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Energy expenditure (EE), energy intake (EI), the relationship between EI and EE, physical activity level (PAL ¼ EE/basal meta- bolic rate) and underreporters in study 1 and study 2
Source publication
To validate energy intake (EI) estimated from pre-coded food diaries against energy expenditure (EE) measured with a validated position-and-movement monitor (ActiReg) in groups of 13-year-old Norwegian schoolchildren.
Two studies were conducted. In study 1 the monitoring period was 4 days; participants recorded their food intake for four consecutiv...
Contexts in source publication
Context 1
... differences in BMI and BMR were observed between the participants in study 1 and study 2 (P ¼ 0.06 and P ¼ 0.38, respectively). Overall, the difference between EI and EE was larger in study 1 than in study 2 (Table 2) (P ¼ 0.001). In study 1 the difference between EI and EE was significantly larger among boys than girls; the opposite was observed in study 2 with the girls having the larger difference (Table 2). ...
Context 2
... the difference between EI and EE was larger in study 1 than in study 2 (Table 2) (P ¼ 0.001). In study 1 the difference between EI and EE was significantly larger among boys than girls; the opposite was observed in study 2 with the girls having the larger difference (Table 2). Table 2 also shows that the physical activity level (PAL ¼ EE/BMR) was higher in both boys and girls in study 1 compared with study 2. ...
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Citations
... In fact, in the FFQ, 36 food items were used to describe the groups of fruits, vegetables, and legumes which could explain the overestimation of vitamin C and folate equivalents intakes in the FFQ (despite an acceptable agreement for the classification). Another possible explanation for the large differences in average nutrients and food intakes between the compared methods is the underreporting bias that interferes with the food intake data obtained from food records (Andersen et al., 2005;Chinnock, 2006). Chinnock (2006) analyzed data from 60 Costa Rican adults and observed that food intake data collected with estimated food records were underestimated for energy, nutrients, and food groups, when compared to the results obtained from a weighed food record. ...
... Chinnock (2006) analyzed data from 60 Costa Rican adults and observed that food intake data collected with estimated food records were underestimated for energy, nutrients, and food groups, when compared to the results obtained from a weighed food record. Andersen et al. (2005) observed that energy intake estimated with a pre-coded food diary was 34% lower than the estimated energy expenditure among Norwegian adolescents. Possible underreporting in the food records and/or overreporting in the FFQ may have influenced the results observed in this study. ...
Introduction: Food Frequency Questionnaires (FFQ) have been widely used in several age groups, including adolescents, due to their greater advantages over other dietary measurement methods. Therefore, this study was designed to assess the validity and reliability of a FFQ designed for use on Costa Rican adolescents. Methodology: The validation and reproducibility studies were carried out in a sample of 107 adolescents of San José province selected through convenience sampling. For validation, a comparison of the nutrient intake and food consumption data obtained with the FFQ was made with those derived from the 3-day food record (3FR). Reliability was assessed by comparing nutrient intake and food consumption derived from the first FFQ with another FFQ performed four weeks after the first. Results: FFQ overestimates 3FR, with an average overestimation of 40.2% for foods and 38.8% for nutrients. The cross-classification was good for 24 of 26 nutrients and for 12 of the 21 food groups, and the weighted kappa showed an acceptable discriminant ability of the FFQ to categorize individuals into broad nutrient intake (except for protein and cholesterol) and food groups categories (dairy products, white rice, beans, vegetables, fruits and fruit juice, sugary drinks, breakfast cereal, candies and sweets, snacks, fast foods, fat, and ice cream). Conclusions: The FFQ designed for Costa Rican adolescents was unable to assess absolute dietary intakes; however, it is a reasonable tool to categorize adolescents into broad ranges of dietary intakes and could be used to evaluate dietary patterns in epidemiological studies of diet-disease associations.
... The pre-coded food diary is developed and validated by the Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo [33][34][35][36], also including breast cancer patients [16]. ...
