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Health issues and nutrition in the elderly

Misreporting of dietary energy intake obtained by 24 h recalls in older adults: a comparison of five previous methods using doubly labeled water

European Journal of Clinical Nutrition volume 76, pages 535–543 (2022)Cite this article

Subjects

Abstract

Background/objective

To test five different methods to detect misreporting in comparison to doubly labeled water in a sample of older adults.

Subjects/methods

A cross-sectional study with thirty-eight Brazilian community-dwelling older adults aged 60–84 years, who had their total energy expenditure measured by doubly labeled water (TEEDLW). Dietary data were collected by two 24 h recalls. Misreporting was compared with estimates obtained by the methods proposed by: Goldberg et al. [1, 2], Black [3], McCrory et al. [4], Huang et al [5], and Rennie et al [6]. Bland–Altman plots with 95% limits of agreement were constructed to assess the agreement between rEI and TEEDLW. Weighted kappa coefficients, sensitivity and specificity analyses, and area under the receiving operator characteristic curve (AUC) were used to test the performance of each method.

Results

The prevalence of under-reporters (UR) and over-reporters (OR) obtained by the reference (DLW) were 57.9% (n = 22) and 5.3% (n = 2), respectively. Black [3] presented the worst agreement and McCrory et al. [4] the best one to accurately classify individuals in the three categories of energy reporting. McCrory et al. [4] had the best performance in the sensitivity and specificity analyses detecting UR and plausible reporters.

Conclusions

There was a high prevalence of misreporting, especially underreporting, in this sample of community-dwelling Brazilian older adults. The study showed a wide variation in the accuracy of predictive methods to handle misreporting, with none of the equations showing outstanding agreement with the reference. When DLW is not available, a valid method should be chosen to address energy intake reporting.

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Fig. 1: Different methods for estimating misreporting of energy intake.
Fig. 2: Bland–Altman plots of energy expenditure measured by doubly labeled water (TEEDLW) and reported energy intake for the general population and stratified by sex. São Paulo—Brazil, 2017.
Fig. 3: Percentage distribution of categories of reporting energy intake by different methods in comparison to the reference (DLW) in 38 free-living older adults. São Paulo—Brazil, 2017.

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Acknowledgements

We would like to thank all fieldworkers and all participants. We also acknowledge the work of the Dietary Intake Research Group (Grupo de Avaliação do Consumo Alimentar) at the University of São Paulo and the workers at the Isotope Ratio Mass Spectrometry Laboratory of the Ribeirão Preto Medical School—University of São Paulo, Brazil. This work was supported by the São Paulo Research Foundation (grant number 2018/01991-4) and the National Council for Scientific and Technological Development (grant number 134149/2018-1). The Health Survey of São Paulo was supported by the São Paulo Research Foundation (grant number 2017/05125-7), and National Council for Scientific and Technological Development (grant number 301597/2017–0).

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Authors and Affiliations

  1. Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, SP, Brazil

    Lais Duarte Batista, Natasha Aparecida Grande de França, Mariane de Mello Fontanelli & Regina Mara Fisberg

  2. Centro Universitário de Rio Preto (UNIRP), São José do Rio Preto, SP, Brazil

    Natasha Aparecida Grande de França

  3. Centro de Investigación del Comportamiento Alimentario, School Nutrition and Dietetics, Faculty of Pharmacy, University of Valparaiso, Valparaíso, Chile

    Angela Graciela Martinez-Arroyo

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  1. Lais Duarte Batista
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Contributions

LDB contributed to the conception and design of the study, analysis, and interpretation of the findings, and drafting the paper. NAGF, MMF, and AMA contributed to the interpretation of findings, and revising it critically for important intellectual content. RMF contributed to the conception and design of the study, data acquisition, and revising it critically for important intellectual content. All authors approved the final version to be published.

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Correspondence to Regina Mara Fisberg.

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Batista, L.D., de França, N.A.G., Fontanelli, M.d.M. et al. Misreporting of dietary energy intake obtained by 24 h recalls in older adults: a comparison of five previous methods using doubly labeled water. Eur J Clin Nutr 76, 535–543 (2022). https://doi.org/10.1038/s41430-021-00998-z

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