The Journal of Nutrition Nutrition and Disease Energy Intake of Swedish Overweight and Obese Children Is Underestimated Using a Diet History Interview1,2

Estimatingenergy intake (EI) of a child by using adiet history interview (DHI)methodmaybea challengebecauseof difficulty for the child to remember what has been eaten as well as to report portion sizes. The aim of this research was to validate reportedEI fromaDHI in childrenclassified asoverweight or obeseby comparing the reportedEI to total energyexpenditure (TEE)measured by 2 objectivemeasures. Eighty-five 10.5-6 1.1-y-old overweight and obese children,with help from1 or 2 parents, reported their EI 2 wk retrospectively in a DHI. Reported EI was compared with TEE, as measured by SenseWear armband (n 85) and the doubly-labeledwater (DLW)method (n 21), during the sameperiod as theDHI. Reported EIwas underestimated by 14 % when validated against both the armband and DLW method. Underestimation did not differ between boys and girls. However, the EI of obese children was underestimated by 22%, which is twice the rate as for the overweight children (95%CI: 0.55, 3.08). Underestimated EI was negatively correlatedwith BMI (r20.38; P,0.01) as well as age (r 20.21; P 0.05). EI is underestimated to a higher extent among children with higher BMI and higher age when using a DHI method. The findings show the importance of validating dietary intake of children in general and in overweight and obese children in particular. J. Nutr. 139: 522–527, 2009