Energy intake and expenditure: validation of a diet history by heart rate monitoring, activity diary and doubly labeled water

OBJECTIVE: To validate a diet history (DH).

DESIGN: Energy intake (EI) estimated by a diet history (DH) was validated against total energy expenditure (TEE) measured by doubly labeled water (DLW) (n = 12) used as reference, by heart rate monitoring (HR) and by an activity diary (AD).

SETTING: Department of Geriatric Medicine, Göteborg University, Vasa Hospital, Gothenburg, Sweden.

SUBJECTS: 20 healthy free-living elderly subjects (73 years) from the gerontological and geriatric population studies, Gothenburg, Sweden (H70).

RESULTS: Mean value for EI was 9.02 (s.d. 2.30), for TEE by HR was 9.66 (s.d. 2.25) MJ/d, and for TEE by AD was 9.40 (s.d. 2.08) MJ/d. In the 12 individuals measured with DLW, EI was 8.62 (s.d. 2.06), TEE by DLW was 9.90 (s.d. 1.43) MJ/d, TEE by HR was 8.94 (s.d. 1.96) MJ/d, and TEE by AD was 9.24 (s.d. 2.15)MJ/d. Mean difference between DH and DLW was 1.28 (s.d. 2.17) MJ (NS) and the DH/DLW ratio was 0.88. Four subjects were identified as under-reporters and one as an over-reporter.

CONCLUSION: The DH slightly underestimated EI compared to the HR, but was in concordance with the AD. Compared to DLW, DH underestimated EI by 12%. On group level, the DH method gave comparable values to HR and AD. The DH was not valid for ranking of individuals. Compared to DLW, the HR method seemed to perform somewhat better than the AD for detection of under- and over-reporters.