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PubMed1998

Magnitude, determinants and impact of under-reporting of energy intake in a cohort study in Greece.

OBJECTIVES: To investigate the frequency and the determinants of under-reporting in a semi-quantitative food frequency questionnaire used in the Greek segment of the European Prospective Study on Nutrition, Cancer and Health (EPIC study). DESIGN: A food frequency questionnaire was completed by 9262 adult men and women. The questions included in this questionnaire covered the average intake of approximately 150 food items and beverages over 1 year. Evaluation of under-reporting was conducted on an individual basis taking into account the expected daily variation of nutritional intakes during the time period of recording. Individuals whose energy intake was lower than 1.14*BMR (basal metabolic rate) were defined as under-reporters. SETTING: Urban and rural population of Greece. RESULTS: The data indicated underestimation of energy intake by 11.8% of individuals enrolled. Results from a logistic regression model indicated that body mass index (BMI), gender, age and educational level were significant predictors of under-reporting. The proportion of overweight participants (BMI >30) who tend to under-report energy intake was more than twice that of normal-weight individuals. Men were significantly more prone to under-reporting compared to women, while low education individuals under-report more often than others. Exclusion of under-reporters generated, as expected, mean nutrient values that were significantly higher (by about 6%) than those derived from the total number of participants. When the nutrient values were energy-adjusted, however, or were expressed as percentages of energy intake for macronutrients or as nutrient densities for micronutrients, the emerging differences were minimal and generally statistically not significant. CONCLUSIONS: Under-reporting does exist and it is more extensive among men, those with low education levels and the overweight participants. Adjustment for energy intake minimizes the bias generated by under-reporting with respect to particular nutrients and their association with various disease outcomes in the cohort.

Adult↗
PubMed1996

Energy intake in patients on continuous ambulatory peritoneal dialysis and haemodialysis.

OBJECTIVES: To compare patients on continuous ambulatory peritoneal dialysis (CAPD) with those on haemodialysis (HD) regarding food composition and energy intake. DESIGN: Prospective food recording during 5 consecutive days. SETTING: Nephrology section at a University hospital. SUBJECTS: Fifteen patients on CAPD and 15 patients on HD, matched for age, gender, duration of dialysis and body mass index (BMI). MAIN OUTCOME MEASURES: Percentage macronutrient energy composition, with and without inclusion of transperitoneal glucose uptake. Daily energy intake, both total and from the different macronutrients. RESULTS: The percentage contribution of the dietary macronutrients to the energy intake was about the same in the two dialysis groups, although the actual energy intake in CAPD patients was lower from all three macronutrients (P = 0.02-0.04). The mean intraperitoneal glucose load in CAPD patients was 159 g day-1, which is approximately equivalent to 2700 kJ. Inclusion of this additional energy (estimated uptake: 70% of the intraperitoneal energy load = 19% of total energy intake) significantly increased the carbohydrate fraction and decreased the protein and fat fractions (P < 0.0001). Furthermore, this inclusion resulted in almost identical values for total energy intake in the two groups (approximately 144 kJ kg-1 day-1) and, in CAPD patients, a significantly higher actual energy contribution from carbohydrates (P = 0.04). CONCLUSIONS: Transperitoneal energy intake more than compensates for the lower oral dietary energy intake seen in CAPD patients. Nevertheless, the level of total energy intake places both patient groups in the risk zone for developing malnutrition.

Adult↗
PubMed1996

[Effect of energy density and fat level of milk formulas on subsequent food and energy intake in preschool children].

The aim of this study was to examine the effects of two levels of energy intakes and two levels of fat at breakfast, on the food and energy intakes in subsequent meal (lunch). The study was performed in 51 children both genders, with ages ranging from 24 to 48 months, attending a day care center. The children selected had normal nutritional status (weight/height index) according to the NCHS standards. The food intake was determined by differential weighing and energy intake was calculated from proximal analysis. The energy densities of the cow's milk formula used were 0.8 and 1.2 kcal/g, resulting in a total energy offer (breakfast) of 267.5 and 367.5 kcal respectively, the fat levels were 6.3 and 0.9 g/250 g of formula, using the design 2 x 2 factorial. In the study, 720 observations of food intake were conducted in those children consuming higher than 75% of the total food offered at breakfast. In the lunch-time were offered in alternated form two preparations with an 0.97 kcal/g of energy density. The results demonstrated that the children consumed significantly higher energy amounts in the subsequent meal, after being fed the high fat and lower energy-content breakfast. When the total energy intake (breakfast + lunch) was compared these results show that the caloric difference of breakfast was reduced and the degree of reduction was influenced by the fat level. These results show evidence for partial caloric compensation of 67% in the higher-fat level, and only 34% for the children with the lower of fat-level. It is conclude that the energy intake and fat intake at breakfast influences the energy intake at the subsequent meal. These findings are important to the preschool children's feeding with risk of malnutrition.

