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BMJ. 1995 October 14; 311(7011): 986–989.
PMCID: PMC2550989

Dietary underreporting by obese individuals--is it specific or non-specific?


OBJECTIVE--To examine the distribution of patterns of macronutrient density in relation to obesity. DESIGN--Cross sectional. SETTING--Denmark. SUBJECTS--323 men and women aged 35-65 years, selected randomly from a larger population sample of Danish adults. MAIN OUTCOME MEASURE--Bias in dietary reporting of energy and protein intake in relation to percentage body fat, assessed by comparison of data from an interview on dietary intake with data estimated from 24 hour nitrogen output, validated by administering p-aminobenzoic acid, and estimated 24 hour energy expenditure. RESULTS--Degree of obesity was positively associated with underreporting of total energy and protein, whereas compared with total energy reported, protein was overreported by the obese subjects. CONCLUSION--Errors in dietary reporting of protein seem to occur disproportionately with respect to total energy, suggesting a differential reporting pattern of different foods. Although, on average, all subjects showed a greater underreporting of energy than of protein, this was most common in the obese subjects. Snack-type foods may be preferentially forgotten when obese people omit food items in dietary reporting. These results seem to agree with the general assumption that obese people tend to underreport fatty foods and foods rich in carbohydrates rather than underreport their total dietary intake. These results may have implications for the interpretation of studies of diet and comorbidities related to obesity.

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Selected References

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  • Hultén B, Bengtsson C, Isaksson B. Some errors inherent in a longitudinal dietary survey revealed by the urine nitrogen test. Eur J Clin Nutr. 1990 Mar;44(3):169–174. [PubMed]
  • Prentice AM, Black AE, Coward WA, Davies HL, Goldberg GR, Murgatroyd PR, Ashford J, Sawyer M, Whitehead RG. High levels of energy expenditure in obese women. Br Med J (Clin Res Ed) 1986 Apr 12;292(6526):983–987. [PMC free article] [PubMed]
  • Schoeller DA. How accurate is self-reported dietary energy intake? Nutr Rev. 1990 Oct;48(10):373–379. [PubMed]
  • Jackson AA. Does the Nutrition Society serve the needs of its overseas members? Proc Nutr Soc. 1991 Mar;50(1):1–7. [PubMed]
  • Isaksson B. Urinary nitrogen output as a validity test in dietary surveys. Am J Clin Nutr. 1980 Jan;33(1):4–5. [PubMed]
  • Bingham SA, Cummings JH. Urine nitrogen as an independent validatory measure of dietary intake: a study of nitrogen balance in individuals consuming their normal diet. Am J Clin Nutr. 1985 Dec;42(6):1276–1289. [PubMed]
  • Lissner L, Lindroos AK. Is dietary underreporting macronutrient-specific? Eur J Clin Nutr. 1994 Jun;48(6):453–454. [PubMed]
  • Heitmann BL. Body fat in the adult Danish population aged 35-65 years: an epidemiological study. Int J Obes. 1991 Aug;15(8):535–545. [PubMed]
  • Jensen KH, Jørgensen T. Incidence of gallstones in a Danish population. Gastroenterology. 1991 Mar;100(3):790–794. [PubMed]
  • Bingham S, Cummings JH. The use of 4-aminobenzoic acid as a marker to validate the completeness of 24 h urine collections in man. Clin Sci (Lond) 1983 Jun;64(6):629–635. [PubMed]
  • Heitmann BL. Prediction of body water and fat in adult Danes from measurement of electrical impedance. A validation study. Int J Obes. 1990 Sep;14(9):789–802. [PubMed]
  • Garby L, Garrow JS, Jørgensen B, Lammert O, Madsen K, Sørensen P, Webster J. Relation between energy expenditure and body composition in man: specific energy expenditure in vivo of fat and fat-free tissue. Eur J Clin Nutr. 1988 Apr;42(4):301–305. [PubMed]
  • Heitmann BL. The effects of gender and age on associations between blood lipid levels and obesity in Danish men and women aged 35-65 years. J Clin Epidemiol. 1992 Jul;45(7):693–702. [PubMed]
  • Drewnowski A, Kurth C, Holden-Wiltse J, Saari J. Food preferences in human obesity: carbohydrates versus fats. Appetite. 1992 Jun;18(3):207–221. [PubMed]
  • Livingstone MB, Prentice AM, Strain JJ, Coward WA, Black AE, Barker ME, McKenna PG, Whitehead RG. Accuracy of weighed dietary records in studies of diet and health. BMJ. 1990 Mar 17;300(6726):708–712. [PMC free article] [PubMed]
  • Summerbell CD, Moody RC, Shanks J, Stock MJ, Geissler C. Sources of energy from meals versus snacks in 220 people in four age groups. Eur J Clin Nutr. 1995 Jan;49(1):33–41. [PubMed]
  • Rutishauser IH. Is dietary underreporting macronutrient specific? Eur J Clin Nutr. 1995 Mar;49(3):219–220. [PubMed]
  • Astrup A, Thorbek G, Lind J, Isaksson B. Prediction of 24-h energy expenditure and its components from physical characteristics and body composition in normal-weight humans. Am J Clin Nutr. 1990 Nov;52(5):777–783. [PubMed]
  • Lichtman SW, Pisarska K, Berman ER, Pestone M, Dowling H, Offenbacher E, Weisel H, Heshka S, Matthews DE, Heymsfield SB. Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. N Engl J Med. 1992 Dec 31;327(27):1893–1898. [PubMed]
  • Lissner L, Habicht JP, Strupp BJ, Levitsky DA, Haas JD, Roe DA. Body composition and energy intake: do overweight women overeat and underreport? Am J Clin Nutr. 1989 Feb;49(2):320–325. [PubMed]
  • Black AE, Goldberg GR, Jebb SA, Livingstone MB, Cole TJ, Prentice AM. Critical evaluation of energy intake data using fundamental principles of energy physiology: 2. Evaluating the results of published surveys. Eur J Clin Nutr. 1991 Dec;45(12):583–599. [PubMed]

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