Estimating activity energy expenditure: How valid are physical activity questionnaires?

Division of Population Health and Information, Alberta Cancer Board, Calgary, Canada.
American Journal of Clinical Nutrition (Impact Factor: 6.77). 03/2008; 87(2):279-91.
Source: PubMed

ABSTRACT Activity energy expenditure (AEE) is the modifiable component of total energy expenditure (TEE) derived from all activities, both volitional and nonvolitional. Because AEE may affect health, there is interest in its estimation in free-living people. Physical activity questionnaires (PAQs) could be a feasible approach to AEE estimation in large populations, but it is unclear whether or not any PAQ is valid for this purpose. Our aim was to explore the validity of existing PAQs for estimating usual AEE in adults, using doubly labeled water (DLW) as a criterion measure. We reviewed 20 publications that described PAQ-to-DLW comparisons, summarized study design factors, and appraised criterion validity using mean differences (AEE(PAQ) - AEE(DLW), or TEE(PAQ) - TEE(DLW)), 95% limits of agreement, and correlation coefficients (AEE(PAQ) versus AEE(DLW) or TEE(PAQ) versus TEE(DLW)). Only 2 of 23 PAQs assessed most types of activity over the past year and indicated acceptable criterion validity, with mean differences (TEE(PAQ) - TEE(DLW)) of 10% and 2% and correlation coefficients of 0.62 and 0.63, respectively. At the group level, neither overreporting nor underreporting was more prevalent across studies. We speculate that, aside from reporting error, discrepancies between PAQ and DLW estimates may be partly attributable to 1) PAQs not including key activities related to AEE, 2) PAQs and DLW ascertaining different time periods, or 3) inaccurate assignment of metabolic equivalents to self-reported activities. Small sample sizes, use of correlation coefficients, and limited information on individual validity were problematic. Future research should address these issues to clarify the true validity of PAQs for estimating AEE.

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Available from: Christine M Friedenreich, Aug 25, 2014
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    • "These findings have been reported in other studies that examined self-reporting energy intake (Schoeller et al., 1990; Weber et al., 2001) and exercise related energy expenditure. (Neilson et al., 2008; Shephard, 2003). In addition, the accuracy of the data may also be questionable if the participants did not fill out the daily fluid chart every day by using the measuring cup, as requested, but rather filled the chart by estimating fluid intake and using memory. "
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    • "Various studies have been conducted in sub-Saharan Africa to investigate participation in physical activity and have shown the urban-rural discrepancies but most of these made use of self-reported information with questionnaires that are not validated for this population (Mbanya et al., 2010; Neilson, Robson, Friedenreich & Csizmadi, 2008; Sobngwi et al., 2004). Despite these concerns expressed by the Mbanya and colleagues (2010), these quantitative studies, in the absence of others, give some indication of physical activity participation and patterns and trends among individuals. "
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    • "Comparisons of physical activity levels assessed through questionnaires and DLW have also produced heterogeneous findings. A review of 20 validation studies on this topic concluded that the validity of physical activity questionnaires in adults to estimate PAEE is ‘unclear’ [12]. Corder et al. conducted a validation study of four different self-report questionnaires for children and adolescents against DLW and accelerometry and found that that there was no single physical activity questionnaire able accurately to assess all dimensions of PAEE, and that the ability to predict PAEE differed according to the questionnaire used and the age group studied [13]. "
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