Animals↗
PubMed1986

Nutrient intakes and foods selected by college students: comparisons among subgroups divided by energy intake.

Food consumption patterns of college students, divided into subgroups of men (no. = 58), women with mean energy intakes greater than 1,200 kcal (no. = 192), and women consuming less than 1,200 kcal (no. = 53), were studied using 3-day food records. Patterns of nutrient intakes, eating frequency, and types of food eaten differed among subgroups. Women with less than 1,200 kcal had lower intakes of protein, carbohydrate, fat, calcium, iron, thiamin, riboflavin, and niacin; they ate less frequently; and they ate less meat and eggs, legumes, bread, cooked starchy vegetables, milk products, desserts, added fat, and added sugar than did men and women whose mean energy intakes exceeded 1,200 kcal. There were differences between the latter two groups for 10 nutrients and for intakes of fluid milk, meat and eggs, legumes, bread, cooked starchy vegetables, alcoholic beverages, and noncarbonated, sweetened beverages. Diets of men met the RDAs for all nutrients calculated, and diets of women whose intakes exceeded 1,200 kcal met all RDAs except that for iron. Group mean intakes of women with less than 1,200 kcal did not meet the RDAs for calcium, iron, thiamin, riboflavin, and niacin. However, the subgroup with intakes less than 1,200 kcal consumed food of greater nutrient density than did other college students.

Adult↗
PubMed2006

Dietary energy density is associated with energy intake and weight status in US adults.

BACKGROUND: Laboratory-based investigations indicate that the consumption of foods with a low energy density (kcal/g) decreases energy intake. Although low-energy-dense diets are recommended for weight management, relations between energy density, energy intake, and weight status have not been clearly shown in free-living persons. OBJECTIVES: A representative US sample was used to determine whether dietary energy density is associated with energy intake, the weight of food consumed, and body weight and to explore the influence of food choices (fruit, vegetable, and fat consumption) on energy density and body weight. DESIGN: A cross-sectional survey of adults (n = 7356) from the 1994-1996 Continuing Survey of Food Intakes by Individuals and two 24-h dietary recalls were used. RESULTS: Men and women with a low-energy-dense diet had lower energy intakes (approximately 425 and 275 kcal/d less, respectively) than did those with a high-energy-dense diet, even though they consumed more food (approximately 400 and 300 g/d more, respectively). Normal-weight persons had diets with a lower energy density than did obese persons. Persons with a high fruit and vegetable intake had the lowest energy density values and the lowest obesity prevalence. CONCLUSIONS: Adults consuming a low-energy-dense diet are likely to consume more food (by weight) but to have a lower energy intake than do those consuming a higher-energy-dense diet. The energy density of a variety of dietary patterns, including higher-fat diets, can be lowered by adding fruit and vegetables. Our findings support the hypothesis that a relation exists between the consumption of an energy-dense diet and obesity and provide evidence of the importance of fruit and vegetable consumption for weight management.

Adult↗
PubMed2001

Physical activity and energy intake selectively predict the waist-to-hip ratio in men but not in women.

