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PubMed1998

Eating attitudes and energy intakes of female skaters.

PURPOSE: This study examined potential links between dietary intakes, body fatness, menstrual status, and hematological and serum iron status in 21 competitive female figure skaters aged 11-16 yr. METHODS: Attitudes toward dieting were assessed using the Eating Attitudes Test (EAT). Dietary intakes were based on 3-d food records. Percent body fat was calculated using measures of triceps, subscapular, suprailiac, pectoral, axillary, abdominal, and thigh skinfold measures. Blood iron status was measured using hematocrit (Hct), hemoglobin (Hgb), total iron binding capacity (TIBC), and serum iron. Menstrual status was based on a self-report questionnaire. RESULTS: Body weights and estimated energy intakes were all within normal range for this age group. Higher EAT scores were associated with lower micronutrient, but not lower energy intakes. Menstrual status and iron status were normal. No significant correlations between measures of body fatness, menstrual status, and hematological or serum iron status were observed. CONCLUSION: Although the measured indices of nutritional status were normal, adolescent athletes have higher energy needs than does the general population. Depending on energy expenditure levels, energy and nutrition intakes in the low normal range may put some athletes at risk for undernutrition.

Adolescent↗

PubMed2003

Personality characteristics as predictors of underreporting of energy intake on 24-hour dietary recall interviews.

OBJECTIVE: To identify characteristics associated with misreporting of energy intake during 24-hour dietary recalls (24 HR). DESIGN: Ninety-eight subjects were administered two 24 HRs. Energy expenditure was determined by doubly labeled water (44 subjects) or intake balance (54 subjects). Data on subjects' physical, lifestyle, and psychosocial characteristics were also collected. Subjects/setting At the Beltsville Human Nutrition Research Center 52 women and 46 men were administered 24HR and completed lifestyle and personality questionnaires and a memory test. Physical characteristics such as weight, percent body fat, and total energy expenditure were measured. Statistical analysis The influences of subject parameters on energy misreporting were assessed by linear regression and Pearson product-moment correlation analysis for continuous variables and by ANOVA for discrete variables. Stepwise regression was used to identify key factors in underreporting. RESULTS: Factors particularly important in predicting underreporting of energy intake include factors indicating dissatisfaction with body image; for example, a 398 kcal/day underreport in subjects attempting weight loss during the past year with a nearly 500 kcal/day underreport in women. Overall, women underreported by 393 kcal/day relative to men and women evinced a social desirability bias amounting to a 26 kcal underreport for each point on the social desirability scale. Gender differences also were evident in the effect of percent body fat (with men underreporting about 16 kcal/day/percent body fat) and in departure from self-reported ideal body weight (with women underreporting about 21 kcal/day/kg). APPLICATIONS/CONCLUSIONS: Body image and fatness are key factors on which health professionals should focus when seeking predictors of underreporting of dietary intake. Dietary interviews must be conducted to minimize bias related to subjects' tendencies to win approval and avoid censure by the interviewer. In addition, dissatisfaction with body image may lead to underestimation of food intake, therefore reducing likelihood of success in weight loss. Thus, health care professionals involved in weight loss counseling may achieve better success if treatment includes generating a more positive body image.

Adipose Tissue↗

PubMed2006

Snacks as an element of energy intake and food consumption.

BACKGROUND: An increasing frequency of snacks has been observed in meal pattern studies. Snacks can alter the diet because of their high-energy density and low-nutrient content or on the contrary. OBJECTIVE: The prominence of snacks in energy intake and food consumption was assessed. DESIGN: Dietary data were collected for 2007 adults by using a computer-assisted 48-h dietary recall in the national FINDIET 2002 survey. Energy intakes and food consumption were aggregated for snacks and for main meals. RESULTS: Daily energy was mostly derived from main meals comprising traditional mixed dishes, milk and bread. However, a snack-dominating meal pattern was observed in 19% of men and 24% of women. This meal pattern was associated with urbanization in both genders and with physical work in men. Higher sucrose intake and lower intake of micronutrients were typical of the snack-dominating meal pattern compared to the others. CONCLUSIONS: As snacks appear to have a higher energy density and a lower content of micronutrients than main meals, a snack-dominating meal pattern is inadvisable. However, further studies are needed to examine the association between meal pattern and health status.

Adult↗

PubMed1994

Effect of a cafeteria diet on energy intake and balance in Wistar rats.

