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How much energy does the breast fed infant consume and expend?

Energy intake in breast fed infants is uncertain. The doubly labelled water method was used to measure, simultaneously and non-invasively, energy expenditure, energy intake, milk volume intake, energy deposition, and the energy content of breast milk in 12 "free living" breast fed babies at 5 and 11 weeks of age. The validity of this new approach was assessed in a parallel study in 12 formula fed infants. The babies who were exclusively breast fed expended 1.28 and 1.68 MJ/day at five and 11 weeks and had intakes of 1.81 and 2.22 MJ/day; these intakes were associated with normal growth but were well below those recommended previously. At five and 11 weeks the calculated energy content of breast milk was 0.24 and 0.25 MJ/100 ml, which is substantially lower than that commonly reported in milk obtained unphysiologically by expression of the breast. These data cast doubt on the widely used published standards for infant feeding.

Breast Feeding↗

Nutrient intake in Jerusalem--consumption in 17-year-olds.

The food intake of 17-yr-old Jerusalem residents was assessed in a random sample, including 627 males and 551 females, by a 24-h dietary recall method. The intake of energy in boys and girls was lower than the recommended energy intake for this age, but the intake relative to body weight was low only in girls. In boys and girls, the intakes of fat relative to energy were 32.4 and 33.7%, respectively; those of saturated fatty acids (SFA) (9.8 and 10.5%) were lower and those of carbohydrates (53.9 and 52.5%) were higher than intakes found in other Western countries. The P:S (polyunsaturated to saturated fatty acids) ratio of their diets was high and ranged from 0.79 to 1.29 in various sex and origin groups. Intake of cholesterol per 1,000 kcal was similar to that in Western countries. There were marked differences in nutrient intake of subjects whose fathers had immigrated from different countries. Boys whose fathers were born in Israel or Europe had higher intakes of fat and cholesterol, and both boys and girls had a higher intake of SFA and a lower intake of carbohydrates and starch as well as a lower P:S ratio than did their counterparts whose fathers were born in Asia and North Africa. Thus, the nutrient intake of youngsters in Jerusalem differs markedly from that of populations in other Western countries.

Adolescent↗

Comparison of women's diet assessed by FFQs and 24-hour recalls with and without underreporters: associations with biomarkers.

BACKGROUND/AIMS: Women's diet can be especially difficult to assess, as women tend to underreport their intakes more often than men and are more likely to do so if they think they are overweight or obese. The aim was to compare two methods to assess women's diet and how well they associate with biomarkers. The influence and frequency of underreporting was also investigated. METHODS: Diet of 53 women was assessed by two 24-hour recalls and a food frequency questionnaire (FFQ). Blood was analyzed for retinol, beta-carotene, vitamin C and serum ferritin, and 24-hour urine for nitrogen, potassium and sodium. Underreporting was evaluated with nitrogen excretion vs. intake, and energy intake vs. basal metabolic rate. RESULTS: Energy percent (E%) from macronutrients was similar from FFQ and 24-hour recalls, but total intake was higher from 24-hour recalls (9,516 +/- 2,080 vs. 8,183 +/- 2,893 kJ, p < 0.01). Intakes of vitamin C and potassium from both methods correlated with their respective biomarkers (r = 0.316-0.393). Underreporters had higher body mass index (BMI) than others (27.7 +/- 5.5 vs. 23.8 +/- 3.7 kg/m2, p < 0.05). They reported lower E% total fat (32 +/- 5 vs. 38 +/- 6 E%, p < 0.01) and higher E% carbohydrate (49 +/- 4 vs. 45 +/- 7 E%, p < 0.05). Correlation between intake and biomarkers increased after exclusion of underreporters. CONCLUSION: For women, FFQ and 24-hour recalls give similar E% and most nutrients correlate, but FFQ gives lower intake. Underreporters have higher BMI and diminish the correlation between calculated intake and biomarkers. This has to be considered when intake data are associated with weight management, disease and lifestyle factors.

Adult↗

Beneficial metabolic effects of regular meal frequency on dietary thermogenesis, insulin sensitivity, and fasting lipid profiles in healthy obese women.

