Nature of dietary reporting by adults in the third National Health and Nutrition Examination Survey, 1988-1994

Objective: Low reporting of food intake is an acknowledged problem in dietary assessments; however, differences in food intake relative to reporting status are poorly understood. This study examined the relation of a measure of dietary reporting status with the nature of food intake reported by adults in the third National Health and Nutrition Examination Survey. Methods: Subjects were 6948 women and 6452 men, 20 years of age or older, with a complete and reliable 24-hour dietary recall. The ratio of reported energy intake to estimated basal energy expenditure (EI/BEE) was computed as a measure of dietary reporting status. The independent relation of EI/BEE ratio with 1) the amount, number, and energy density of nutrient-dense and low-nutrient-dense foods, 2) the number of reported eating occasions, 3) macro- and micronutrient intake and 4) serum concentrations of folate, ascorbate and carotenoids were examined using gender-specific multiple regression models. Results: The EYBEE ratio related positively with the amount, number and energy density of both nutrient-dense and low-nutrient-dense foods, and grams of alcoholic beverages. The EYBEE ratio was an independent negative predictor of serum folate, ascorbate and,alpha-carotene concentrations confirming the underreporting of food sources of these nutrients. The relative odds of reporting less than or equal to 30% of energy as fat or < 10% of energy as saturated fat decreased - with ratio of EYBEE; however, the odds of reporting all five food groups or meeting the recommended intake of selected micronutrients increased with EI/BEE. Conclusions: The quantity and the quality of food intake reported in the 24-hour recall in NHANES III differed in relation to the ratio of EI/BEE.