Misreporting of energy intake in a new web-based food record for children and adolescents

Background: Misreporting of energy intake is well known from traditional dietary assessment methods, and assessment among the youngest is especially challenging. Web-based tools are increasingly popular. However, little is known whether these web-tools improve the recording accuracy.

Objective: To assess the accuracy of children and adolescent’s energy intake estimated from the first Norwegian web-based dietary assessment tool for children and adolescents, the Web-based Food Record (WebFR). This was done by comparing energy expenditure (TEE) calculated from accelerometer counts to energy intake (EI). Established Goldberg cut-offs for EI:BMR using measured individual physical activity levels, were also applied for comparison.

Design: In total 253 Norwegian children (8-14 years), were instructed to complete four consecutive days of registration in the WebFR and to wear a validated accelerometer (Actigraph GT3X+) for seven days the same week.

Statistics: Acceptable-reporters were defined as children within the 95% confidence limits of EI/TEE agreement. Results: A total of 33% were acceptable-reporters (AR), 11% over-reporters (OR) and 56% under-reporters (UR). Mean EI/TEE was 0.81, and mean EI-TEE was -397kcal/day (SD 538). Under-reporting was positively associated with age, overweight/obesity, low parental education level, non-Norwegian parents/guardians, and living in a household without both biological parents. When applying the Goldberg cut-offs, 74%, 0% and 26% were AR, OR and UR, respectively. However, subjects characteristics associated with UR were similar for both methods.

Conclusion: Even though under-reporting of energy is a concern in this study, we argue that the WebFR is a promising tool for dietary assessment in the younger age groups.