BACKGROUND: The waist-to-hip ratio (WHR) has emerged as an important risk factor for several chronic diseases, but little quantitative information exists about its relation with energy intake and expenditure in men and women. OBJECTIVE: We examined the relative role of energy intake and physical activity as determinants of WHRs in men and women, after adjustment for body mass index (BMI) and other likely confounding factors. DESIGN: In the context of the European Prospective Investigation into Cancer and Nutrition (EPIC), 16433 women and 11520 men aged 30-82 y, apparently healthy and from all over Greece, were examined between 1994 and 1999. Anthropometric measurements were taken, a validated semiquantitative food-frequency questionnaire was administered, and time-weighted occupational and leisure activities were assessed. The WHR was regressed, separately for men and women, on energy intake and energy expenditure after age and BMI were controlled for. RESULTS: Results for women and men differed. In women, neither energy intake nor energy expenditure was associated with the WHR in any way other than that mediated through BMI. In contrast, in men, higher energy intakes and higher energy expenditures were associated significantly, and largely independently of BMI, with higher and lower WHRs, respectively. CONCLUSIONS: Because the WHR is an important predictor of several cardiovascular and other chronic diseases, documentation of a strong effect of physical activity on the WHR selectively in men may provide a partial explanation of how the effect of physical activity is mediated and why physical activity is more effective in men than in women in reducing disease risk.

Activities of Daily Living↗
PubMed2003

Metabolic abnormalities (hypertension, hyperglycemia and overweight), lifestyle (high energy intake and physical inactivity) and endometrial cancer risk in a Norwegian cohort.

Since high energy intake, inactivity, hypertension and diabetes are linked to obesity and an unfavorable hormonal profile, we wanted to test whether energy intake, physical activity, blood pressure and serum glucose are related to the risk of endometrial cancer independent of the body mass index (BMI). A cohort of 24,460 women, aged 20-49 years, attended a Norwegian health screening twice during 1974-1981; they answered questions about diet, physical activity and chronic diseases, and their height, weight, blood pressure and non-fasting serum glucose were measured. By the end of 1996, during 15.7 years of follow-up, 130 cases of endometrial carcinomas were identified. The relative risks (RRs) for endometrial cancer were estimated in proportional hazards models including potentially confounding factors. Obese women (BMI > or = 30 kg/m(2)) were at 2.6 times increased risk of endometrial cancer compared to normal weight women (BMI < 25 kg/m(2)) (RR = 2.57, 95%CI = 1.61-4.10). Among overweight women (BMI > or = 25 kg/m(2)), non-fasting serum glucose in the upper quartile vs. in the lower quartile was associated with a 2.4 times increase in risk (RR = 2.41, 95%CI = 1.08-5.37), whereas among obese women, blood pressure above 140/90 mmHg vs. below 140/90 mmHg in both surveys was associated with a 3.5 times increase in risk (RR = 3.47, 95%CI = 1.24-9.70). Especially in women younger than 50 years, high energy intake (5,044-6,401 kJ/day) conferred higher risk compared to low energy intake (< 4266 kJ/day) (RR = 3.40, 95%CI = 1.52-7.60). Increasing recreational activity tended to be protective. Among obese women with non-sedentary jobs at both screenings, RR declined to 0.18 (95%CI = 0.05-0.62) as the level of sustained occupational activity increased (p(trend) = 0.03). Our results suggest that inactivity and high energy intake are major risk factors for endometrial cancer independent of BMI, and that hypertension and relative hyperglycemia are significant markers of risk, especially among the heaviest women.

Adult↗
PubMed2003

Association of energy intake with prostate cancer in a long-term aging study: Baltimore Longitudinal Study of Aging (United States).

OBJECTIVES: To examine the association of total energy intake and macronutrient contributors to energy with prostate cancer risk among men in the Baltimore Longitudinal Study of Aging. METHODS: In the Baltimore Longitudinal Study of Aging cohort, 444 men completed at least one food frequency questionnaire (FFQ). At their earliest FFQ completion, men were 45 to 92 years old. The total number of prostate cancer cases (n = 68) consisted of men who were diagnosed with cancer before their FFQ completion (n = 46) and those who were diagnosed after their FFQ completion (n = 22). Multiple logistic regression analysis was used to calculate the odds ratio of prostate cancer and its 95% confidence interval. RESULTS: Total energy intake was positively associated with prostate cancer. Compared with the lowest quintile of energy intake, the odds ratio for the highest quintile was 3.79 (95% confidence interval 1.52 to 9.48, P TREND = 0.002). Energy-adjusted intakes of protein, fat, and carbohydrates were not statistically significantly associated with prostate cancer risk. CONCLUSIONS: This analysis, in which we used current energy intake as a surrogate for past prediagnostic intake, suggests a higher risk of prostate cancer with increased energy intake.

