Predictors of misreporting in an elderly population: the ‘Quality of life after 65’ study

Abstract

Objectives: To evaluate the prevalence and identify some predictors of misreporting in an elderly Belgian population and to assess the effect of underreporting on estimated intakes of macronutrients and foods. Design: A 1-day food record was completed by 2083 adult men and women aged 65 years or more. Individuals whose energy intake was lower than 0.90 £ BMR (basal metabolic rate) were defined as underreporters. Overreporting was defined as energy intake greater than 2 £ BMR. Results: Underreporting and overreporting occurred in 13.6% and 7.9% of food records, respectively. Results from logistic regression models indicated that gender and body mass index (BMI) were predictors of misreporting. Whereas women were more likely to underreport energy intake, the prevalence of overreporting was higher in men. Underreporting was more prevalent among obese people and overreporting more prevalent in normal-weight subjects. Smoking status and education level did not predict underreporting; however, overreporting was more likely to occur in more highly educated subjects. A cultural difference in reporting of nutrient intakes was also found, with the percentage of underreporters being higher among Walloons compared with Flemish. Conclusion: BMI seemed to be one of the most important factors in misreporting. This calls for special attention when dietary surveys are performed on obese or lean people. Keywords Dietary assessmentEnergy intake Misreporting Validity Basal metabolic rateThe measurement of nutrient intake in dietary surveys represents a methodological challenge. This measurement sometimes relies on self-reports of food intake over varying periods of time. The most widely used methods are dietary recalls, where subjects report on foods consumed over the previous 24 hours; diet diaries, in which subjects record all food consumed on a daily basis; and food-frequency questionnaires, which require subjects to report food consumption patterns over times ranging from one month to one year or more. Because all dietary methods have their limitations, none of these can be considered a 100% reliable reference measure for assessing dietary intake. Therefore, biological markers of food intake have been sought in order to validate selfreported energy intake by objective measures 1 -5 . The doubly labelled water technique is an example of a biomarker that can be used to validate self-reported energy intake 1 -4 . This technique is used to measure energy expenditure in free-living subjects and is currently considered the 'gold standard' for the measurement of total energy expenditure in humans. Comparing measured energy expenditure with reported energy intake gives an idea of the degree of misreporting in a dietary survey.All mentioned dietary methods are prone to under-or/and overreporting of energy intake 6 . This misreporting may result from difficulties in accurately reporting food consumption and portion size, changing eating patterns or overestimating consumption of more socially desirable foods, etc. 7 . Because the...

Anthropometric, metabolic, dietary and psychosocial profiles of underreporters of energy intake: a doubly labeled water study among overweight/obese postmenopausal women—a Montreal Ottawa New Emerging Team study

“…This suggests that higher levels of fat mass and perceived stress may be associated with a higher risk of underreporting. Accordingly, similar results have been shown in other studies (Rosell et al, 2003;Samuel-Hodge et al, 2004;Bazelmans et al, 2007;Lanctot et al, 2008). These results potentially underscores the importance of fat mass and perceived stress as potential modulating factors in the development of underreporting in overweight and obese postmenopausal women because multiple factors in different fields were used in this study.…”

Misreporting of dietary energy intake in adolescents

“…Os métodos mais comumente usados, incluindo o recordatório de 24 horas, os questionários de frequência alimentar e os diários alimentares, estão todos associados aos desafios de uma avaliação precisa. A magnitude da subnotificação apresenta grande variação entre os estudos 1,[7][8][9] . Portanto, o objetivo deste estudo foi examinar a prevalência da sub e supernotificação entre adolescentes obesos e de peso normal e seus fatores associados.…”

Notificação imprecisa da ingestão energética entre usuários de Serviços de Promoção à Saúde

“…Rasmussem et al 11 ain- da encontraram associação com a tentativa de comer de forma mais saudável e a preocupação com o peso corporal. Associado a esse fator encontra-se a relação com o excesso de peso, que é bem relatada pela literatura 3,4,11,[22][23][24][25][26] em virtude da comum insatisfação corporal evidenciada nestes casos 22,27 . No presente estudo observou-se relação independente entre subnotificação e a classificação de CC muito elevada, que também é um indicativo de excesso de peso, principalmente no que diz respeito ao excesso de gordura abdominal 29 .…”

“…Essa imprecisão pode comprometer, seriamente, a interpretação dos resultados de pesquisas que relacionam nutrição e saúde, sobretudo quando se refere ao conteúdo energético da dieta, interferindo, consequentemente, na avaliação da ingestão de nutrientes 3,4 .…”

“…Essa ocorrência da notificação imprecisa pode ser determinada por métodos que validam a ingestão energética autorreferida 3,5 , propiciando magnitudes diferentes entre os estudos e as populações 5 . Estudo de revisão bibliográfica apontou prevalência de subnotificação da ingestão alimentar variando de 21,5% a 67%, e de supernotificação, de 1% a 6% entre as mulheres e 1,6% entre homens, com o uso do R24h como método para avaliação do consumo alimentar.…”