Validity of dietary assessment methods compared with doubly labeled water in children: A systematic review and meta‐analysis

Summary Objectives We aimed to validate dietary assessment methods against the gold standard, doubly labeled water (DLW), for estimating total energy intake (TEI). Methods PubMed, Scopus, Web of Science, and Google Scholar databases were searched until May 2023. Inclusion criteria encompassed studies involving participants aged 1–18 years, employing dietary assessment methods like food records, dietary histories, food frequency questionnaire (FFQ), or 24‐h recalls estimating TEI alongside DLW to measure total energy expenditure (TEE). Data were pooled using random‐effects meta‐analysis models. Results Thirty‐three studies were identified, with sample sizes ranging from 9 to 118 participants. Meta‐analysis of 22 studies identified underestimation of TEI (mean difference [MD] = −262.9 kcal/day [95% CI: −380.0, −145.8]; I2 = 93.55%) for food records compared with TEE estimated by DLW. Other dietary assessment methods, including food recalls (n = 9) (MD = 54.2 kcal/day [95% CI: −19.8, 128.1]; I2 = 49.62%), FFQ (n = 7) (MD = 44.5 kcal/day [95% CI: −317.8, 406.8]; I2 = 94.94%), and diet history (n = 3) (MD = −130.8 kcal/day [95% CI: −455.8, 194.1]; I2 = 77.48%), showed no significant differences in TEI compared with DLW‐estimated TEE. All studies were of high quality. Conclusion Food records may underestimate TEI, yet additional research is needed to identify the most accurate methods for assessing children's dietary intake.