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Br J Nutr. 2016 Apr;115(8):1439-52. doi: 10.1017/S0007114516000283. Epub 2016 Feb 18.

Correlates of dietary energy misreporting among European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study.

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1Growth, Exercise, Nutrition and Development (GENUD) Research Group,University of Zaragoza,Pedro Cerbuna 12,50009 Zaragoza,Spain.
3ImFINE Research Group,Department of Health and Human Performance,Technical University of Madrid,Avenida Martín Fierro 7,28040 Madrid,Spain.
4Leibniz Institute for Prevention Research and Epidemiology-BIPS,Achterstr. 30,28359 Bremen,Germany.
5Department of Public Health,Ghent University,P/A UZ 4K3,De Pintelaan 185,B-9000 Ghent,Belgium.
7Research Institute of Child Nutrition Dortmund,Heinstueck 11,D-44225 Dortmund,Germany.
8Department of Physiology,School of Medicine,University of Granada,Avenida Madrid 11,18012 Granada,Spain.
10LIRIC UMR995, Faculté de Médecine,University of Lille 2,CHRU Lille,Bd Pr Leclercq,Hôpital Cardiologique,59037 Lille,France.
11Department of Pediatrics,University of Pécs,József A 7,7623 Pécs,Hungary.
12Unit for Preventive Nutrition,Department of Biosciences and Nutrition,Karolinska Institutet,SE 141 57 Huddinge,Sweden.
13Institut Pasteur de Lille, 1 rue du Prof. Calmette,59019 Lille,France.
14Preventive Medicine & Nutrition Unit,University of Crete School of Medicine,Heraklion,Crete,GR-71003,Greece.
15Council for Agricultural Research and Economics (CREA),Research Center for Food and Nutrition,Via Ardeatina 546,00178 Rome,Italy.
16Division of Clinical Nutrition and Prevention,Department of Pediatrics,Medical University of Vienna,Währinger Gürtel 18-20,A-1090 Vienna,Austria.
6Department of Nutrition and Dietetics,Harokopio University,70 El. Venizelou,Kallithea17671,Athens,Greece.
17Department of Public Health and Surveillance,Scientific Institute of Public Health,Rue Juliette Wytsmanstraat 14,1050 Brussels,Belgium.
19INSERM,UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS),Early ORigin of the Child's Health And Development Team (ORCHAD),16,avenue Paul Vaillant Couturier,94807 Villejuif Cedex,France.
20Department of Pediatrics,Medical College of Georgia,1120 15th Street,BT-1852 Augusta,GA 30912,USA.
2Dietary Exposure Assessment (DEX) Group,International Agency for Research on Cancer,150 Cours Albert Thomas,69372 Lyon,France.


This study examined the correlates of dietary energy under-reporting (UR) and over-reporting (OV) in European adolescents. Two self-administered computerised 24-h dietary recalls and physical activity data using accelerometry were collected from 1512 adolescents aged 12·5-17·5 years from eight European countries. Objective measurements of height and weight were obtained. BMI was categorised according to Cole/International Obesity Task Force (IOTF) cut-off points. Diet-related attitudes were assessed via self-administered questionnaires. Reported energy intake (EI) was compared with predicted total energy expenditure to identify UR and OV using individual physical activity objective measures. Associations between misreporting and covariates were examined by multilevel logistic regression analyses. Among all, 33·3 % of the adolescents were UR and 15·6 % were OV when considering mean EI. Overweight (OR 3·25; 95 % CI 2·01, 5·27) and obese (OR 4·31; 95 % CI 1·92, 9·65) adolescents had higher odds for UR, whereas underweight individuals were more likely to over-report (OR 1·67; 95 % CI 1·01, 2·76). Being content with their own figures (OR 0·61; 95 % CI 0·41, 0·89) decreased the odds for UR, whereas frequently skipping breakfast (OR 2·14; 95 % CI 1·53, 2·99) was linked with higher odds for UR. Those being worried about gaining weight (OR 0·55; 95 % CI 0·33, 0·92) were less likely to OV. Weight status and psychosocial weight-related factors were found to be the major correlates of misreporting. Misreporting may reflect socially desirable answers and low ability to report own dietary intakes, but also may reflect real under-eating in an attempt to lose weight or real over-eating to reflect higher intakes due to growth spurts. Factors influencing misreporting should be identified in youths to clarify or better understand diet-disease associations.


24-HDR 24-h dietary recall; Adolescence; EI energy intake; HELENA-CSS Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study; Healthy Lifestyle in Europe by Nutrition in Adolescence study; MVPA moderate-to-vigorous physical activity; Misreporting; OV over-reporting; Obesity; PA physical activity; SES socio-economic status; TEE total energy expenditure; UR under-reporting; Under-reporting

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