The energy balance and nutrient selection strategies of 30-day-old Wistar rats offered a reference pellet and a seven-item cafeteria diet were studied in two consecutive 15-day periods: 30-45 and 45-60 days after birth. Cafeteria-fed rats grew faster, incorporating more fat and water, but a similar amount of protein to reference-fed animals. In the second 15 days all rats ate less and produced less heat than in the first 15 days. Reference-fed rats also deposited less energy in their bodies, in contrast to the tendency towards higher carcass energy deposition in cafeteria-fed rats. Cafeteria-fed rats selected much more fat and sugars than controls, with similar protein and less starch; in the second period studied, cafeteria-fed rats significantly increased their sugar consumption, with no change in fat or protein. It is suggested that the switch to selecting more sugars may be an essential factor in the shift towards increased fat deposition at the expense of heat production in cafeteria-fed rats.

Animals↗

PubMed2000

Influence of body composition on the accuracy of reported energy intake in children.

OBJECTIVE: Mis-reporting dietary intake is a substantial barrier to understanding the role of dietary behavior in disease. Work with adults indicates that heavier individuals under-report dietary intake and that under-reporting may be macronutrient-specific. Whether weight status and macronutrient intake influence the accuracy of dietary reports among children, however, is less clear. This research evaluated children's dietary reporting accuracy as a function of their relative weight, body composition, and macronutrient intake. RESEARCH METHODS AND PROCEDURES: Participants included 146 4- to 11-year-old children. Reported energy intake was determined by interviewing children in the presence of parents, using three multiple pass, 24-hour recalls. Children were classified as having had an under-reported, accurately reported, or over-reported dietary intake relative to total energy expenditure, as measured by doubly labeled water. Reporting accuracy was examined as a function of children's body weight, body composition (using dual energy x-ray absorptiometry), and macronutrient intake. RESULTS: Average reported intake was, on average, 14% greater than children's estimated expenditure (p < 0.01). Reporting accuracy varied as a function of children's relative weight and body composition; under-reporting tended to occur among heavier children, having the highest body fat content (p < 0.0001) and relative weight (p < 0.0001). DISCUSSION: These findings suggest that weight status influences the accuracy of dietary reports made by children and their parents. More research is needed to address possible psychological and social factors that introduce bias in reporting children's dietary data.

Absorptiometry, Photon↗

PubMed2002

Digestible energy intake, dry matter digestibility and mineral status of grazing New Zealand Thoroughbred yearlings.

AIM: To measure the nutritive value of pasture in terms of digestible energy intake (DEI) and dry matter (DM) digestibility, and to determine the effect of Ca, P, Cu, Zn, and Se supplementation on growth rate and degree of physeal swelling in Thoroughbred yearlings grazed on pasture. METHODS: Fourteen yearling horses were randomly allocated to 1 of 2 groups and rotationally grazed on a ryegrass/white clover pasture for 7 months. One group was supplemented daily with a mineral mix. Liveweight changes were recorded at fortnightly intervals and pasture mineral composition determined at monthly intervals. The DM intake (DMI) was determined from daily faecal DM outputs divided by the indigestible DM fraction (1 - digestible DM) determined from a digestibility study. The DEI was determined from the difference between the gross energy intake and the gross energy faecal output. The DM, gross energy content, crude protein (CP), soluble carbohydrate, acid detergent fibre (ADF), neutral detergent fibre (NDF), lipid and mineral composition of pasture offered and faeces were analysed and their digestibility or apparent absorption calculated. RESULTS: The DM digestibility of pasture averaged 0.64 while the daily DMI and DEI of a 350 kg yearling, gaining 0.6 kg liveweight/day, averaged 6.9 kg DM/day and 78 MJ DE/day, respectively. The mineral supplement had no significant effect on the growth of yearlings grazing pasture that had a mineral composition of (g/kg DM) Na 0.17, K 32.8, Ca 3.6, P 3.4, Mg 2.1, S 3.0, and (mg/kg DM) Cu 7.9, Fe 177, Mn 83, Zn 28 and Se 0.016. Plasma Se was elevated (e.g. 40-218 microg/l) by Se supplementation while Cu supplementation had no effect on plasma and liver Cu concentrations. Physeal swelling was observed in all horses, regardless of treatment. CONCLUSION: Good quality ryegrass/white clover pasture that had a DE content of 11.3 MJ/kg DM and adequate mineral composition (as observed in this study, with the possible exception of Se) will provide an adequate intake of nutrients to ensure good growth in yearling horses.

