Public Health Nutrition

Research Article

Severe underreporting of energy intake in normal weight subjects: use of an appropriate standard and relation to restrained eating

I Asbecka1, M Masta1, A Bierwaga1, J Westenhöfera2, KJ Achesona3 and MJ Müllera1 c1

a1 Institut für Humanernährung und Lebensmittelkunde der Universität Kiel, Düsternbrooker Weg 17-19, D-24105 Kiel, Germany

a2 Fachhochschule Hamburg, Lohbrügger Kirchstrasse 65, D-21033 Hamburg, Germany

a3 Nestlé Research Center, PO Box 44, CH-1000 Lausanne 26, Switzerland


Objective: To assess the influence of different standards and restrained eating on underreporting in healthy, non-obese, weight-stable young subjects.

Design and subjects: Eighty-three young adults (20–38 years, 55 women, 28 men) were assessed under weight-stable conditions with a 7-day dietary record and the three-factor eating questionnaire by Stunkard and Messick. Resting energy expenditure (REE; indirect calorimetry) plus data derived from physical activity records (PA) (Standard 1) or REE times an activity factor (AF) (Standard 2) was used as standard for total energy expenditure (TEE). For comparison, doubly labelled water (DLW) was used to measure TEE in a subgroup of subjects.

Results: There was an association between self-reported energy intake and Standard 2 (r = 0.72) but not with Standard 1. When compared with DLW both calculated standards were inaccurate, but Standard 2 avoided high levels of overreporting. Using Standard 2 to identify ‘severe’ underreporting (SU; as defined by a deviation of energy intake (EI) and TEE of >20%), SU was seen in 37% of all subjects. It was more frequently found in women than in men (49% of women, 14.3% of men, P < 0.05). Underreporting subjects had a reduced EI (P < 0.01) but there were no significant differences in nutritional status (body weight and height, body mass index, fat mass and fat-free mass), energy expenditure and the proportion of energy from macronutrients between normal and underreporting subjects. However, high restraint was associated with a higher degree of underreporting in the total group, whereas disinhibition had an influence only in men.

Conclusions: A high prevalence of SU is seen in non-obese subjects. Characteristics of eating behaviour (restraint and disinhibition) were associated with underreporting but seemed to have a different influence in men and women.

(Received December 23 1999)

(Accepted June 20 2001)


c1 *Corresponding author: Email