BACKGROUND: Although a regular meal pattern is recommended for obese people, its effects on energy metabolism have not been examined. OBJECTIVE: We investigated whether a regular meal frequency affects energy intake (EI), energy expenditure, or circulating insulin, glucose, and lipid concentrations in healthy obese women. DESIGN: Ten women [x +/- SD body mass index (in kg/m(2)): 37.1 +/- 4.8] participated in a randomized crossover trial. In phase 1 (14 d), the subjects consumed their normal diet on 6 occasions/d (regular meal pattern) or followed a variable meal frequency (3-9 meals/d, irregular meal pattern). In phase 2 (14 d), the subjects followed the alternative pattern. At the start and end of each phase, a test meal was fed, and blood glucose, lipid, and insulin concentrations were determined before and for 3 h after (glucose and insulin only) the test meal. Subjects recorded their food intake on 3 d during each phase. The thermogenic response to the test meal was ascertained by indirect calorimetry. RESULTS: Regular eating was associated with lower EI (P < 0.01), greater postprandial thermogenesis (P < 0.01), and lower fasting total (4.16 compared with 4.30 mmol/L; P < 0.01) and LDL (2.46 compared with 2.60 mmol/L; P < 0.02) cholesterol. Fasting glucose and insulin values were not affected by meal pattern, but peak insulin concentrations and area under the curve of insulin responses to the test meal were lower after the regular than after the irregular meal pattern (P < 0.01 and 0.02, respectively). CONCLUSION: Regular eating has beneficial effects on fasting lipid and postprandial insulin profiles and thermogenesis.

Adult↗

Appendicular skeletal muscle mass, physical activity, and cognitive status in patients with Alzheimer's disease.

OBJECTIVE: To examine the interrelations among appendicular skeletal muscle mass and physical activity, energy intake, and cognitive status in free-living patients with AD. BACKGROUND: Increasing disease severity in AD patients may contribute to poor nutritional status and loss of skeletal muscle mass. This may lead to impaired physical function and loss of functional independence. METHODS: Participants in our study were 30 noninstitutionalized AD patients (74 +/- 8 years) and 30 healthy age- and body mass index-matched control subjects (73 +/- 7 years). We measured appendicular skeletal muscle mass by dual-energy X-ray absorptiometry, energy expenditure by doubly labeled water, and energy intake by food diaries. RESULTS: As expected, the AD group had lower Mini-Mental State Examination scores than the control subjects (p < 0.05). No differences in energy intake or energy expenditure and its components were noted between the groups. Higher levels of appendicular muscle mass in AD patients were associated with increased energy expenditure of physical activity (r = 0.52, p < 0.01) and daily energy intake (r = 0.49, p = 0.01). Cognitive status was not related to appendicular muscle mass, daily energy intake, or energy expenditure of physical activity in AD patients. CONCLUSIONS: Higher levels of physical activity and energy intake are associated with higher appendicular skeletal muscle mass in AD patients. Nutritional and physical activity interventions may represent practical and inexpensive strategies in their therapeutic management.

Adipose Tissue↗

PPARgamma, energy balance, and associations with colon and rectal cancer.

Peroxisome proliferator-activated receptor-gamma (PPARgamma) has been hypothesized as being involved in colorectal cancer given its role in adipocyte development and insulin resistance. In this study we evaluated the association between the Pro12Ala (P12A) PPARgamma polymorphism and body mass index (BMI), waist-to-hip ratio (WHR), physical activity level, and energy intake and risk of colorectal cancer using data from a population-based, case-control study of colon cancer (1,577 cases and 1,971 controls) and rectal cancer (794 cases and 1,001 controls). We further evaluated how the P12A PPARgamma polymorphism is associated with obesity and fat pattern in the control population. The odd ratio for PPARgamma PA or AA genotype relative to the PP genotype for colon cancer was 0.9 (95% confidence interval, CI=0.8-1.0) and for rectal cancer was 1.2 (95% CI=1.0-1.5) adjusting for race, age, and sex. P12A PPARgamma did not significantly interact with BMI, WHR, energy intake, and energy expenditure to alter risk of colon or rectal cancer. Furthermore, the P12A PPARgamma polymorphism was not associated with obesity or WHR in the control population; it did not interact with energy intake or energy expenditure to alter risk of obesity or large WHR. These data do not support the hypothesis that the P12A PPARgamma polymorphism is associated with colon or rectal cancer through regulation of energy balance.

Aged↗

Effects of pre- and postfresh transition diets varying in dietary energy density on metabolic status of periparturient dairy cows.