... The mean intake of energy (Fig. 1a) The sugar intake on the normal days was 30 g/day (95% CI 28-32) 3 weeks post-surgery, and 29 g/day (95% 28-31) 6 months post-surgery (Fig. 1b). The intake on the unusual days was 35 g/day (95% CI 33-38), 3 weeks post-surgery and significantly higher (P < 0.05) at 6 months post-surgery, with 38 g/day (95% CI [36][37][38][39][40]. A similar pattern was seen for E% from sugar (details not shown). ...
Purpose
There are several reasons to report days as being unusual with regard to dietary intake, including special occasions and celebrations. For breast cancer patients during the 12 month post-surgery period, unusual days may also include days that are affected by being a cancer patient. The aim of this study was to study dietary intake on “normal” and “unusual” days, and to study what is reported in “free text fields” of a food diary.
Methods
Women (n = 456), mean age 55.5 years newly diagnosed with invasive breast cancer (stage I/II) were included in this clinical study. “Normal” and “unusual” days in general, over time and during the week and weekends were studied using repeated administration of a 7-day pre-coded food diary.
Results
The breast cancer patients reported 26% of all days as unusual. The intake of energy, most nutrients, especially alcohol and sugar, red and processed meat, and sweets, cakes, and snacks was 5–126% higher, whereas intake of fiber, fruit and berries, vegetables, and dairy products was 7–17% lower on unusual than on normal days (P < 0.001). The same pattern was seen for normal/unusual days during the weekdays, weekends and over time. Finally, 99% of the breast cancer patients used the free text fields to report additional intake with a mean energy of 1.1 MJ/day.
Conclusion
For breast cancer patients during the 12-month post-surgery period, unusual days are important drivers of total intake, especially for alcohol. The free text fields in the pre-coded food diary contributed substantially to the total intake.
... nutritional intake on random days, consumption of some foods which are part of FFQ-m might have been missed on days when 3D-FRs were filled. Indeed, frequent underreporting of food intake obtained from food records (28)(29)(30) and over-reporting in FFQs (31,32) have been observed in previous studies. ...
... The average correlation coefficients for energy and nutrients in our validation study was 0.40, which is in accordance with other studies (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33), and has ranged up to 0.7 for energy intake, similar to that of Morel et al. (26). When separated, mean correlation for macronutrients (r=0.51) is higher from that of micronutrients (r=0.30), ...
Food frequency questionnaire (FFQ) is an important method for the estimation of dietary intake in epidemiologic studies. The aim of the study is to develop a FFQ and evaluate its relative validity for adolescents 12 to 18 years old.
FFQ was developed from a previously validated youth/adolescent diet questionnaire (YAQ) by modifying it in order to include Croatian national foods. The final version of the FFQ (FFQ-m) comprised 87 food items. The reference method was a set of two 3-day food records (3DFR) administered twice during the 3 non-consecutive days, one month apart. The FFQ-m was administered approximately on the last day of the second applied dietary food record. Adolescents were recruited from randomly selected elementary and high schools in urban and rural areas of Croatia. FFQ-m was validated on a sample of 84 adolescents (70.2% female). Nutritional intake from FFQ-m and 3DFR were analysed for each participant. Spearman correlation coefficients (r) and Bland-Altman method were used to assess the validity of the FFQ-m compared to 3DFR. Anthropometric parameters were assessed in 78 adolescents.
The mean nutrient intake estimated by the FFQ-m was higher than that of the 3DFR. The average correlation coefficient for energy and nutrients in our validation study was 0.40. On average, 76.5% of adolescents were classified in the same or adjacent quartile of the nutrient intake. Bland-Altman analysis showed good agreement with all macronutrients and some micronutrients (sodium, phosphorus, potassium, calcium, magnesium and iron). A simple self-administered questionnaire completed by adolescents is a valid tool for measuring energy and nutrient intake among adolescent population.
