Validity of dietary assessment methods compared with doubly labeled water in children: A systematic review and meta-analysis

Obes Rev. 2024 Sep;25(9):e13768. doi: 10.1111/obr.13768. Epub 2024 May 24.

Abstract

Objectives: We aimed to validate dietary assessment methods against the gold standard, doubly labeled water (DLW), for estimating total energy intake (TEI).

Methods: PubMed, Scopus, Web of Science, and Google Scholar databases were searched until May 2023. Inclusion criteria encompassed studies involving participants aged 1-18 years, employing dietary assessment methods like food records, dietary histories, food frequency questionnaire (FFQ), or 24-h recalls estimating TEI alongside DLW to measure total energy expenditure (TEE). Data were pooled using random-effects meta-analysis models.

Results: Thirty-three studies were identified, with sample sizes ranging from 9 to 118 participants. Meta-analysis of 22 studies identified underestimation of TEI (mean difference [MD] = -262.9 kcal/day [95% CI: -380.0, -145.8]; I2 = 93.55%) for food records compared with TEE estimated by DLW. Other dietary assessment methods, including food recalls (n = 9) (MD = 54.2 kcal/day [95% CI: -19.8, 128.1]; I2 = 49.62%), FFQ (n = 7) (MD = 44.5 kcal/day [95% CI: -317.8, 406.8]; I2 = 94.94%), and diet history (n = 3) (MD = -130.8 kcal/day [95% CI: -455.8, 194.1]; I2 = 77.48%), showed no significant differences in TEI compared with DLW-estimated TEE. All studies were of high quality.

Conclusion: Food records may underestimate TEI, yet additional research is needed to identify the most accurate methods for assessing children's dietary intake.

Keywords: Diet history; doubly labeled water; energy intake; food frequency questionnaires; food recalls; food record; total energy expenditure.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Systematic Review
  • Validation Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Diet
  • Diet Records
  • Diet Surveys / standards
  • Energy Intake*
  • Energy Metabolism / physiology
  • Humans
  • Infant
  • Nutrition Assessment*
  • Oxygen Isotopes / analysis
  • Reproducibility of Results
  • Water

Substances

  • Oxygen Isotopes
  • Water