Journal Article↗

PubMed1994

Energy intake and physical activity in relation to indexes of body fat: the National Heart, Lung, and Blood Institute Growth and Health Study.

The relationship between energy intake, physical activity, and body fat was investigated in the baseline visit of 2379 black and white girls aged 9-10 y enrolled in the National Heart, Lung, and Blood Institute Growth and Health Study. Three-day food records, three-day physical activity diaries, physical-activity-patterns questionnaires, and an assessment of the number of hours of television and video watched were obtained. Multivariate-regression analyses showed that age, the number of hours of television and video watched, the percent of energy from saturated fatty acids, and the activity-patterns score best explained the variation in body mass index and sum of three skin-fold-thickness measurements for black girls. The best model for white girls included age, the number of hours of television and video watched, and the percent of energy from total fat. These results indicate that body fatness is related to energy intake and expenditure in both black and white girls. Longitudinal studies will help assess the value of these variables in predicting changes in body fat.

Black People↗

PubMed1998

Determinants of obesity-related underreporting of energy intake.

Data from an ongoing Dutch health examination monitoring project carried out in 1995 (n = 2,079 men and 2,467 women, aged 20-65 years) were used to study whether various determinants of underreporting of energy intake influenced the association between underreporting and body mass index. Further, the authors examined whether these determinants were mutually independent predictors of underreporting. As a measure for the degree of underreporting, they calculated energy ratios of reported daily energy intake divided by the estimated basal metabolic rate. They observed that underreporting occurred more with increasing degrees of overweight in men and women. Each increase in body mass index by 1 kg/m2 was associated with a decrease in reported energy intake/basal metabolic rate (in men, beta = -0.0364; standard error, 0.0024; in women, beta = -0.0262; standard error, 0.0018). After adjustment for age, education, smoking habits, physical activity, dieting behavior, and dieting frequency during the last year, the slopes were reduced by 29% in men and 17% in women but remained negative and highly statistically significant. Adjustment for current dieting behavior particularly decreased the association between body mass index and underreporting. Age was another independent determinant of underreporting in men and women and, in men only, so were smoking habits and education level. In conclusion, overweight individuals give biased dietary information, and this may distort the relations between self-reported dietary intake and diseases related to body mass index.

Adult↗

PubMed2001

Evaluation of dietary assessment instruments against doubly labeled water, a biomarker of habitual energy intake.

Epidemiological studies of diet and disease rely on the accurate determination of dietary intake and subsequent estimates of nutrient exposure. Although methodically developed and tested, the instruments most often used to collect self-reported intake data are subject to error. It had been assumed that this error was only random in nature; however, an increasing body of literature suggests that systematic error in the reporting of true dietary intake exists as well. Here, we review studies in which dietary intake by self report was determined while energy expenditure was simultaneously measured using the doubly labeled water (DLW) method. In seeking to establish the relative accuracy of each instrument to capture true habitual energy intake, we conclude that none of the self-reported intake instruments demonstrates greater accuracy against DLW. Instead, it is evident that the physical and psychological characteristics of study participants play a significant role in the underreporting bias observed in these studies. Further research is needed to identify underreporters and to determine how to account for this bias in studies of diet and health.

Body Mass Index↗

PubMed1995

Changes in energy expenditure, anthropometry, and energy intake during the course of pregnancy and lactation in well-nourished Indian women.

Basal metabolic rate (BMR), thermic effect of a meal (TEM), anthropometry, and dietary intakes were measured in 18 control subjects; 18 pregnant women at 12, 24, and 34 wk gestation; and in 17 of these women at 12 and 24 wk postpartum, to uncover any metabolic economy associated with either pregnancy or lactation. Results indicated that the BMR and TEM were not associated with any energy saving either during pregnancy or lactation. Mean weight gain from 12 wk gestation to term was 11.4 +/- 3.7 kg; mean birth weight of the infants was 3.06 +/- 0.41 kg. Estimated gain in adipose tissue and fat mass were 3.1 +/- 3.6 and 2.5 +/- 2.9 kg, respectively. Energy cost of pregnancy was estimated to be 303 +/- 171 MJ. The cumulative increase in energy intake over the last two trimesters of pregnancy was 290 +/- 280 MJ, meeting a large part of the total estimated cost of pregnancy. Weight gained by infants who were exclusively breast-fed from birth to 12 wk of age was used as a proxy indicator of adequate lactational performance. The extra energy required during lactation appeared to have been met largely by increases in energy intake, rather than by any metabolic economy or increase in fat mobilization.