This is the first FFQ developed and validated for population of adolescents in Croatia. It will contribute to further research of nutritional intake in the population of adolescents, especially those from the region.
... We did not explore the role of over-or under-reporting of energy intake on the analysis. Studies shown that subjects underreport energy intake in FR [42] and over-report energy intake in FFQ [43]. To what extent this underreporting of energy had an impact on the vitamin D intake in this study is not known. ...
The measurement of vitamin D nutritional status through dietary assessment is cost effective. Food frequency questionnaire (FFQ) is usually validated against food records (FR). There is no vitamin D-specific FFQ for Qatar population. The objective of this study was to develop a vitamin D-centric FFQ and validate FFQ against three-day FR for Qatar population. A quantitative FFQ based on vitamin D containing foods consumed in Qatar was developed. Vitamin D contents of foods were gathered from food labels and food composition tables from the United States Department of Agriculture. A vitamin D content database was developed for this study purpose. Dietary intakes while using FFQ and three-day FR were collected from 62 women. Vitamin D intakes from FFQ and three-day FR were validated with quartile comparison and Bland-Altman (BA) tests. BA plot showed an agreement between FFQ and three-day FR vitamin D intakes. The BA index was 3.23%, which is <5%, a commonly used standard for validation. Quartile correlation showed that ≈73% of subjects were within the same or adjacent quartile. In conclusion, an agreement was found between vitamin D intakes from FFQ and three-day FR in Qatari women. More studies are needed to validate the vitamin D-specific FFQ in Qatari population at large.
... The PDF has previously been validated against measured EE in children, adolescents and older men [11,15,21]. Nine-year-olds and 13-year-olds underreported EI by an average of 18 and 24-34%, respectively [15,21]. ...
... The PDF has previously been validated against measured EE in children, adolescents and older men [11,15,21]. Nine-year-olds and 13-year-olds underreported EI by an average of 18 and 24-34%, respectively [15,21]. In a group of older men the mean difference between EE and EI was -0.2 MJ/day (95% CI: -1.5, 1.1) in normal weight participants and -2.4 MJ/day (95% CI: -3.4, ...
... Among children and adolescents in Norway, the correlation coefficient between EI and EE varied from 0.28 (9-year-olds) to 0.47-0.74 (two studies of 13-year-olds) [15,21]. The PFD's ability to classify individuals into the same quartile as the reference method was good among men (50%), and acceptable among women (30%) [24]. ...
The aim of this study was to validate energy intake (EI) reported by a pre-coded food diary (PFD) against energy expenditure (EE) measured by the ActiReg system consisting of an activity and position monitor and a calculation program (ActiCalc). Dietary intake was recorded by the PFD and EE was measured by the ActiReg system over a 7-day period. One hundred and twenty adult participants completed the study, 42 men and 78 women. The average group EI was 17% lower compared to measured EE. The 95% limits of agreement were 6.7 and -2.9 MJ/day. Of all participants, 68% were classified as acceptable reporters, 29% as underreporters and only 3% as overreporters. Fifty percent of the men and 30% of the women were classified into the same quartile for EI and EE, whereas 5% of both men and women were ranked in the opposite quartile by the two methods (weighted kappa coefficient = 0.29). Pearson correlation coefficient between reported EI and measured EE was 0.49 (p<0.001). High BMI was related to larger underreporting when EE was low. Furthermore, this study found that PFD underestimates EI on the group level with an average of 17% and showed large variation in the validity of the PFD on the individual level.
... The doubly labeled water method (measuring energy expenditure) for validating energy intake is very expensive and measuring nitrogen in 24-h urine collections for protein intake requires very motivated study participants. An alternative option is to estimated total energy expenditure from accelerometer data and equations [17][18][19]. Although, this estimation of energy expenditure is not without errors, the physical activity level is objectively measured. Thus it can be assumed that errors are uncorrelated to subjectively reported energy intake. ...