Aged↗
PubMed1999

Water incorporated into a food but not served with a food decreases energy intake in lean women.

BACKGROUND: Previous research showed that decreasing the energy density (kJ/g) of foods by adding water to them can lead to reductions in energy intake. Few studies have examined how water consumed as a beverage affects food intake. OBJECTIVE: This study examined the effects of water, both served with a food and incorporated into a food, on satiety. DESIGN: In a within-subjects design, 24 lean women consumed breakfast, lunch, and dinner in our laboratory 1 d/wk for 4 wk. Subjects received 1 of 3 isoenergetic (1128 kJ) preloads 17 min before lunch on 3 d and no preload on 1 d. The preloads consisted of 1) chicken rice casserole, 2) chicken rice casserole served with a glass of water (356 g), and 3) chicken rice soup. The soup contained the same ingredients (type and amount) as the casserole that was served with water. RESULTS: Decreasing the energy density of and increasing the volume of the preload by adding water to it significantly increased fullness and reduced hunger and subsequent energy intake at lunch. The equivalent amount of water served as a beverage with a food did not affect satiety. Energy intake at lunch was 1209 +/- 125 kJ after the soup compared with 1657 +/- 148 and 1639 +/- 148 kJ after the casserole with and without water, respectively. Subjects did not compensate at dinner for this reduction in lunch intake. CONCLUSION: Consuming foods with a high water content more effectively reduced subsequent energy intake than did drinking water with food.

Adult↗
PubMed1999

Patterns of energy intake in patients with cirrhosis and healthy volunteers.

Fuel utilization and N economy are optimized in patients with cirrhosis by provision of several small meals throughout the day and a late-night snack of complex carbohydrate. Currently, however, only limited information is available on the patterns of energy intake in patients with chronic liver disease. The aims of the present study were to determine the number of days required to undertake such an investigation and to observe the daily distribution of energy intake in this patient population. Eight patients with cirrhosis and eight matched healthy volunteers kept weighed dietary intake records for fifteen separate days over a 6-month period. The records were analysed for energy intake per hour and the number and size of energy intake episodes per 24 h calculated. Intake was verified against resting energy expenditure. Fourteen separate observational days were required to investigate the pattern of energy intake in the cirrhotic patients while 20 d were required for healthy volunteers. Considerable inter- and intrasubject variations in the number and size of energy intake episodes were observed in both the patients and healthy volunteers. However, no significant differences were observed between the mean total number of daily energy intake episodes (6.3 (SD 1.6) v. 7.0 (SD 1.4)) or in the distribution of daily energy intake between the two groups. Most patients and volunteers tended to eat frequent small meals, often including a late-night snack, rather than two or three large meals daily. It should, therefore, be possible to establish optimum patterns of energy intake in these patients in line with recent guidelines.

Adult↗
PubMed1987

Energy expenditure, energy intake and body composition in geriatric long-stay patients.

Energy expenditure, energy intake, body composition and selected biochemical analyses were studied in 14 males and 16 females with a mean age of 83 years (range 68-92) in geriatric long-stay wards. Energy expenditure was predicted from heart rate monitoring, and energy intake was assessed with a 4-day dietary record. Lean body mass (LBM), body fat (BF), and total body water (TBW) were estimated with a bioelectrical impedance method. The mean energy expenditure and energy intake were 1845 kcal/d (7719 kJ/d) and 1746 kcal/d (7305 kJ/d) in male, and 1550 kcal/d (6485 kJ/d) and 1489 kcal/d (6230 kJ/d) in female subjects. Thirty per cent of the patients were in a negative energy balance. Mean values (+/- SD) of LBM were 50.2 +/- 7.81 kg and 39.6 +/- 6.78 kg, of BF 14.4 +/- 4.98 kg and 19.6 +/- 6.26 kg, of TBW 38.2 +/- 4.67 kg and 29.2 +/- 4.16 kg, and of basal metabolic rate expressed per unit LBM 24 +/- 2.6 kcal/kg LBM and 27 +/- 4.5 kcal/kg LBM in male and female subjects, respectively. The males had a lower per cent body fat expressed per kg body weight, also supported by low triceps skinfold values. Twenty per cent of the patients had triceps skinfold values indicating severe malnutrition according to definitions in the literature. The values of serum sodium, potassium, triiodothyronine and thyroid-stimulating hormone were within reference limits.