Adult↗

PubMed2002

Severe underreporting of energy intake in normal weight subjects: use of an appropriate standard and relation to restrained eating.

OBJECTIVE: To assess the influence of different standards and restrained eating on underreporting in healthy, non-obese, weight-stable young subjects. DESIGN AND SUBJECTS: Eighty-three young adults (20-38 years, 55 women, 28 men) were assessed under weight-stable conditions with a 7-day dietary record and the three-factor eating questionnaire by Stunkard and Messick. Resting energy expenditure (REE; indirect calorimetry) plus data derived from physical activity records (PA) (Standard 1) or REE times an activity factor (AF) (Standard 2) was used as standard for total energy expenditure (TEE). For comparison, doubly labelled water (DLW) was used to measure TEE in a subgroup of subjects. RESULTS: There was an association between self-reported energy intake and Standard 2 but not with Standard 1. When compared with DLW both calculated standards were inaccurate, but Standard 2 avoided high levels of overreporting. Using Standard 2 to identify 'severe' underreporting (SU; as defined by a deviation of energy intake (EI) and TEE of >20%), SU was seen in 37% of all subjects. It was more frequently found in women than in men (49% of women, 14.3% of men, ). Underreporting subjects had a reduced EI but there were no significant differences in nutritional status (body weight and height, body mass index, fat mass and fat-free mass), energy expenditure and the proportion of energy from macronutrients between normal and underreporting subjects. However, high restraint was associated with a higher degree of underreporting in the total group, whereas disinhibition had an influence only in men. CONCLUSIONS: A high prevalence of SU is seen in non-obese subjects. Characteristics of eating behaviour (restraint and disinhibition) were associated with underreporting but seemed to have a different influence in men and women.

Adult↗

PubMed1997

Energy intakes, anthropometry and body composition of Nigerian adolescent girls: a case study of an institutionalized secondary school in Ibadan.

Twenty-two apparently healthy Nigerian adolescent girls aged 11-17 years residing in a hostel, were studied over five consecutive days in order to assess their energy intake (EI), energy cost of specific activities and body composition (BC). The mean characteristics of the group were: height 1.58 (SD 0.1, range 1.42-1.68) m, body weight 49.1 (SD 7.9, range 34.0-61.0) kg and BMI 19.5 (SD 2.0, range 16.0-23.0) kg/m2. The food intake of each subject was assessed by direct weighing and its energy value was determined by means of a ballistic bomb calorimeter. BMR values were calculated according to Food and Agriculture Organization/World Health Organization/United Nations University (FAO/WHO/UNU) (1985) equations. Percentage body fat (BF%) values were derived from three skinfold thickness measurements, using population-specific equations. The adolescents' mean daily EI was found to be 6510 (SD 855) kJ/d (138.3 (SD 27.8) kJ/kg body weight per d) which is lower than the FAO/WHO/UNU (1985) calculated energy requirement of 8800 kJ/d for adolescent girls aged 12-14 years. The contributions of specific nutrients and individual meals to the total EI were: carbohydrate, protein and fat, 59.2, 12.5 and 28.3% of energy respectively and breakfast, lunch and supper, 21.5, 41.0 and 37.4% respectively. However, the mean BMR was 5627 kJ/d, which is comparable with that given by FAO/WHO/UNU (1985) for adolescent girls aged 13-14 years. The mean BF% was found to be 21.7. The comparatively low EI of the participants in the present study may be indicative of energy deficiency in their meals. This assumption is also reflected in their BC values. Nevertheless, further studies of this kind on adolescents in Nigeria are needed to confirm these observations.

Adolescent↗

PubMed2001

Food presentation and energy intake in a feeding laboratory study of subjects with binge eating disorder.

