Body Composition Indicators Are Positively Associated With Underreporting Of Energy Intake In European Adolescents: Results From The HELENA Study

Silvia BEL-SERRAT, International Agency for Research on Cancer, France

1 Dietary Exposure Assessment (DEX) group, International Agency for Research on Cancer, Lyon, France
2 Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
3 Facultad de Ciencias de la Actividad Física y del Deporte, Universidad Politécnica de Madrid, Madrid, Spain
4 Department of Public Health, Ghent University, Ghent, Belgium

Purpose: Misreporting of food intake, including underreporting, is a major concern when addressing diet-disease associations and remains a key limitation of self-reported dietary intake. Although information is still scarce among adolescents, existing literature suggests a positive association between underreporting and body mass index (BMI); however, there is no evidence about the association with body composition indicators. Therefore, we aimed to investigate the association between underreporting and body mass compartments in European adolescents.
Methods: Two self-administered computerized 24-hour dietary recalls were obtained from 1,493 adolescents aged 12.5-17.5 across eight European countries (Austria, Belgium, France, Germany, Greece, Italy, Spain and Sweden). Objective measures of height, weight, waist circumference and tricipital and subscapular skinfold thicknesses were obtained. The percentage of fat mass (%FM) and total FM (kg) and fat free mass (FFM, kg) were calculated by applying skinfold-thickness equations from Slaughter et al. Bioelectrical impedance was used to obtain indices of FM and FFM. Adapted Goldberg cut-offs were applied to identify underreporters using individual objective measures of physical activity. Associations between underreporting and body composition indicators were investigated by multilevel logistic regression analyses after adjustment for confounders.
Results: The risk of underreporting significantly increased with predicted %FM (OR=1.07, 95%CI=1.03-1.11) and with predicted total FM (kg) (OR=1.13, 95%CI=1.08-1.18) and FFM (kg) (OR=1.12, 95%CI=1.08-1.18). Identical results were observed for FM (kg) and FFM (kg) measured with bioelectrical impedance. Waist circumference was positively associated with underreporting (OR=1.12, 95%CI=1.07-1.17).
Conclusions: Underreporting seems to be influenced by adolescents’ abdominal fat and total body mass, regardless of the compartment evaluated, i.e. FM or FFM. However, adolescents reporting low energy intake may reflect attempts to lose weight corresponding to real undereating rather than underreporting. Identification of factors influencing underreporting in young populations is crucial to interpret potentially biased findings.
Funding sources: European Community Sixth RTD Framework Programme (FOODCT-2005-007034).