Aged↗
PubMed1992

[Effect of daily energy intake and amount of walking on body weight reduction and its maintenance].

The relationship of daily energy intake and the amount of walking performed, based on pedometer readings, for effective body weight reduction were studied based on results of a weight reduction program at the Aichi Prefectural Center of Health Care from 1983 to 1990. In addition, a follow-up study based on a mailed questionnaire was performed, to further determine the relationship to maintenance of body weight reduction of energy intake and amount of walking after the conclusion of program. The subjects were two-hundred and forty middle-aged obese women who were placed on a 5-month weight reduction program consisting of diet (1500 kcal/day) and exercise (10000 walk steps/day). At the end of the program, the mean energy intake and the mean number of steps per day had reached target levels and the mean body weight reduction was 4.2 kg. The relationship of energy intake, and the number of steps walked at the end of program to the amount of reduction in body weight during the program was analyzed by multiple regression analysis, and the amount of walking expressed in the number of steps necessary for weight reduction were calculated for various energy intakes. A follow-up study was performed in 1988, with sixty-six women responding to the mailed questionnaire. Since the end of the program, body weight increase of 1.1 kg occurred, but body weight was still lower than initially. Although mean energy intake increased after the program, a level about 200 kcal less than at the beginning of the program was being maintained, so the effect of diet recommendation in the program appeared to be retained.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1998

Uncoupling the effects of energy expenditure and energy intake: appetite response to short-term energy deficit induced by meal omission and physical activity.

The effects of two methods of inducing an acute energy deficit (exercise and a low-energy breakfast) on appetite were investigated in 11 healthy females, all of whom were regular exercisers and regular breakfast eaters. There were four experimental days: with exercise and a high-energy (500 kcal) breakfast (EHB), exercise and a low-energy (64 kcal) breakfast (ELB), no exercise and a high-energy breakfast (NEHB) and no exercise and a low-energy breakfast (NELB). Hunger and moods were monitored each hour from 8 a. m. until 5 p.m. Energy and macronutrient intake were measured during an ad libitum lunch test meal 4 h after the exercise and breakfast. Heart rate was continuously monitored using the Polar sport tester. The low-energy breakfasts (ELB and NELB) led to increased hunger during the morning and an increase in energy intake at lunch compared with the high-energy breakfasts. Subjects also experienced significantly more food cravings after LBs than after HBs. Exercise failed to have any significant effect on these variables. Thus, two methods of inducing a short-term energy deficit had markedly different effects on appetite. The low-energy breakfast presumably fails to generate the inhibitory satiety signals induced by the 500 kcal breakfast, whereas the metabolic effects of an exercise session failed to generate excitatory signals to hunger and food intake.

Adult↗
PubMed1994

Energy intake, anthropometry and blood pressure of expeditioners in the Antarctic.

The energy intakes, anthropometry and blood pressure of 62 expeditioners at one Australian sub-Antarctic (Macquarie Island) and two Antarctic stations (Davis and Casey) were examined over a 12 month period. High mean energy intakes were found at all stations (approximately 16,000 kJ/subject/day). Mean subject body weight tended to rise during the winter months (midway during the study) and fall during the spring, although there were no significant changes (p < 0.05) seen at any of the stations over the year. Subjects were generally leaner at the end of 12 months as evidenced by significant falls (p < 0.01) in mean sum of skinfold thickness at two stations over the year. At all stations, blood pressure trended downwards during the year, with significant rises (p < 0.01) seen at one station during the spring. Two 12-week dietary intervention periods were introduced during the year at one of the Antarctic stations to investigate the effects of low-cholesterol (< 300 mg/day), low-fat (< 30% of energy) and high-fibre (> 30 g/day) diets. The average energy intake/day during these two periods (14,973 kJ and 14,515 kJ) was slightly less than during the baseline diet (average of 16,228 kJ). This was reflected in the anthropometric measurements with the mean body weight, sum of skinfold thickness and waist/hip ratios trending down during the diet periods. The study confirms earlier reports of high mean energy intake in Antarctica and suggests that the techniques of measuring intake may have been more accurate than those used in large population studies where intake may have been under-estimated. The results indicate seasonal fluctuations in blood pressure and anthropometric parameters and demonstrate that these anthropometric parameters were affected by the balance of energy intake and activity.

