Background & aims: Little is known about the validity of repeated 24-h dietary recalls (24-HDR) as a measure of total energy intake (El) in young children. This study aimed to evaluate the validity of proxy-reported El by comparison with total energy expenditure (TEE) measured by the doubly labeled water (DLW) technique.
Methods: The agreement between El and TEE was investigated in 36 (47.2% boys) children aged 4-10 years from Belgium and Spain using subgroup analyses and Bland-Altman plots. Low-energy-reporters (LER), adequate-energy-reporters (AER) and high-energy-reporters (HER) were defined from the ratio of El over TEE by application of age- and sex-specific cut-off values.
Results: There was good agreement between means of El (1500 kcal/day) and TEE (1523 kcal/day) at group level though in single children, i.e. at the individual level, large differences were observed. Almost perfect agreement between El and TEE was observed in thin/normal weight children (EI: 1511 kcal/day; TEE: 1513 kcal/day). Even in overweight/obese children the mean difference between El and TEE was only 86 kcal/day. Among the participants, 28(78%) were classified as AER, five (14%) as HER and three (8%) as LER.
Conclusion: Two proxy-reported 24-HDRs were found to be a valid instrument to assess El on group level but not on the individual level.
- Doubly labeled water
- Energy expenditure
- Energy intake
- DOUBLY-LABELED WATER
- SUBJECT VARIATION