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Validation of a pre-coded food diary used among 13-year-olds: comparison of energy intake with energy expenditure

  • Lene F Andersen (a1), Magnhild L Pollestad (a1), David R Jacobs (a1) (a2), Arne Løvø (a1) and Bo-Egil Hustvedt (a1)...



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.


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.


Participants were recruited from grade 8 in a school in and one outside Oslo (Norway).


Forty-one and 31 participants from study 1 and 2, respectively, completed the study.


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 -0.2 MJ 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.


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.


Corresponding author

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1Berenson, GS. Childhood risk factors predict adult risk associated with subclinical cardiovascular disease. The Bogalusa Heart Study. American Journal of Cardiology 2002; 90: 3L7L.
2McGill, HC Jr, McMahan, CA, Herderick, EE, Malcom, GT, Tracy, RE, Strong, JP. Origin of atherosclerosis in childhood and adolescence. American Journal of Clinical Nutrition 2000; 72: 1307S–15S.
3Livingstone, MB, Robson, PJ. Measurement of dietary intake in children. Proceedings of the Nutrition Society 2000; 59: 279–93.
4Rockett, HR, Berkey, CS, Colditz, GA. Evaluation of dietary assessment instruments in adolescents. Current Opinion in Clinical Nutrition and Metabolic Care 2003; 6: 557–62.
5Overby, NC, Lillegaard, ITL, Johansson, L, Andersen, LF. High intake of added sugar among Norwegian children and adolescents. Public Health Nutrition 2004; 7: 285–93.
6Andersen, LF, Nes, M, Bjørneboe, G-E, Drevon, CA. Food habits among 13-year-old Norwegian adolescents. Scandinavian Journal of Nutrition 1997; 41: 150–4.
7Trabulsi, J, Schoeller, DA. Evaluation of dietary assessment instruments against doubly labeled water, a biomarker of habitual energy intake. American Journal of Physiology. Endocrinology and Metabolism 2001; 281: E891–9.
8Bandini, LG, Schoeller, DA, Cyr, HN, Dietz, WH. Validity of reported energy intake in obese and nonobese adolescents. American Journal of Clinical Nutrition 1990; 52: 421–5.
9Bandini, LG, Cyr, H, Must, A, Dietz, WH. Validity of reported energy intake in preadolescent girls. American Journal of Clinical Nutrition 1997; 65: 1138S–41S.
10Bratteby, LE, Sandhagen, B, Fan, H, Enghardt, H, Samuelson, G. Total energy expenditure and physical activity as assessed by the doubly labeled water method in Swedish adolescents in whom energy intake was underestimated by 7-d diet records. American Journal of Clinical Nutrition 1998; 67: 905–11.
11Livingstone, MB, Prentice, AM, Coward, WA, Strain, JJ, Black, AE, Davies, PS, et al. Validation of estimates of energy intake by weighed dietary record and diet history in children and adolescents. American Journal of Clinical Nutrition 1992; 56: 2935.
12Goldberg, GR, Black, AE. Assessment of the validity of reported energy intakes – review and recent developments. Scandinavian Journal of Nutrition 1998; 42: 69.
13Schoeller, DA. Validation of habitual energy intake. Public Health Nutrition 2002; 5: 883–8.
14Hustvedt, BE, Christophersen, A, Johnsen, LR, Tomten, H, McNeill, G, Haggarty, P, et al. Description and validation of the ActiReg: a novel instrument to measure physical activity and energy expenditure. British Journal of Nutrition 2004; 92: 1001–8.
15Løvø, A, Tomten, H, Christophersen, A, Haggarty, P, Hustvedt, BE. Measuring energy expenditure – validation of ActiReg and heart-rate monitoring against doubly labeled water. Medicine and Science in Sports and Exercise 2000; 32(Suppl. 5): 326.
