Underreporting of energy intake in four populations of African origin

OBJECTIVE: To investigate the frequency of dietary underreporting in four A frican populations in different geographic and cultural settings. SUBJECTS: Seven-hundred and forty three men and women from rural Cameroon, 1042 men and women from urban Cameroon, 857 men and women from Jamaica and 243 male and female African Caribbeans from the UK. Subjects who reported d ieting or weight control were excluded. MEASUREMENTS: Habitual dietary intake was estimated with a quantitative foo d frequency questionnaire, developed specifically for each country. Underre porting was defined using three cut-off revers for energy intake/estimated basic metabolic rate (EI/BMRest), based on age, sex and weight, in each sit e. RESULTS: The EI/BMRest was highest in rural Cameroonian men at 3.07 (95% co nfidence interval: 2.97, 3.17) and women at 2.84 (2.74, 2.94), intermediate in urban Cameroon and Jamaica and lowest in the UK men and women at 1.44 ( 1.26, 1.62) and 1.41 (1.21, 1.61). This trend existed even after adjustment for age, BMI and education (P for trend < 0.0001). The trend in the freque ncy of underreporting using the lowest cut-off level for EI/BMRest of 1.15 was 6% and 6% in rural Cameroon for women and men, respectively, 4% and 5% in urban Cameroon, 24% and 19% in Jamaica and 28% and 39% in the UK. With h igher cut off levels this trend was similar. CONCLUSION: The results suggest that the frequency of dietary underreportin g differs between societies and that Westernization may be one of the facto rs underlying this phenomenon.