Effects of dietary energy density during late gestation and early lactation on metabolic status of periparturient cows were studied. Four weeks before expected calving, animals were fed a low (DL; 1.58 Mcal of NEL/kg) or high energy density diet (DH; 1.70 Mcal of NEL/kg). After calving, half of the cows from each prepartum treatment were assigned to a low (L; 1.57 Mcal of NEL/kg) or high energy density diet (H; 1.63 Mcal of NEL/kg) until d 20 postpartum. After d 20, all animals were fed H until d 70. Animals fed DH had a more positive energy balance during the prepartum period. Animals fed DH had higher plasma concentrations of glucose and insulin and lower concentrations of plasma nonesterified fatty acid (NEFA) on d -7 relative to calving compared with animals fed DL. No differences in blood concentrations of metabolites, insulin and liver triglycerides (TG) content were observed on d 1. Liver TG content at d 1 and 21 were more related to magnitude of change in energy intake prepartum than to energy intake in the last week of gestation. Cows fed H had higher concentrations of plasma glucose and insulin, but similar plasma NEFA during the postpartum period compared with cows fed L. Plasma concentrations of beta-hydroxybutyrate (BHBA) and liver TG content on d 21 were 46 and 30% lower, respectively, for cows fed H compared with cows fed L. Interactions between prepartum and postpartum treatments indicated that negative effects of delaying higher concentrate feeding until d 21 postpartum can be partially offset by increasing concentrate in the diet before calving. Cows fed L had a higher increase in white line hemorrhage scores between prepartum and 10 wk postpartum compared with cows fed H. Energy density of prepartum diets had a minor influence on metabolic status of cows postpartum. A more favorable metabolic profile occurs when increasing the concentrate content of the diet immediately postpartum compared with delaying the increase until d 21 postpartum.

3-Hydroxybutyric Acid↗

Food substitution with worker feeding programs: energy supplementation in guatemalan sugarcane workers.

An energy supplementation program provided free of charge a low energy (15 kcal) and a high energy (350 kcal) soft drink to two group of sugarcane workers in Guatemala. The high energy supplement supplied 550 kcal/day on a weekly basis. The workers tended to be moderately energy deficient before supplementation. Significant increases in total daily energy intake were obtained with the high energy supplement, but by less than the energy content of the supplement. Workers maintained energy balance with supplementation. The degree of substitution with energy supplementation was not related to the energy intake status of the workers' households. These households did generally not improve their energy intake status with worker supplementation.

Adolescent↗

Plasma catecholamines and autonomic responsiveness in obesity.

The autonomic responsiveness of lean women to standing, passsive vertical tilting, noradrenaline infusion and the valsalva manoeuvre has been compared with that of obese women and a group of formerly obese women (post-obese). Upon standing, the lean and obese groups had comparable cardiovascular responses with similar rises in plasma noradrenaline. With passive 85 degrees head-up tilting at an ambient temperature of 26 degrees C the obese and post-obese subjects had a greater rise in plasma noradrenaline than the lean group who were less able to withstand the test. Noradrenaline infusions (at 26 degrees C) in the lean and post-obese subjects led to similar increases in plasma noradrenaline, systolic and diastolic pressures and plasma free fatty acids but the post-obese showed a greater bradycardia. The response to the valsalva manoeuvre was normal in lean and obese patients and was unaltered after a reduced energy intake in the obese. On energy restriction for two weeks 10 obese subjects showed a fall in pulse rate, in systolic and diastolic pressures and in plasma noradrenaline while the subjects remained supine. On standing there was less of a rise in plasma noradrenaline than when energy intake was high. The response in noradrenaline was restored to that seen on high energy intakes by giving L-dopa. Seasonal changes in venous noradrenaline concentrations were apparent in obese and post-obese patients but not in lean subjects. These differences may relate to altered responses to environmental temperature or to an altered food intake in the two obese groups. There appears to be no generalised in the autonomic system in obese women either before or after weight loss but the process of slimming does lead to a reduction in plasma noradrenaline levels.

Autonomic Nervous System↗

The effect of dietary modification and hyperglycaemia on gastric emptying and gastric inhibitory polypeptide (GIP) secretion.

