A Comparison of Self-Reported Energy Intake With Total Energy Expenditure Estimated by Accelerometer and Basal Metabolic Rate in African-American Women With Type 2 Diabetes

A Comparison of Self-Reported Energy Intake With Total Energy Expenditure Estimated by Accelerometer and Basal Metabolic Rate in African-American Women With Type 2 Diabetes Carmen D. Samuel-Hodge , PHD 1 , Louise M. Fernandez , MPH 2 , Carlos F. Henríquez-Roldán , PHD 3 4 , Larry F. Johnston , MPH 5 and Thomas C. Keyserling , MD 6 1 Department of Nutrition, Schools of Public Health and Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 2 Department of Nutrition, Schools of Public Health and Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 3 Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 4 Department of Statistics, University of Valparaíso, Valparaíso, Chile 5 Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 6 Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Address correspondencereprint requests to Carmen D. Samuel-Hodge, PhD, MS, RD, University of North Carolina at Chapel Hill, Schools of Public HealthMedicine, Department of Nutrition, 1700 Airport Rd., CB #8140, Chapel Hill, NC 27599-8140. E-mail: carmen_samuel{at}unc.edu Abstract OBJECTIVE —This study assesses the validity of dietary data from African-American women with type 2 diabetes by comparing reported energy intake (EI) with total energy expenditure (TEE) estimated by an accelerometer and basal metabolic rate (BMR). RESEARCH DESIGN AND METHODS —EI of 200 African-American women was assessed by three telephone-administered 24-h diet recalls using a multiple-pass approach. Physical activity was measured over a 7-day period by accelerometer, which also provided an estimate of TEE. Underreporting of EI was determined by using cutoffs for EI-to-TEE and EI-to-BMR ratios. RESULTS —Participants, on average, were 59 years of age, with a BMI of 35.7, 10.5 years of diagnosed diabetes, and 10.7 years of education. Mean EI was 1,299 kcal/day; mean EI-to-TEE and EI-to-BMR ratios were 0.65 and 0.88, respectively. Among the 185 subjects with complete dietary data, 81% ( n = 150) were classified as energy underreporters using the EI-to-TEE ratio cutoff; 58% ( n = 107) were classified as energy underreporters using the EI-to-BMR ratio. Energy underreporters had significantly lower reported fat, higher protein, but similar carbohyd