... The Bland-Altman plots showed large variation at the individual level for both methods as generally seen in validation studies of energy intake [40]. Food records and 24HDR interviews have earlier been validated against accelerometer estimated energy expenditure in children [17][18][19], but our study is the first study to do this for a web-based method in adolescents. Thus direct comparison is difficult, nevertheless limits of agreement, that were narrower for RiksmatenFlexDiet than for Recall interviews, were in line with studies of [12][13] year old children where average energy intake also was underestimated [17,18]. ...
... Food records and 24HDR interviews have earlier been validated against accelerometer estimated energy expenditure in children [17][18][19], but our study is the first study to do this for a web-based method in adolescents. Thus direct comparison is difficult, nevertheless limits of agreement, that were narrower for RiksmatenFlexDiet than for Recall interviews, were in line with studies of [12][13] year old children where average energy intake also was underestimated [17,18]. Less misreporting and narrower limits of agreement have been observed in younger children [18,19]. ...
BACKGROUND
A web-based dietary assessment tool, RiksmatenFlex, was developed for the national dietary survey of adolescents in Sweden.
OBJECTIVE
To describe the development of RiksmatenFlex and to test the validity of reported dietary intake by RiksmatenFlexDiet.
METHODS
Adolescents aged 11-12, 14-15 and 17-18 years were recruited through schools. In total, 78 students had complete dietary information and were included in the study. Diet was reported at two school visits a few weeks apart with either RiksmatenFlexDiet (the day before, a random day later) or 24-hour dietary recall interviews (face-to-face, random day later by phone) in a cross-over, randomized design. Weight and height were measured and blood samples drawn at the first school visit. Students wore an accelerometer for 7 days. Dietary intake captured by both dietary methods was compared and energy intake by both methods was compared with accelerometer estimated energy expenditure. Intake of whole grain wheat and rye and fruit and vegetables by both methods was compared with carotenoids and alkylresorcinols (AR) in plasma, respectively.
RESULTS
Mean (SD) of reported energy intake was 8.92 (2.77) by RiksmatenFlexDiet and 8.04 (2.67) MJ by the dietary recall interviews (P=.01). Intake of fruit and vegetables was 224 (169) and 227 (150) grams, and whole grain wheat and rye 12.4 (13.2) and 12.0 (13.1), respectively, and intake did not differ between the methods. Intraclass correlations ranged from 0.57 for protein and carbohydrates to 0.23 for vegetables. Compared with accelerometer estimated energy expenditure energy intake by RiksmatenFlexDiet was over reported by 8% (P=.03) but not by the dietary recall interviews (P=.53). The spearman correlations between reported energy intake and estimated energy expenditure was 0.34 (P=.008) for RiksmatenFlexDiet and 0.16 (P=.21) for the dietary recall interviews. Spearman correlations between whole grain wheat and rye and plasma total AR homologues was 0.36 (P=.002) for RiksmatenFlexDiet and 0.29 (P=.02) for the dietary recall interviews. Spearman correlations between intake of fruit and vegetables and plasma carotenoids were weak for both dietary tools. The strongest correlations were observed between fruit- and vegetable intake and lutein/zeaxanthin, for RiksmatenFlexDiet 0.46 (P<.001) and for recall interviews 0.28 (P=.02).
CONCLUSIONS
RiksmatenFlexDiet provides information on energy, fruit, vegetables and whole grain wheat and rye that is at least as valid as that from 24-hour dietary recall interviews in Swedish adolescents. The tool is user friendly and can easily be adapted to other age groups and has a great potential for cost-effective collections of dietary intake in national surveys and other studies in Sweden.
... The questionnaires were the same, although covering different time-periods. The patients also recorded all their food and drink consumption in a modified version of a PFD developed and validated by the Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo [28][29][30]. The PFD is 19 pages and includes 310 questions on consumption of different food items arranged and grouped after the regular Norwegian meal pattern. ...