1. Five healthy volunteers whose usual fat and energy intakes were moderately high (fat intake 155 (SE 11) g/d; energy intake 13683 (SE 909) kJ/d) were given on two separate occasions (a) 96 g fat and (b) 96 g fat and intravenous (IV) glucose (250 g glucose/l; 100 ml followed by a 2 ml/min infusion for 180 min). 2. Subjects continued on a low-fat diet for 35 d (fat intake 25 (SE 4) g/d; energy intake 6976 (SE 539) kJ/d) and the tests repeated. 3. The gastric inhibitory polypeptide (GIP) response to oral fat was significantly attenuated by IV glucose whilst subjects were consuming their normal diets and the GIP response to fat alone was significantly diminished during the low-fat diet. Post-prandial plasma triglycerides, light scattering indices (LSI; an index of post-prandial chylomicronaemia) and paracetamol levels paralleled the integrated GIP responses on both normal and low-fat diets. 4. The study of oral fat with or without glucose was repeated on seven further volunteers consuming their usual diet, substituting 10 MBq 99Tcm-labelled tin colloid for the paracetamol to investigate the rate of gastric emptying by radionuclide imaging. 5. Plasma GIP, insulin, triglyceride and LSI levels were similar to those found in the first study. IV glucose almost doubled the gastric emptying time of the oral fat load (half emptying time (t1/2) 148 (SE 11) min after fat alone and 224 (SE 18) min after fat and IV glucose). Post-prandial plasma motilin levels were significantly depressed by IV glucose.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Preschoolers' mid-afternoon snack intake is not affected by lunchtime food consumption.

The purpose of this study was two-fold: to determine the contribution of mid-afternoon snack intake to total daily energy intake and to examine the effect of lunchtime eating on subsequent snack intake in preschool children. Lunch energy intake was manipulated by varying the energy content of the milk beverage served at lunch. Mid-afternoon snack consumption in 135 children, aged 18-66 months, offered chocolate-flavored or plain milk at lunch. Nutritious mid-morning snacks, lunches and mid-afternoon snacks were served on a rotating schedule 2 days per week for 12 weeks. The children were allowed to consume as much as they wanted of any food items served at lunch or snacktime, including the beverages. Although the children consumed significantly more energy during lunchtime meals at which sucrose-sweetened chocolate milk was served, their intake of the mid-afternoon snack was not affected by the type of milk beverage served or the energy consumed at lunch. All children consumed between 20 and 25% of their daily energy requirement at lunch and between 8 and 22% of their daily energy requirement during the mid-afternoon snack. Snacks are an important source of energy for young children, especially those under three years of age.

Appetite↗

Parents' and children's adiposity and eating style.

OBJECTIVE: To investigate children's ability to self-regulate energy intake and to determine whether individual differences in the precision of food intake regulation are related to children's anthropometric measures. We collected information pertaining to parental adiposity and dieting practices, as well as mothers' child-feeding practices. Of special interest was the degree of control imposed by mothers over their children's food intake. Our intent was to explore whether these variables might influence children's regulation of energy intake. SUBJECTS AND SETTING: Seventy-seven 3-5-year-old children who attended a university preschool setting and their parents participated in this experiment. MEASUREMENTS AND MAIN RESULTS: Children completed controlled, two-part meals used to estimate their ability to adjust food intake in response to changes in caloric density of the diet. An eating index, reflecting children's precision in the ability to regulate energy intake, was correlated to children's anthropometric measures. These correlations provided evidence for a relation between children's body fat stores and their responsiveness to caloric density cues: Pearson correlation coefficients revealed that children with greater body fat stores were less able to regulate energy intake accurately. The best predictor of children's ability to regulate energy intake was parental control in the feeding situation: mothers who were more controlling of their children's food intake had children who showed less ability to self-regulate energy intake (r = -.67, P < .0001). CONCLUSIONS: These findings suggest that the optimal environment for children's development of self-control of energy intake is that in which parents provide healthy food choices but allow children to assume control of how much they consume.

Body Weight↗

Monitoring energy balance: metabolites of fatty acid synthesis as hypothalamic sensors.

