Abstract

BackgroundNational surveys have demonstrated a long-term decrease in mean energy intake in Japan, despite the absence of a decrease in the prevalence of overweight and obesity. We aimed to examine whether total energy intake of survey respondents is associated with completion of an in-person review of dietary records and whether it affects the trend in mean energy intake.MethodsWe pooled data from individuals aged 20–89 years from the National Nutrition Surveys of 1997–2002 and the National Health and Nutrition Surveys of 2003–2011. We conducted a linear mixed-effects regression to estimate the association between total energy intake and the lack of an in-person review of semi-weighed household dietary records with interviewers. As some respondents did not have their dietary data confirmed, we used regression coefficients to correct their total energy intake.ResultsCompared with respondents completing an in-person review, total energy intake was significantly inversely associated with respondents not completing a review across all sex and age groups (P < 0.001). After correction of total energy intake for those not completing a review, mean energy intake in each survey year significantly increased by 2.1%–3.9% in men and 1.3%–2.6% in women (P < 0.001), but the decreasing trend in mean energy intake was sustained.ConclusionsTotal energy intake may be underestimated without an in-person review of dietary records. Further efforts to facilitate completion of a review may improve accuracy of these data. However, the increasing proportion of respondents missing an in-person review had little impact on the decreasing mean caloric intake.

Highlights

  • The prevalence of overweight and obesity has been growing worldwide for the past 30 years,[1] making trends in mean energy intake of significant public health interest

  • This is the first study to investigate the association of total energy intake with the lack of an in-person review of semi-weighed household dietary records in the National Health and Nutrition Survey (NHNS)

  • Our results demonstrated that total energy intake of respondents who did not participate in a physical examination was significantly lower compared with respondents who did

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Summary

Introduction

The prevalence of overweight and obesity has been growing worldwide for the past 30 years,[1] making trends in mean energy intake of significant public health interest. In Japan, the prevalence of overweight and obesity in the population aged 20 years and older has increased among men from 18% in 1980 to 30% in 2010, while it has been stable at approximately 20% among women.[3] The diet and nutritional status of the population of Japan has been monitored since 1947 through annual cross-sectional household surveys using nationally representative samples. These surveys have shown that the national average caloric intake increased after the end of the World War II, but started to gradually decrease in the early 1970s. The increasing proportion of respondents missing an in-person review had little impact on the decreasing mean caloric intake

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