Adult↗
PubMed1985

Energy intake, norepinephrine excretion, and oxygen consumption in low birthweight infants.

Eleven healthy, appropriately grown low birthweight infants, ages 3-15 days and 28-33 weeks gestation, were the subjects of this study. Energy intake, urinary norepinephrine excretion, and metabolic rate as reflected in VO2 were examined concurrently. Energy intakes were recorded. Simultaneous collection of a timed urine for norepinephrine excretion and measurement of VO2 using indirect calorimetry were performed. A servo control device was used to maintain an abdominal skin temperature of 36.5 degrees C. The results demonstrated increases in energy intake, urinary norepinephrine, and VO2 with advancing postnatal age. Simple linear regression analysis revealed significant positive correlations between energy intake and VO2 (p less than 0.003), norepinephrine excretion and VO2 (p less than 0.003), postnatal age and VO2 (p less than 0.01), and postnatal age and energy intake (p less than 0.001). Multiple regression analysis revealed a strong positive correlation between urinary norepinephrine excretion and VO2, and energy intake and VO2. When postnatal age was added to the multiple linear regression analysis as a variable, energy intake was no longer strongly correlated with VO2. This implies postnatal age and energy intake are closely linked in this study, and further studies are needed to better define these relationships.

Birth Weight↗
PubMed1997

Effect of one week of fibre supplementation on hunger and satiety ratings and energy intake.

The effect of one week of supplementation with a water-soluble fibre (guar gum) was studied in obese women who had lost weight. In study 1 (N=17; mean+/-SEM: age 38.5+/-2.3 yrs; weight 86.8+/-2.3 kg; BMI 32.2+/-0.9 kg.m-2) energy intake and hunger and satiety scores were assessed under free-living conditions. In study 2 (N=14; age 44. 5+/-1.8 yrs; weight 78.8+/-3.1 kg; BMI 29.0+/-0.9 kg.m-2) energy intake was fixed at 6 MJ.day-1 (their normal energy intake at that time) or 4 MJ.day-1 (low energy intake). In both studies, the effect of one week of fibre supplementation (40 g in study 1 and 20 g in study 2) was compared with no supplementation. In study 1, mean energy intake decreased significantly from 6.7+/-0.4 MJ to 5.4+/-0.2 MJ daily after fibre supplementation, while hunger and satiety scores did not change. At a low energy intake level of 4 MJ given in study 2, hunger scores were significantly decreased after fibre supplementation. No changes were seen in hunger and satiety scores during fibre supplementation at 6 MJ. The reduction in energy intake by soluble fibre under free living conditions and the hunger-reducing effect of fibre at the low energy intake level (4 MJ) suggests that fibre may be useful in the treatment of obesity, by facilitating compliance to low energy intake.

Adult↗
PubMed1989

Adaptation of energy metabolism of overweight women to alternating and continuous low energy intake.

To investigate whether a slimming diet based on alternating (low with normal) energy intakes could counteract a decrease in energy requirement, 24-h energy expenditure (24EE), sleeping energy expenditure (sleeping EE), and physical activity were determined in a respiration chamber in 27 overweight women: before weight reduction and after 4 and 8 wk of slimming. Daily alternating and continuous slimming diets were supplied. Average weight losses over 8 wk of slimming were 6.9-9.0 kg. After 8 wk at low energy intake, 24EE had declined by 12-16% (from 2328 +/- 219 to 1987 +/- 204 kcal, mean +/- SD). Sleeping EE had declined by 7-13% (from 64 +/- 6 to 57 +/- 6 kcal/h). Measurements of physical activity indicated a reduction of spontaneous physical activity during slimming. Alternating low energy intake did not prevent 24EE from declining. The reduction in 24EE was determined by a decrease of body weight, dietary induced thermogenesis (in proportion to caloric restriction), and physical activity. There seems little reason to consider other adaptive mechanisms.

Adaptation, Physiological↗