Objective: To validate energy intake (EI) estimated from pre-coded food diaries against energy expenditure (EE) measured with a validated position-and-movement monitor (ActiReg®) in groups of 13-year-old Norwegian schoolchildren. Design: Two studies were conducted. In study 1 the monitoring period was 4 days; participants recorded their food intake for four consecutive weekdays using food diaries and wore the ActiReg® during the same period. In study 2 the monitoring period was 7 days; participants recorded their food intake for four consecutive days but wore the ActiReg® for a whole week. Settings: Participants were recruited from grade 8 in a school in and one outside Oslo (Norway). Subjects: Forty-one and 31 participants from study 1 and 2, respectively, completed the study. Results: The group average EI was 34% lower than the measured EE in study 1 and 24% lower in study 2. The width of the 95% confidence limits of agreement in a Bland-Altman plot for EI and EE varied from -0.2M J to 8.2 MJ in study 1 and from -2.3 MJ to 6.9 MJ in study 2. The Pearson correlation coefficients between reported energy intake and expenditure were 0.47 (P = 0.002) in study 1 and 0.74 (P < 0.001) in study 2. Conclusion: The data showed that there was substantial variability in the accuracy of the food diary at the individual level. Furthermore, the diary underestimated the average energy intake. The ability of the food diary to rank individuals according to energy intake was found to be good in one of the studies and moderate in the other.
Bibliographical noteFunding Information:
This work was supported by the National Council on Nutrition and Physical Activity (now part of the Directorate for Health and Social Affairs) and the Norwegian Food Control Authorities (now part of the Norwegian Food Safety Authority).
- Energy expenditure
- Energy intake
- Food diary