Mendez, Michelle A.; Wynter, Suzanne; Wilks, Rainford J.; Forrester, Terrence E.
Author Affiliation, Ana.
Tropical Medicine Research Institute
Under-and over reporting of energy is related to obesity, lifestyle factors and food group intakes in Jamaican adults
Public health nutrition
Date of Publication
Objective: Research in industrialized countries has documented a high prevalence of underreported energy intakes associated with characteristics such as obesity. This paper examines the prevalence, patterns and impact of energy under- and over reporting on diet-obesity relationships in a middle-income developing country. Design: A 70-item food-frequency questionnaire was used. Underreports had reported energy intakes <1.35 x basal metabolic rate (BMR), over reporters > 2.4 x BMR. Multinomial models were used to identify characteristics associated with implausible reporting. Associations between diet and obesity were compared with and without adjustment for implausible reporting. Setting: Spanish Town, neighbouring the capital city of Kingston, Jamaica. Subject: Eight hundred and ninety-one Jamaican adults, aged 25-75 years, were randomly recruited. Results: More women than men (38. 6 % vs. 22. 5 %) underreported, but more men over reported energy (23. 7 % vs. 16.0 %). Underreporting was positively associated with obesity, special diet, smoking and age, age was inversely associated with over reporting. Under reporters estimated lower energy from potentially socially undesirable food groups (e.g. snacks) and higher intakes of ‘healthy’ foods (e.g. fruit) than did plausible reports. For some of these food groups, significant differences in intakes among normal-weight versus obese subjects observed among plausible reports were absent when implausible reporters were included. In models of food group-obesity associations, adjusting for implausible energy yielded more credible results that more closely resembled findings in plausible reporters. Conclusions: Energy under-and over reporting are highly prevalent in Jamaica. Adjusting for implausible reporting may help to reduce bias in diet-health outcome associations.....