Adherence
Higher body mass index (BMI) is significantly associated with a greater likelihood of underreporting energy intake in 24-hour dietary recalls, while older age is associated with a lower likelihood of underreporting.
When interpreting self-reported dietary data, especially from individuals with higher body weight, expect a systematic underestimation of calorie intake. Research models should adjust for BMI and age to correct for this bias, as it is not random error but a predictable pattern.
logistic regression analyses resulted in an odds ratio (OR) of being an underreporter for the highest vs. the lowest quartile of body mass index (BMI) of 3.52... in men and 4.80... in women, indicating that overweight subjects are significantly more likely to underestimate energy intake than subjects in the bottom BMI category. Older people were less likely to underestimate energy intake: ORs were 0.58... and 0.74... for age (> 65 years vs. < 50 years).
Why this rating
Large sample size (n=35,955) and rigorous statistical adjustment, though it relies on self-reported data validated by BMR ratios rather than objective gold standards like doubly labeled water for the whole cohort.
Source
Evaluation of under- and overreporting of energy intake in the 24-hour diet recalls in the European Prospective Investigation into Cancer and Nutrition (EPIC)
Pietro Ferrari et al. · Public Health Nutrition · 2002
DOI 10.1079/phn2002409
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