OBJECTIVE: The purpose of this study was to examine the influence of the number of foods presented and the amount of food presented on overeating or binge eating behavior in obese subjects with and without binge eating disorder (BED). METHOD: Ten subjects (5 BED, 5 non-BED), male and female, aged 18-65, participated. Their body weight was > or =130% of their ideal body weight (IBW). They were evaluated in a feeding laboratory setting on four occasions when they were presented with (a) either one or two binge foods presented in (b) either two or four times the amount of their self-reported usual intake during a binge/overeating episode. Measurement included energy intake and self-recorded measures of hunger, fullness, anxiety, and depression. RESULTS: The results indicated that the number and amount of food presented influenced significantly the amount of food consumed. Although subjects with BED tended to eat more than the non-BED obese, the differences did not reach statistical significance. DISCUSSION: The results have implications for the interpretation of results obtained in feeding laboratory settings, suggesting that attention needs to be given to both the number and amount of foods presented because both variables have an impact on the amount of food eaten during overeating or binge eating episodes.

Adolescent↗

PubMed1985

Effect of reduced energy intake versus increased physical activity on the outcome of nitrogen balance experiments in man.

The effects of energy deficiency created by a reduced energy intake versus an increased physical activity on urinary nitrogen excretion, nitrogen balance and the biological value of the dietary protein (0.57 g/kg/day from a mixed diet) are reported. Two experiments, 21 and 27 days respectively, designed to even out possible effects of time on nitrogen balance, were conducted on 12 young adult men and women. During energy deficiency, urinary nitrogen increased while nitrogen balance and biological value decreased. No significant differences between the two kinds of energy deficiency were found but the effect on the parameters studied tended to be less pronounced the longer the subjects had been on the experimental diets.

Adult↗

PubMed2001

Effects of energy density and sweetness of gruels on Burkinabe infant energy intakes in free living conditions.

In free living conditions, 24 breastfed infants, aged 6 to 10 months, were given successively five experimental gruels to study the effect of energy density (ED) and sweetness (sweet taste) on energy intakes (EI). Four gruels (G0, G1, G9 and G20) were prepared with experimental flours which were composed of the same local ingredients and which contained different levels of sucrose. The fifth gruel (GC) was prepared with an industrial flour. G0 had an average ED of 45 kcal/100 g (189 kJ/100 g) and the other gruels an average ED of 110 kcal/100 g (461 kJ/100 g). Although the sugar contents of the flours were 1% for G1, 9% for G0 and G9 and 20% for G20, because of flour composition and gruel dry matter content, the gruel G1 had the same sweetness as G0, G20 the same sweetness as GC and G9 a sweetness between that of G1 and G20. The results show that the amounts of G0 consumed were significantly higher than those of high ED gruels (7.84 for G0 vs 6.12, 5.63, 4.46, 4.72 g/kg body weight/meal, respectively for G20, G9, G1 and GC, P < 0.05). However, EI from high ED gruels were significantly (P < 0.001) higher than those from G0 (6.65, 6.10, 4.86, 4.83 kcal/kg/meal, respectively for G20, G9, G1 and GC vs 3.46 for G0). Energy intakes from G9 and G20 gruels were not significantly different but were significantly higher than those from GC and G1 (P < 0.001). So, consumption of sweet gruels with high ED and composed of local ingredients increased, at least by 76%, the EI from gruels in comparison with those from low ED gruels, but the amounts consumed by the infants remained too low to cover more than 15% of their daily total energy needs.

Analysis of Variance↗

PubMed2000

Regulation of energy intake may be impaired in nutritionally stunted children from the shantytowns of São Paulo, Brazil.

We tested the hypothesis that nutritionally stunted children have impaired regulation of energy intake (EI), a factor that could help explain the increased risk of obesity associated with stunting in developing countries. A 3-d residency study was conducted in 56 prepubertal boys and girls aged 8-11 y from the shantytowns of Sao Paulo, Brazil. Twenty-seven of the subjects were stunted and 29 were not stunted; weight-for-height Z-scores were not significantly different between the groups. Parents of the two groups had equivalent heights and body mass indices. Measurements were made of voluntary EI from a self-selection menu, resting energy expenditure (REE) and body composition. In addition, a 753-kJ yogurt supplement was administered at breakfast on one study day (with an equal number of children receiving the supplement on each of the 3 study days) and its effect on daily EI assessed. There was no change in EI over time in either group (P: = 0.957), and no significant difference in EI between stunted and nonstunted children, even though the stunted children weighed 10% less. Energy intake per kilogram body weight was significantly higher in the stunted children (278 +/- 89 (SD), vs. 333 +/- 67 kJ/kg, P: < 0.05) and EI/REE was also significantly higher (1.91 +/- 0.34 vs. 1.68 +/- 0.38, P: < 0.05). However, the relationship between EI and body weight was not significantly influenced by stunting (P: = 0.12). There was no significant effect of the breakfast supplement on daily EI in either group although the absolute difference in EI between supplement and control days was greater in stunted than in nonstunted children (DeltaEI: +460 +/- 1574 vs. -103 +/- 1916 kJ/d, P: = 0.25). These data provide preliminary evidence consistent with the suggestion that stunted children tend to overeat opportunistically, but further studies are required to confirm these results in a larger study.