Because energy balance is important for survival, a system is required to monitor energy status and to make appropriate adjustments in energy intake and energy expenditure. In higher animals, a centrally located system has evolved to accomplish this task. When caloric intake exceeds expenditure, the surplus is channeled into energy storage pathways, primarily the synthesis of fatty acids, which are converted into fat and stored in adipose tissue. Thus, metabolic flux through the pathway of fatty acid synthesis, located in the lipogenic tissues, reflects the "energy status" of the animal. The enzymatic machinery of this pathway is also expressed in the brain, notably the hypothalamus. In the hypothalamus, intermediates in this pathway appear to serve as energy sensors that signal higher brain centers to produce appropriate responses, e.g., altered food intake and energy expenditure.

Acyl Coenzyme A↗

Energy and macronutrient metabolism.

In general, obesity is a state of high energy stores, high energy intake, and high energy expenditure. The high energy expenditure is largely due to the increased fat-free mass. The failure to find a positive relationship between reported energy intake and body size reflects a greater under-reporting of calorie intake among obese individuals. Obesity, therefore, develops as a consequence of a chronic imbalance between intake and expenditure, although the cause of this is not apparent from the energy balance equation. However, this equation can be dissected into its component nutrient balance equations because net de novo lipogenesis is negligible in free-living humans. Fat calories are handled very differently from non-fat calories. Non-fat nutrient oxidation rates rise and fall to match the fluctuations in non-fat intake so that non-fat calorie balance is actively maintained. In contrast, changes in fat intake do not acutely affect fat oxidation but are matched by changes in storage. Therefore, within the fat balance equation there is ample scope for a chronic imbalance between fat intake and oxidation. Also, there is some evidence that carbohydrate balance may be an important signal for hunger and satiety. These concepts imply that, under free-living, ad libitum eating conditions, changes in nutrient intake composition (e.g. an increased proportion of fat in the diet) or changes in nutrient oxidation composition (e.g. a decrease in the proportion of fat oxidized) will lead to body weight change (in these cases, to weight gain). Considering obesity as a consequence of normal physiology (with its normal variation between individuals) in a 'pathological' environment (high fat diet, low exercise) offers an important perspective for explaining the interpopulation and interindividual differences in obesity and for formulating treatment and prevention options. Low energy expenditure (relative to body size), high respiratory quotient and insulin sensitivity have been shown to be predictors of weight gain, although upon gaining weight these metabolic factors tend to 'normalize'. Metabolic responses to underfeeding or overfeeding are largely predictable from the changes in calorie intake and changes in body composition, but some adaptive changes may occur.

Body Weight↗

Comparison of high-calorie, low-nutrient-dense food consumption among obese and non-obese adolescents.

OBJECTIVE: The purpose of this study was to determine whether obese adolescents eat more high-calorie low-nutrient-dense foods than non-obese adolescents. RESEARCH METHODS AND PROCEDURES: Using a cross-sectional design, 22 non-obese and 21 obese adolescents kept 14-day food records. Records provided estimates of total daily energy intake and caloric intake from five categories of high-calorie, low-nutrient-dense (HC) foods: candy, chips, soda, baked goods, and ice cream. Body composition was determined by 18O dilution and daily energy expenditure by doubly labeled water. Percentage of energy intake reported (%report) was calculated as the ratio of reported energy intake to measured energy expenditure (x 100%). RESULTS: Both groups underreported energy intake, but the percentage reported was significantly greater in the non-obese group (78.2+/-20.5% non-obese vs. 55.5+/-21.8% obese, p<0.001). Consumption of calories from chips and soda was similar among non-obese and obese adolescents. However, total energy intake from all HC foods was higher in the non-obese group than among the obese (617+/-356 kcal/day vs. 362+/-223 kcal/day; p<0.01) and represented 27.2+/-10.5% and 19.9+/-9.6% of reported energy intake in the non-obese and obese groups, respectively. After adjustment for under-reporting, the percentage of calories provided by each of the HC foods was similar in the obese and non-obese groups except for ice cream, which remained significantly greater in the non-obese group (p<0.05). DISCUSSION: Our findings suggest that both non-obese and obese adolescents consume a substantial portion of reported calories from HC foods and that obese adolescents do not consume more calories from these foods than non-obese adolescents. These data offer no evidence to support the widespread notion that obese adolescents eat more "junk food" than non-obese adolescents. Health professionals who treat obese adolescents must be aware that the excess calories in their diets may come from a variety of food sources and not solely from high-calorie snack foods.

Adipose Tissue↗

Meal energy content is related to features of meal-related ghrelin profiles across a typical day of eating in non-obese premenopausal women.

