Influence of body composition on the accuracy of reported energy intake inchildren

Objective: Mis-reporting dietary intake is a substantial barrier to underst anding the role of dietary behavior in disease. Work with adults indicates that heavier individuals underreport dietary intake and that under-reportin g may be macronutrient-specific. Whether weight status and macronutrient in take influence the accuracy of dietary reports among children, however, is less clear. This research evaluated children's dietary reporting accuracy a s a function of their relative weight, body composition, and macronutrient intake. Research Methods and Procedures: Participants included 146 4- to Ii-year-ol d children. Reported energy intake was determined by interviewing children in the presence of parents, using three multiple pass, 24-hour recalls. Chi ldren were classified as having had an under-reported, accurately reported, or over-reported dietary intake relative to total energy expenditure, as m easured by doubly labeled water. Reporting accuracy was examined as a funct ion of children's body weight, body composition (using dual energy x-ray ab sorptiometry), and macronutrient intake. Results: Average reported intake was, on average, 14% greater than children 's estimated expenditure (p < 0.01), Reporting accuracy varied as a functio n of children's relative weight and body composition; under-reporting tende d to occur among heavier children, having the highest body fat content (p < 0.0001) and relative weight (p < 0.0001). Discussion: These findings suggest that weight status influences the accura cy of dietary reports made by children and their parents. More research is needed to address possible psychological and social factors that introduce bias in reporting children's dietary data.