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An evaluation of the sensitivity and specificity of energy expenditure measured by heart rate and the Goldberg cut-off for energy intake: basal metabolic rate for identifying mis-reporting of energy intake by adults and children: a retrospective analysis

European Journal of Clinical Nutrition volume 57, pages 455–463 (2003)Cite this article

An Erratum to this article was published on 08 May 2003

Abstract

Objective: To identify adults and children as under- (UR), acceptable (AR), or over-reporters (OR) of energy intake (EI) using energy expenditure measured by doubly labelled water (DLW) (EEDLW), and to use this as a reference to determine the sensitivity and specificity of (i) EE measured by heart rate (EEHR), and (ii) the Goldberg cut-off technique for classifying subjects into the same categories.

Design: Retrospective analysis of a dataset comprising concurrent measurements of EEDLW, EEHR, basal metabolic rate (BMR), and EI by weighed record (EIWR) on 14 adults and 36 children. EI by diet history (EIDH) was also measured in the children only. EIWR:EEDLW provided the reference definition of subjects as UR, AR or OR. Three strategies for classifying mis-reporters based on EEHR and Goldberg cut-offs were then explored. Sensitivity and specificity were calculated respectively as the proportion of UR and non-UR correctly identified.

Results: Approximately 80% of all subjects were AR. For EIWR and EIDH respectively, the sensitivity of EEHR was 0.50 and 1.00, and specificity was 0.98 and 1.00. Although designating subjects as having low, medium or high activity levels (EEHR:BMRmeas) and calculating cut-offs based on appropriate WHO physical activity level PALs did not change sensitivity, specificity dropped to 0.98 (EIWR) and 0.97 (EIDH). Cut-offs based on a PAL of 1.55 reduced sensitivity to 0.33 (EIWR) and 0.00 (EIDH), but specificity remained unchanged. The sensitivity of all cut-offs based on physical activity level (PALs) for EIWR was 0.50 (adults) and 0.25 (children).

Conclusions: If the precision of EEHR was improved, it may be useful for identifying mis-reporters of EI.

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Acknowledgements

We thank the subjects who took part in these studies.

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Authors and Affiliations

  1. Northern Ireland Centre for Diet and Health, University of Ulster, Coleraine, Co Londonderry, Northern Ireland, UK

    M B E Livingstone, P J Robson, J M W Wallace, M C McKinley, J J Strain & P G McKenna

  2. 9 Birch Close, Cambridge, UK

    A E Black

  3. MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK

    W A Coward

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  1. M B E Livingstone
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  2. P J Robson
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  3. A E Black
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  4. W A Coward
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  6. M C McKinley
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  7. J J Strain
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  8. P G McKenna
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Contributions

Guarantor: Dr M B E Livingstone.

Contributors: MBEL was the principal author and was responsible for executing the original adult and child cohorts. PJR participated in the conceptualisation, data analysis, drafting and critical review of the manuscript. AEB formulated the specific hypothesis and critically reviewed the manuscript. WAC was responsible for over-seeing the original doubly labelled water analysis and critically reviewed the manuscript. JMWW, McMcK, JJS and PGMcK participated in conceptualisation and helped with the drafting and critical review of the manuscript.

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Correspondence to M B E Livingstone.

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Livingstone, M., Robson, P., Black, A. et al. An evaluation of the sensitivity and specificity of energy expenditure measured by heart rate and the Goldberg cut-off for energy intake: basal metabolic rate for identifying mis-reporting of energy intake by adults and children: a retrospective analysis. Eur J Clin Nutr 57, 455–463 (2003). https://doi.org/10.1038/sj.ejcn.1601563

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