Basal Metabolism↗

PubMed1986

Effects of dietary protein, fat and energy intake during an initiation phase study of 7,12-dimethylbenz[a]anthracene-induced breast cancer in rats.

A factorial experiment was conducted to examine the effects of dietary protein (8, 16, 32% of energy from casein) and dietary fat (12, 24, 48% of energy from corn oil) on the initiation of 7,12-dimethylbenz[a]anthracene (DMBA)-induced breast carcinogenesis in rats. Forty weanling female Sprague-Dawley rats were assigned to each of nine diets fed ad libitum. After 4 wk each rat received DMBA (20 mg/kg) via gastric intubation. For an additional 22 wk after carcinogen administration all rats consumed a diet containing 16% of dietary energy from protein and 24% from fat. Dietary fat, protein and ad libitum energy consumption exhibited statistically significant effects on final tumor prevalence, but interactive effects were not found. At necropsy, rats fed corn oil at 12, 24 and 48% of energy prior to DMBA administration showed tumor prevalences of 58, 58 and 85% with 116, 153 and 231 total tumors, respectively. The data indicate a significant nonlinear effect of dietary fat. Corresponding numbers for rats fed casein at 8, 16 and 32% of energy prior to DMBA were prevalences of 79, 65 and 59%, with total tumor counts of 194, 144 and 162. Higher dietary protein during the initiation phase was associated with a significant reduction in tumor prevalence, which was most striking between 8 and 16% of energy from protein. In addition, results of multiple logistic regression showed that tumorigenesis was increased with greater ad libitum energy intake. The odds of a tumor at necropsy were multiplied by 1.19 for each kilocalorie increase in ad libitum energy intake averaged over the post-DMBA phase of the experiment. An additional six weanling rats fed each diet for 4 wk were killed for assay of hepatic carcinogen metabolizing enzymes at the time corresponding to DMBA administration in the initiation experiment. Both protein and fat showed independent effects on the activity of several enzymes. However, enzyme activity did not suggest a unifying mechanism whereby these nutrients influence DMBA-induced mammary carcinogenesis.

9,10-Dimethyl-1,2-benzanthracene↗

PubMed2000

Does energy intake underreporting involve all kinds of food or only specific food items? Results from the Fleurbaix Laventie Ville Santé (FLVS) study.

OBJECTIVE: To determine if energy intake underreporting concerns all major food groups or if it occurs for specific food groups only. DESIGN: Cross-sectional study on dietary habits and food consumption. SUBJECTS: Five-hundred and four women and 529 men, aged between 25 and 55y participating in the Fleurbaix Laventie Ville Sante study. MEASUREMENTS: A nutritional survey was conducted between March and June 1993 using a 3-day food record. Reported weight and height were used to estimate body mass index and basal metabolic rate. Underreporters were defined as subjects whose ratio of mean energy intake to basal metabolic rate was lower than 1.05. Food consumption was compared between underreporters and non-underreporters. RESULTS: Energy percentage of fat and carbohydrate were lower in underreporters than in non-underreporters in contrast to the energy percentage of protein. This was due to the fact that food items rich in fat and/or carbohydrates (such as butter, French fries, sugars and confectionery, cakes and pastries) were reported to be less frequently eaten and/or in smaller quantities in underreporters compared to non-underreporters. CONCLUSION: Although this study presents some limitations, like the use of reported weight and a standard value for physical activity, it shows that reported foods differed, quantitatively and qualitatively, between severe underreporters and non-underreporters. Underreporting of food intake does not result from a systematical underestimation of portion sizes for all food items, but seems to concern specific food items which are generally considered 'bad for health'.

Adult↗