Lecture 18: Dietary Assessment Challenges Flashcards
What is low energy reporting?
When people report very low energy intakes
- May be under-reporting or under-eating
What is under-reporting?
Deliberate or unintentional omission or underestimation of foods
What is under-eating?
Process of diet reporting can make people change their eating habits
What are mean adult energy intakes (Adult Nutrition Survey 2008)?
Males (19-30y) = 11.9 MJ
Females (19-30y) = 8.4 MJ
How can we identify low energy reporters?
Doubly Labeled water (DLW) or Goldberg Equation
What is DLW error?
Very accurate (only 1-2% error)
What is energy balance?
Energy in = Energy out
What is energy in?
Reported energy intake
What is energy out?
Energy expenditure
How are carbohydrates metabolised?
Use 6 oxygen -> produce 6 carbon dioxide
How is fat metabolised?
Use 23 oxygen -> produce 16 carbon dioxide
What are both CHO and Fat equations the basis of?
Indirect calorimetry
What is indirect calorimetry?
Measuring oxygen going in and carbon dioxide coming out to figure out how much energy was expended and metabolised
What are stable isotopes used for doubly labelled water?
Deuterium and oxygen-18
What is deuterium?
Stable isotope of hydrogen (added neutron)
What is oxygen-18?
Stable isotope of oxygen (2 added neutrons)
What does double labelled water estimate?
CO2 production without needed breathing apparatus
How does doubly labelled water work?
Drink a small amount of labelled water with both isotopes on them and collect urine samples to determine how quickly isotopes disappear from the body
- Isotopes weigh a different amount so you can measure them
What does deuterium attach to?
onto H2
What does oxygen-18 attach onto?
Oxygen (O)
What are advantages of DLW?
- Once know CO2 losses for time period can calculate total energy expenditure
- If in energy balance then reported energy intake should = energy expenditure
- Very accurate
- Relatively simple for participant
What are disadvantages of DLW?
- Very expensive
- Only get average total energy expenditure (not for ind days)
- Assumes energy balance
How do we use DLW to identify LER?
- Collect dietary data
- Measure energy expenditure by DLW at the same time
- Calculate difference
How can we identify low energy reporters when DLW is inconvenient or too expensive?
Equations can be used based on estimated basic energy requirements e.g. Goldberg Equation