Energy intake in Swedish adolescents: validation of diet history with doubly labelled water

Objective: To compare habitual energy intake (EI) estimated from diet history (DH) with total energy expenditure (TEE) measured with doubly labelled water (DLW) in adolescents. Design: DH included a detailed questionnaire and an interview. TEE was measured during a 14-day period. Adequate (AR), under-(UR) and over-reporters (OR) were defined from the ratio EI/TEE: AR 0.84-1.16, UR <0.84 and OR >1.16. Setting: Participants were recruited from grade 9 in a compulsory school in Goteborg, Sweden. All data were collected at school and DLW dosages were distributed at Sahlgrenska University Hospital. Subjects: A total of 35 adolescents (18 boys, 17 girls), 15.7 (0.4) y. Results: EI was 11.0 (3.6) MJ and TEE was 11.4 (2.1) MJ (P=0.42). DH was able to rank EI compared to TEE (Spearman's r=0.59, Pless than or equal to0.001). For girls, EI was 18% lower (P=0.0067) and for boys, EI was 7% higher (P=0.26) compared to TEE. The 95% limits of agreement for difference between TEE and EI were -5.6 to 6.5 MJ. In total, 20 subjects were defined as AR (57%), nine as UR (26%) and six as OR (17%). Energy from in-between meals was 33% lower (P=0.0043) in UR girls and 57% higher (P=0.026) in OR boys, compared to adequate reporting girls and boys, respectively. In UR girls, energy-adjusted intake (10 MJ) of specific foods did not differ significantly, fat was lower and carbohydrate and vitamin C were higher compared to AR girls (all P<0.05). OR boys had no significant differences in food and nutrient intake in 10 MJ compared to AR boys. Conclusion: The diet history was able to capture EI for the group and to rank subjects. There was a wide individual range in reporting-accuracy related to gender. Sponsorship: The Ingabritt and Arne Lundberg Foundation, The Wilhelm and Martina Lundgren Foundation.