Energy intake misreport: how different methods affect its prevalence and nutrient intake estimates

Abstract

Background: Although different methods for the evaluation of energy intake (EI) misreport have been described, it is unclear which one is the most appropriate. Aim: To assess the performance of these methods in the prevalence of EI misreports and accuracy of nutrient intake estimates. Methods: Reports of 3,639 adults from the Portuguese National Food, Nutrition and Physical Activity Survey 20152016 were classified using univariate (Willett; interquartile range) and multivariate (Goldberg; predicted total energy expenditure [pTEE], testing different standard deviations [SD]) methods. Self-reported intakes were compared to their respective estimates by urinary excretion in a sub-sample of 80. The effect of the exclusion of misreporters on nutrient estimates was assessed by the differences in linear regression coefficients between plausible and total sample. Results: The highest prevalence of EI misreport was observed using pTEE 1SD (63.9%). Differences in the associations between nutrient self-reported intake and estimated intake using urinary biomarkers were verified with misreporters exclusion by pTEE 1SD method (ß-protein = 0.209; 95% CI = 0.0740.529; ß-potassium = 0.276; 95% CI = 0.0600.560) and Goldberg 2SD (ß-protein = 0.080; 95% CI = 0.0250.235; ß-potassium = 0.106; 95% CI = 0.0480.246). Conclusions: Multivariate methods lead to a higher prevalence of misreports and larger differences in nutrient estimates. The application of the pTEE 1SD and Goldberg 2SD methods resulted in more accurate nutrient estimates.