Background
The role of n-3 polyunsaturated fatty acids (PUFAs) in breast cancer is not clear and under debate. To explore this relationship it is important to have proper validated dietary assessment methods for measuring the intake of n-3 PUFAs. The aim of the current study is to validate two different methods used to assess the intake of selected n-3 PUFAs as well as food sources of long-chained n-3 PUFAs. Also, we aim to study how stable the intake of fatty acids is during breast cancer treatment.
Methods
The study-population was patients with breast cancer (Stages I-II) or ductal carcinoma in situ (DCIS-grade III) undergoing treatment (n = 49) in Norway. Dietary intake was assessed by two self-administered methods, a 256 food item food frequency questionnaire (FFQ) and a 7-day pre-coded food diary (PFD). The FFQ was administered presurgery and twelve months postsurgery, and the PFD was administered shortly after surgery (10 +/− 2 days), six and twelve months postsurgery. Fasting blood samples (presurgery, six and twelve months postsurgery) were analysed for serum phospholipid fatty acids, a biomarker for intake of n-3 PUFAs.
Results
Mean (SD) age was 54.2 (7.8) years at diagnosis, and the mean (SD) body mass index (BMI) was 24.8 (3.4) kg/m2. Correlation coefficients between dietary intakes of n-3 PUFAs measured with the FFQ and the PFD ranged from 0.35 to 0.66. The correlation coefficients between the PFD and the biomarker (serum phospholipid n-3 PUFAs) as well as between the FFQ and the biomarker demonstrated stronger correlations twelve months after surgery (ρ 0.40–0.56 and 0.36–0.53, respectively) compared to around surgery (ρ 0.08–0.20 and 0.28–0.38, respectively). The same pattern was observed for intake of fatty fish. The intake of n-3 PUFAs did not change during treatment assessed by the FFQ, PFD or biomarker.
Conclusion
These results indicate that the FFQ and the PFD can be used to assess dietary intake of fish and n-3 PUFAs in breast cancer patients during breast cancer treatment. Still, the PFD shortly after surgery should be used with caution. The diet of patients undergoing breast cancer treatment was quite stable, and the intake of n-3 PUFAs did not change.
... The PFDs were to be filled in either immediately after finishing a meal, or foods could be recorded on attached notepaper and entered into the diary in the evening. The PFD takes about 10-15 minutes per day to fill in [13]. Oral instructions were given in person or in small groups, and all participants received written information about the use of the diaries. ...
... Due to the social desirability of being physically active, it is possible that part of the observed discrepancy between energy intake and energy expenditure was due to the participants being unusually active during the registration period without adjusting their energy intake to the increased activity level. This tendency has been found in another Norwegian study validating energy intake from the food diary against ActiReg1 in a group of 13 year olds [13]. ...
Estimating dietary intake is important for both epidemiological and clinical studies. In large studies, a balance has to be achieved between methods with high accuracy and methods that are easy to use. The aim of the present study was to compare results from a pre-coded scanable food diary (PFD) with results from a weighed record (WR) in a group of Norwegian adults. We also explored differences in day-to-day energy intake and the distribution of energy intake across the day in acceptable reporters (ARs) and underreporters (URs). Participants (n = 114, mean age 35 years, 68% women) recorded dietary intake with the PFD for 7 consecutive days. One week after completing the PFD, participants completed a 7 days WR. No difference in mean energy intake was seen between methods. Few differences were seen for the macronutrients, the most noticeable difference being the percentage of energy (E%) from carbohydrates which was significantly lower with the PFD (47 E%) than with the WR (49 E%). For the micronutrients, intakes of calcium and vitamin A were both significantly higher with the PFD than with the WR. Pearson’s correlation coefficient ranged from 0.47 (tocopherol) to 0.76 (E% carbohydrates) for all nutrients. Bread intake was significantly lower with the PFD while the intakes of edible fats, cheese and beverages were higher. Twenty-eight percent of the participants were found to be URs with the PFD. No clear pattern of underreporting at certain recording days or times of the day was seen. In conclusion, the results showed similar energy intakes and few differences in food and nutrient intakes between the PDF and the WR at the group level. Somewhat larger differences between the methods were seen at the individual level. Because of the reduced work load on both participants and researchers, the PFD seems a suitable alternative to the WR.
