrated relative stability in the assessment of dietary patterns over time (Hu et al, 1999; Khani et al, 2004; Borland et al, 2008). The estimation of energy intake using self‐reported dietary data is a topic of current concern (Dhurandhar et al, 2015). Although we did not observe large changes in energy intake across the nausea categories in early pregnancy associated with NVP, there may have been small differences in intake that were obscured by measurement error.…”

A pilot study to determine whether using a lightweight, wearable micro-camera improves dietary assessment accuracy and offers information on macronutrients and eating rate

“…To understand the impact of nutritional health in the population there is a need to understand and measure energy expenditure and intake accurately. Common techniques mainly include self-reported questionnaires and dietary records, which are subjective and known to have varying degrees of accuracy, and for this reason some have argued that all memory-based techniques should not be used in nutrition research and that objective measures should be developed in their place (1,2) . Estimates from a sample of adults aged 19-65 years participating in the 2000 UK National Diet and Nutrition Survey suggest that under-reporting occurs in up to 88 % of the sample depending on the method used to calculate underreporting and the various sub-samples examined (3) .…”

Identifying dietary differences between Scotland and England: a rapid review of the literature

“…For example, Scotland has not reported lower levels of overweight and obesity, which would be the expected outcome of lower energy intakes (75) . At a population level there are not yet objective measures of dietary intake that can be utilised (85,86) ; however, we would not expect dietary assessment data collected in Scotland to be less accurate than those collected in England. Weighed intake (considered the gold standard) was used in many of the studies, with only a small number using non-validated food frequency measures.…”