Comparison of total energy expenditure and energy intake in children aged 6-9 y

Background: The accurate measurement of food intake in children is important for assessing nutritional status. Objective: We sought to both compare measurements of energy intake (EI) from diet records and of total energy expenditure (TEE) by the doubly labeled water (DLW) method and to investigate misreporting of El. Design: Forty-seven children (22 boys and 25 girls) aged 7.4 +/- 0.8 y ((x) over bar +/- SD) were recruited from 25 schools in western Sydney. TEE was measured by DLW over 10 d and El by use of 3-d food records. Misreporting was defined as [(EI - TEE)/TEE] X 100%. Results: Girls had a higher (P = 0.02) percentage of body fat (28.2 +/- 7.0%) than did boys (22.9 +/- 8.0%); otherwise there were no differences among sex. Although mean ( SD) values for El (7514 +/- 1260 kJ/d) and TEE (7396 +/- 1281 kJ/d) were not significantly different, there was no significant correlation between El and TEE. El and TEE were 9% and 11% lower, respectively, than current World Health Organization recommendations for EI. The relative bias (mean difference, El - TEE) was low at 118 kJ/d, but the limits of agreement (bias +/- 2 SD of the difference) were wide at 118 +/- 3345 kJ/d. Although the mean percentage of misreporting was low (4 +/- 23%), the high SD indicates large intraindividual differences between El and TEE. The most significant predictor of misreporting was dietary fat intake (r(2) = 0.45, P < 0.0001). Misreporting was not associated with sex or body composition. Conclusions: In this age group, reported El is not representative of TEE at the individual level. However, at the population level, 3-d food records may be used for surveys of El by 6-9-y-old children