A Comparison of Self-Reported Energy Intake With Total Energy Expenditure Estimated by Accelerometer and Basal Metabolic Rate in African-American Women With Type 2 Diabetes

  1. Carmen D. Samuel-Hodge, PHD1,
  2. Louise M. Fernandez, MPH2,
  3. Carlos F. Henríquez-Roldán, PHD34,
  4. Larry F. Johnston, MPH5 and
  5. Thomas C. Keyserling, MD6
  1. 1Department of Nutrition, Schools of Public Health and Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
  2. 2Department of Nutrition, Schools of Public Health and Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
  3. 3Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
  4. 4Department of Statistics, University of Valparaíso, Valparaíso, Chile
  5. 5Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
  6. 6Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
  1. Address correspondencereprint requests to Carmen D. Samuel-Hodge, PhD, MS, RD, University of North Carolina at Chapel Hill, Schools of Public HealthMedicine, Department of Nutrition, 1700 Airport Rd., CB #8140, Chapel Hill, NC 27599-8140. E-mail: carmen_samuel{at}unc.edu

Abstract

OBJECTIVE—This study assesses the validity of dietary data from African-American women with type 2 diabetes by comparing reported energy intake (EI) with total energy expenditure (TEE) estimated by an accelerometer and basal metabolic rate (BMR).

RESEARCH DESIGN AND METHODS—EI of 200 African-American women was assessed by three telephone-administered 24-h diet recalls using a multiple-pass approach. Physical activity was measured over a 7-day period by accelerometer, which also provided an estimate of TEE. Underreporting of EI was determined by using cutoffs for EI-to-TEE and EI-to-BMR ratios.

RESULTS—Participants, on average, were 59 years of age, with a BMI of 35.7, 10.5 years of diagnosed diabetes, and 10.7 years of education. Mean EI was 1,299 kcal/day; mean EI-to-TEE and EI-to-BMR ratios were 0.65 and 0.88, respectively. Among the 185 subjects with complete dietary data, 81% (n = 150) were classified as energy underreporters using the EI-to-TEE ratio cutoff; 58% (n = 107) were classified as energy underreporters using the EI-to-BMR ratio. Energy underreporters had significantly lower reported fat, higher protein, but similar carbohydrate intakes compared with non-underreporters. The EI-to-TEE ratio was not significantly associated with any demographic variables or following a diet for diabetes, but it was inversely associated with BMI (r = −0.37, P < 0.0001). In a multivariate model, demographic variables, BMI, and following a diet for diabetes explained 16% of the variance in the EI-to-TEE ratio, with the latter two variables being the only significant predictors (inversely associated).

CONCLUSIONS—Widespread energy underreporting among this group of overweight African-American women with type 2 diabetes severely compromised the validity of self-reported dietary data.

Footnotes

    • Accepted December 8, 2003.
    • Received September 26, 2003.
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