Abstract
Little is known about the validity of repeated 24-h dietary recalls (24-HDR) as a measure of total energy intake (EI) in young children. This study aimed to evaluate the validity of proxy-reported EI by comparison with total energy expenditure (TEE) measured by the doubly labeled water (DLW) technique. The agreement between EI and TEE was investigated in 36 (47.2% boys) children aged 4-10 years from Belgium and Spain using subgroup analyses and Bland-Altman plots. Low-energy-reporters (LER), adequate-energy-reporters (AER) and high-energy-reporters (HER) were defined from the ratio of EI over TEE by application of age- and sex-specific cut-off values. There was good agreement between means of EI (1500kcal/day) and TEE (1523kcal/day) at group level though in single children, i.e. at the individual level, large differences were observed. Almost perfect agreement between EI and TEE was observed in thin/normal weight children (EI: 1511kcal/day; TEE: 1513kcal/day). Even in overweight/obese children the mean difference between EI and TEE was only-86kcal/day. Among the participants, 28 (78%) were classified as AER, five (14%) as HER and three (8%) as LER. Two proxy-reported 24-HDRs were found to be a valid instrument to assess EI on group level but not on the individual level.
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