... Results from other studies, in which accelerometers have been used to validate estimated EI from more traditional paper-based methods among children, are in line with our study: suggesting the proportion of under-reporters is a large problem [29][30][31]. For example, estimated The percentage of AR, UR and OR, identified using two different approaches. ...
... Moreover, underestimation was larger in boys compared with girls [30], this is also in line with findings from the present study. Severe under-reporting was also observed in a similar validation study of a paper-based pre-coded food diary among 13 year olds; the mean difference between EI and TEE showed underreporting that varied from -1.3 to -4.8 MJ/day [29]. Rothausen et al. report a difference between EI from a seven days food diary and TEE of -2.7 and -2.1 MJ/day for 12-13 year old boys and girls, respectively [31], which is comparable to our observations. ...
The purpose of this study was to validate estimated energy intake from a web-based food recall, designed for children and adolescents. We directly compared energy intake to estimates of total energy expenditure, calculated from accelerometer outputs, combined with data on weight and sex or resting energy expenditure prediction equations. Children (8–9 years) and adolescents (12–14 years) were recruited through schools in Norway in 2013 (N = 253). Results showed that more than one third (36–37%) were identified as under-reporters of energy. In contrast, only 2–4% were defined as over-reporters of energy. The mean energy intake was under-reported with -1.83 MJ/day for the entire study sample. Increased underestimation was observed for overweight and obese participants, the oldest age group (12–14 years), boys, those with parents/legal guardians with low educational level and those living in non-traditional families. In conclusion, energy intake from the web-based food recall is significantly underestimated compared with total energy expenditure, and should be used with caution in young people.
... All subjects who received allocated intervention completed a four-day, pre-coded food diary at the beginning and at the end of the intervention period. The diary used was originally developed for use among Norwegian children and adolescents (18)(19)(20) . The diary included >270 food items grouped together according to the typical Norwegian meal pattern (18)(19)(20) . ...
... The diary used was originally developed for use among Norwegian children and adolescents (18)(19)(20) . The diary included >270 food items grouped together according to the typical Norwegian meal pattern (18)(19)(20) . Each food group was supplemented with open-ended alternatives. ...
The healthy Nordic diet has been previously shown to have health beneficial effects among subjects at risk of CVD. However, the extent of food changes needed to achieve these effects is less explored. The aim of the present study was to investigate the effects of exchanging a few commercially available, regularly consumed key food items (e.g. spread on bread, fat for cooking, cheese, bread and cereals) with improved fat quality on total cholesterol, LDL-cholesterol and inflammatory markers in a double-blind randomised, controlled trial. In total, 115 moderately hypercholesterolaemic, non-statin-treated adults (25–70 years) were randomly assigned to an experimental diet group (Ex-diet group) or control diet group (C-diet group) for 8 weeks with commercially available food items with different fatty acid composition (replacing SFA with mostly n -6 PUFA). In the Ex-diet group, serum total cholesterol ( P <0·001) and LDL-cholesterol ( P <0·001) were reduced after 8 weeks, compared with the C-diet group. The difference in change between the two groups at the end of the study was −9 and −11 % in total cholesterol and LDL-cholesterol, respectively. No difference in change in plasma levels of inflammatory markers (high-sensitive C-reactive protein, IL-6, soluble TNF receptor 1 and interferon- γ ) was observed between the groups. In conclusion, exchanging a few regularly consumed food items with improved fat quality reduces total cholesterol, with no negative effect on levels of inflammatory markers. This shows that an exchange of a few commercially available food items was easy and manageable and led to clinically relevant cholesterol reduction, potentially affecting future CVD risk.
