Comparison of total energy expenditure and energy intake in children aged 6-9 y

Background: The accurate measurement of food intake in children is importan t for assessing nutritional status. Objective: We sought to both compare measurements of energy intake (EI) fro m diet records and of total energy expenditure (TEE) by the doubly labeled water (DLW) method and to investigate misreporting of El. Design: Forty-seven children (22 boys and 25 girls) aged 7.4 +/- 0.8 y ((x) over bar +/- SD) were recruited from 25 schools in western Sydney. TEE was measured by DLW over 10 d and El by use of 3-d food records. Misreporting was defined as [(EI - TEE)/TEE] X 100%. Results: Girls had a higher (P = 0.02) percentage of body fat (28.2 +/- 7.0 %) than did boys (22.9 +/- 8.0%); otherwise there were no differences among sex. Although mean ( SD) values for El (7514 +/- 1260 kJ/d) and TEE (7396 +/- 1281 kJ/d) were not significantly different, there was no significant c orrelation between El and TEE. El and TEE were 9% and 11% lower, respective ly, than current World Health Organization recommendations for EI. The rela tive bias (mean difference, El - TEE) was low at 118 kJ/d, but the limits o f agreement (bias +/- 2 SD of the difference) were wide at 118 +/- 3345 kJ/ d. Although the mean percentage of misreporting was low (4 +/- 23%), the hi gh SD indicates large intraindividual differences between El and TEE. The m ost significant predictor of misreporting was dietary fat intake (r(2) = 0. 45, P < 0.0001). Misreporting was not associated with sex or body compositi on. Conclusions: In this age group, reported El is not representative of TEE at the individual level. However, at the population level, 3-d food records m ay be used for surveys of El by 6-9-y-old children.