UNLABELLED: Some features of the meal-related profile of ghrelin correspond to acute energy intake, suggesting a role in short-term energy homeostasis. Yet, no studies have examined this relationship across a typical day of eating when effects of time of day and or cumulative energy intake may also exist. AIM OF STUDY: To examine the relation between ghrelin and acute energy intake by quantifying changes in ghrelin over 24 hours in response to three typical meals and a snack occurring throughout the day. METHODS: Fourteen non-obese women consumed three meals and a snack at specific times; total ghrelin was measured repeatedly over 24 hours. RESULTS: Significant correlations existed between: 1) meal calories and the post-meal trough (r = - 0.36; p < 0.05), and 2) the sum of breakfast and lunch calories and subsequent dinner rise (r = - 0.45; p < 0.02) and 3) the sum of breakfast and lunch calories and dinner peak (r = - 0.54; p < 0.003). Thus, as energy intake increased across the day, pre-meal rises of subsequent meals were reduced. CONCLUSION: Meal-related profiles of ghrelin are not only associated with the energy content of specific meals, but also with the accumulated calories prior to a subsequent meal, suggesting a role in the modulation of acute energy homeostasis.

Adult↗

Serum leptin and insulin levels in lactating protein-restricted rats: implications for energy balance.

The present study analysed the effect of protein restriction on serum insulin and leptin levels and their relationship with energy balance during lactation. Four groups of rats received isocaloric diets containing 170 g protein/kg or 60 g protein/kg from pregnancy until the 14th day of lactation: control non-lactating, control lactating (both fed a control diet), low-protein non-lactating and low-protein lactating. Energy intake, body composition, energy balance, serum insulin and leptin concentrations and the relationship between these hormones and several factors related to obesity were analysed. Low-protein-intake lactating rats exhibited hypoinsulinaemia, hyperleptinaemia, hypophagia and decreased energy expenditure compared with control lactating rats. The protein level in the carcasses was lower in the low-protein lactating group than in the control lactating group, resulting in a higher fat content in the first group compared with the latter. Body fat correlated inversely with serum insulin and positively with serum leptin level. There was a significant negative correlation between serum leptin and energy intake, and a positive relationship between energy intake and serum insulin level in lactating rats and in the combined data from both groups. Energy expenditure was correlated positively with serum insulin and negatively with serum leptin in lactating rats and when data from control non-lactating and lactating rats were pooled. Lactating rats submitted to protein restriction, compared with lactating control rats, showed that maternal reserves were preserved owing to less severe negative energy balance. This metabolic adaptation was obtained, at least in part, by hypoinsulinaemia that resulted in increased insulin sensitivity favouring enhanced fat deposition, hyperleptinaemia and hypophagia.

Animal Nutritional Physiological Phenomena↗

Estimated energy balance in female university students: differences with respect to body mass index and concern about body weight.

OBJECTIVE: To assess the relationships between concern over bodyweight, anthropometric parameters (both real and ideal) and estimated energy balance. DESIGN: Prospective study. SUBJECTS: 126 young, female university students from Madrid, Spain, between the ages of 19 and 36. MEASUREMENTS: Energy intake was measured by means of a "seven day food record'. Anthropometric data were collected both at the beginning of the study and at 30 d to determine any change in weight. Subjects were grouped with respect to body mass index (BMI) (BMI < 30th percentile, between 30th and 60th percentiles and > or = 60th percentile). Subjects also completed a questionnaire asking if they would like to lose some weight. RESULTS: The concern of these young women about their body image was greater amongst those with higher BMI. However, 31.6% of subjects with BMI falling < 30th percentile (< 20.1 Kg/m2) wished to lose some weight. Though the mean discrepancy between energy intake and estimated energy expenditure was 5.7%, there were great differences with respect to BMI and concern expressed about bodyweight. The declared energy intake was 9.3% greater than estimated energy expenditure in very thin subjects (BMI < 30th percentile) who expressed no desire to lose weight. However, in subjects with BMI between the 30th and 60th percentiles and who wanted to lose weight, declared energy intake was 11.4% below estimated expenditure. Similarly in subjects with BMI > or = 60th percentile, declared energy intake was 15.7% below estimated expenditure. CONCLUSION: In order to gain more exact knowledge of food intake in dietary studies, factors such as subject BMI and desire for a different bodyweight should be taken into account.

Adult↗