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

Samuel-Hodge, Carmen D.; Fernandez, Louise M.; Henríquez-Roldán, Carlos F.; Johnston, Larry F.; Keyserling, Thomas C.
March 2004
Diabetes Care;Mar2004, Vol. 27 Issue 3, p663
Academic Journal
This study assesses the validity of dietary data from African-American women with type 2 diabetes by comparing reported energy intake (El) with total energy expenditure (TEE) estimated by an accelerometer and basal metabolic rate (BMR). 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 El was 1,299 kcal/day; mean El-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 under-reporters using the El-to-TEE ratio cutoff; 58% (n = 107) were classified as energy under-reporters using the EI-to-BMR ratio. Energy under-reporters had significantly lower reported fat, higher protein, but similar carbohydrate intakes compared with non-under-reporters. The El-to-TEE ratio was not significantly associated with any demographic variables or following a diet for diabetes, but it was inversely associated with BM1 (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 El-to-TEE ratio, with the latter two variables being the only significant predictors (inversely associated).Widespread energy underreporting among this group of overweight African-American women with type 2 diabetes severely compromised the validity of self-reported dietary data.


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