16Lillegaard, IT, Overby, NC, Andersen, LF. Can children and adolescents use photographs of food to estimate portion sizes? European Journal of Clinical Nutrition 2005; 59: 611–7.
17Rimestad, AH, Løken, EB, Nordbotten, A. The Norwegian food composition table and calculation system used at the Institute for Nutrition Research. Norwegian Epidemiology 2000; 107–10.
18Food and Agriculture Organization/World Health Organization (WHO)/United Nations University. Energy and Protein Requirements. Report of a Joint Expert Consultation Technical Report Series No. 724 Geneva: WHO, 1985.
19Bland, JM, Altman, DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307–10.
20Black, AE. The sensitivity and specificity of the Goldberg cut-off for EI:BMR for identifying diet reports of poor validity. European Journal of Clinical Nutrition 2000; 54: 395404.
21Klesges, LM, Baranowski, T, Beech, B, Cullen, K, Murray, DM, Rochon, J, et al. Social desirability bias in self-reported dietary, physical activity and weight concerns measures in 8- to 10-year-old African-American girls: results from the Girls Health Enrichment Multisite Studies (GEMS). Preventive Medicine 2004; 38(Suppl.): S78–87.
22Taren, DL, Tobar, M, Hill, A, Howell, W, Shisslak, C, Bell, I, Ritenbaugh, C. The association of energy intake bias with psychological scores of women. European Journal of Clinical Nutrition 1999; 53: 570–8.
23Tooze, JA, Subar, AF, Thompson, FE, Troiano, R, Schatzkin, A, Kipnis, V. Psychosocial predictors of energy underreporting in a large doubly labeled water study. American Journal of Clinical Nutrition 2004; 79: 795804.
24Bandini, LG, Must, A, Cyr, H, Anderson, SE, Spadano, JL, Dietz, WH. Longitudinal changes in the accuracy of reported energy intake in girls 10–15 y of age. American Journal of Clinical Nutrition 2003; 78: 480–4.
25Perks, SM, Roemmich, JN, Sandow-Pajewski, M, Clark, PA, Thomas, E, Weltman, A, et al. Alterations in growth and body composition during puberty. IV. Energy intake estimated by the youth–adolescent food-frequency questionnaire: validation by the doubly labeled water method. American Journal of Clinical Nutrition 2000; 72: 1455–60.
26Sjoberg, A, Slinde, F, Arvidsson, D, Ellegard, L, Gramatkovski, E, Hallberg, L, et al. Energy intake in Swedish adolescents: validation of diet history with doubly labelled water. European Journal of Clinical Nutrition. 2003; 57: 1643–52.
27Livingstone, MBE, Prentice, AM, Strain, JJ, Coward, WA, Black, AE, Barker, ME, et al. Accuracy of weighed dietary records in studies of diet and health. British Medical Journal 1990; 300: 708–12.
28Kristjansdottir, G, Vilhjalmsson, R. Sociodemographic differences in patterns of sedentary and physically active behavior in older children and adolescents. Acta Paediatrica 2001; 90: 429–35.
29Osler, M, Clausen, JO, Ibsen, KK, Jensen, GB. Social influences and low leisure-time physical activity in young Danish adults. European Journal of Public Health 2001; 11: 130–4.
30Ekelund, U, Sjostrom, M, Yngve, A, Nilsson, A. Total daily energy expenditure and pattern of physical activity measured by minute-by-minute heart rate monitoring in 14–15 year old Swedish adolescents. European Journal of Clinical Nutrition 2000; 54: 195202.
31Muller, MJ, Bosy-Westphal, A, Klaus, S, Kreymann, G, Luhrmann, PM, Neuhauser-Berthold, M, et al. World Health Organization equations have shortcomings for predicting resting energy expenditure in persons from a modern, affluent population: generation of a new reference standard from a retrospective analysis of a German database of resting energy expenditure. American Journal of Clinical Nutrition 2004; 80: 1379–90.
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Public Health Nutrition
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