Underreporting of energy intake in an elderly German population

OBJECTIVES: Within the longitudinal study on nutrition and health status in an aging population in Giessen, Germany (GISELA), the underreporters of energy intake (EI) were identified and characterized. METHODS: EI was assessed in 238 female and 105 male participants of the GISELA study (age range = 60–89 y) by means of a 3-day estimated dietary record developed especially for this study. Resting metabolic rate (RMR) was measured by indirect calorimetry after an overnight fast. EI was expressed as a multiple of RMR and subjects with an EI:RMR ratio below 1.073 were classified as underreporters. RESULTS: Mean EI:RMR was 1.62 ± 0.46 in females and 1.53 ± 0.46 in males; 7.6% of the females and 16.2% of the males were identified as underreporters. They showed lower levels of education and significantly greater body weight, body mass index, and fat mass than the adequate reporters. Further, underreporters stated more often than adequate reporters that they want to lose weight. Except for β-carotene in males, reported nutrient intakes were significantly lower in underreporters than in adequate reporters. Carbohydrate and fat intake in both sexes, protein intake in females calculated as a percentage of EI, and vitamin and mineral densities were not affected by underreporting. CONCLUSIONS: The results indicate that underreporting of EI is related to a low educational level and greater body weight, body mass index, and fat mass and affects all nutrients. These findings should be considered when the association between nutrition and health status is investigated in the elderly.