ELEVATED ENERGY-EXPENDITURE AND REDUCED ENERGY-INTAKE IN OBESE PREPUBERTAL CHILDREN - PARADOX OF POOR DIETARY RELIABILITY IN OBESITY

The purpose of this study was to assess the validity of two common met hods used to assess energy intake. A 3-day weighed dietary record and a dietary history were collected and compared with the total dairy ene rgy expenditure (TEE) assessed by the heart rate method in a group of 12 obese and 12 nonobese prepubertal children (mean age 9.3 +/- 1.1 ye ars vs 9.3 a 0.4 years). The TEE value was higher in obese than in non obese children (9.89 +/- 1.08 vs 8.13 +/- 1.39 MJ/day; p <0.01). Energ y intake assessed by the dietary record was significantly lower than T EE in the obese children (7.06 +/- 0.98 MJ/day; p <0.001) but comparab le to TEE in the nonobese children (8.03 +/- 0.99 MJ/day; p = not sign ificant). Energy intake assessed by diet history was lower than TEE in the obese children (8.37 +/- 1.35 MJ/day, p <0.05) but close to TEE i n the nonobese children (8.64 +/- 1.54 MJ/day, p = not significant). T hese results suggest that obese children underreport food intake and t hat the dietary record and the diet history are not valid means of ass essing energy intake in obese prepubertal children.