Abstract
Dietary under-reporting is a common problem when using self-reported dietary assessment tools. However, there are few studies regarding under-reporting during pregnancy. This study aimed to explore the demographic and psychosocial characteristics related to dietary under-reporting in pregnant Japanese women. A cross-sectional study was conducted between 2010 and 2011 at a university hospital in Tokyo, Japan. Nutrient intake was assessed using a self-administered Diet History Questionnaire (DHQ), which had questions about the consumption frequency and portion size of selected food items. The 24-h urinary excretion levels of urea N and K were used as the dietary protein and K intake reference values, respectively. Under-reporting of protein and K was defined as the bottom 25% of the reporting accuracy (the ratio of reported intake on the DHQ to the estimated intake based on urinary excretion). Under-reporters were defined as participants who under-reported both protein and K intake. Multiple logistic regression analysis was performed to examine the factors associated with under-reporters. Of 271 healthy women at 19-23 weeks of gestation, thirty-five participants (12·9%) were identified as under-reporters. Under-reporters had a lower pre-pregnancy BMI (adjusted OR (AOR)=0·81) and lower gestational weight gain (AOR=0·82); they also reported managing their gestational weight gain with the aim to return to their pre-pregnancy weight soon after childbirth (AOR=2·99). Healthcare professionals should consider the potential for dietary under-reporting and the possible related factors when assessing the dietary intakes of pregnant Japanese women using self-administered questionnaires.
Highlights
Dietary under-reporting is a common problem when using self-reported dietary assessment tools
Dietary under-reporting may lead to incorrect assessment and instructions by healthcare professionals
The objective of the present study was to examine the factors related to dietary under-reporting in the Diet History Questionnaire (DHQ) among pregnant Japanese women, using 24-h urine markers
Summary
Dietary under-reporting is a common problem when using self-reported dietary assessment tools. Previous studies on pregnant women showed that high BMI and low education levels were associated with dietary under-reporting[4,5,6]; a detailed examination including behavioural and psychological factors has not been conducted in this population. These related factors vary depending on the target population or country; some factors related to under-reporting in pregnant women may not exist in non-pregnant populations. Identifying the factors related to underreporting during pregnancy is important in yielding reliable data for dietary research because non-random dietary underreporting could distort diet–disease associations
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