Energy Intake in Socially Vulnerable Women Living in Brazil: Assessment of the Accuracy of Two Methods of Dietary Intake Recording Using Doubly Labeled Water

Abstract Background Diet is related to the prevention of chronic diseases, but assessing dietary intake is a complex task, especially in socially vulnerable populations. Objectives To assess the accuracy of the 24-hour food recall (24HFR) and the food frequency questionnaire (FFQ) methods in socially vulnerable women in Brazil and compare these methods against doubly labeled water (DLW). Design Cross-sectional study. Energy intake (EI) was measured using 3 24HFRs and 1 FFQ. Total energy expenditure (TEE) was measured using DLW. Cutoff points were calculated to assess underreporting and overreporting using both the difference and the ratio between the EI and TEE. Participants/setting Sixty-seven socially vulnerable, nondieting adult women with stable body weight and mothers of malnourished children. Main outcome measures EI, in kilocalories, derived from 24HFR and FFQ. Statistical analyses Repeated measures analysis of variance was used to compare EI and TEE and Bland-Altman graphs were plotted to assess the agreement between these variables. Spearman correlation coefficient between the ratio of EI to TEE and socioeconomic or anthropometric variables was calculated. Results Mean TEE was 2,186 kcal (95% CI 2,063 to 2,309 kcal). EI obtained through 24HFR (mean=1,848.6 kcal [95% CI 1,737.5 to 1,959.7 kcal]) was significantly lower than TEE ( P =0.01), and significantly lower than the EI obtained through FFQ (mean=2,084.5 [95% CI 1,929.0 to 2,240.0 kcal]; P