1. Comparison of energy expenditure measured by accelerometry and energy intake in overweight African American children Justin B. Moore, Ph.D. 1, Dean E. Jacks, Ph.D. 1, Wendy S. Bibeau, B.S. 1, Ximena L. Valdes 2, M.D. 2, V. Faye Jones, M.D. 2, Valerie M. Crabtree, Ph.D. 2, Rita T. Wedig, Ph.D. 3, Robert V. Topp, Ph.D. 4 1 Department of Health and Sport Sciences, 2 Department of Pediatrics, 3 HSC Research Office, 4 School of Nursing University of Louisville CONCLUSIONABSTRACTINTRODUCTION RESULTS REFERENCES THE AMERICAN COLLEGE OF SPORTS MEDICINE 53RD ANNUAL MEETING, 2006DENVER, COLORODO The accurate measurement of food intake is difficult in children, with overweight children more often under- report their intake than their normal weight peers. This under-reporting affects the validity of estimating total energy intake among overweight children. Currently there is sparse information concerning food intake reporting among overweight African American children. PURPOSE: To compare measurements of total energy intake (TEI) from two 24 hour food recalls and total energy expenditure (TEE) estimated from accelerometry. METHODS: Participants were sixteen children (7M 9F, age = 10.6yrs ± 1.1, weight = 73.7kg ± 15.3, height = 153.7cm ± 10.9, BMI = 31.1 kg/m 2 ± 3.3) enrolled in a longitudinal obesity management study recruited from two urban pediatric clinics. Participant’s anthropometrics were assessed, with TEE assessed by accelerometry and TEI assessed with a two twenty four hour food recall. Misreporting (%) was defined as [(TEI – TEE)/TEE] x 100. RESULTS: There were no significant differences between males and females for age, BMI, or TEI. Males exhibited higher TEE than females (2592.61 vs. 2161.32; p <.05). Mean values for TEI (2319.10 ± 634.76) and TEE (2350.01 ± 447.35) were not significantly different, nor was there a significant correlation between TEE and TEI (r =.34, p =.19). The mean percentage of misreporting (.11 ± 28.07%) was smaller than previously reported in normal weight children but with a large standard deviation indicating large intraindividual differences. The only significant dietary predictor of misreporting was carbohydrate (g) intake (r =.41, p <.05). CONCLUSIONS: Self reported TEI appears to be unrelated to TEE among overweight African American children. However, TEI assessed by two, 24 hour food recalls appears to be accurate in this population relative to previous studies of normal weight children. METHODS ACKNOWLEDGEMENTS These results suggest under-reporting of TEI in overweight African American male children but not females, though the difference was not significant (p=.09). When regressing misreporting on BMI, protein, carbohydrate, and fat consumption (controlling for age and sex), only carbohydrate was a significant predictor (r =.41, p <.05), in contrast to a previous study which found fat as the only significant predictor in 6-9yr old Australian children. 4 The findings of the present study utilizing accelerometry to estimate TEE reinforce those reported from other studies using more rigorous methodology (e.g., doubly labeled water) and suggest that caution should be taken when interpreting data from food recalls in overweight African American children. Sixteen African-American children were recruited from two primary care community based clinics located in an urban setting. Inclusion criteria for the sample consisted of the child being 8 to 12-years old, African American, and having a BMI greater than the 85th percentile for age and gender. Physical activity was continually measured over a 6 day period using a MiniMitter Actical® monitor (Mini Mitter Co., Inc, Bend, OR) which was affixed to the subject’s wrist. Total energy expenditure (TEE) was estimated from accelerometry utilizing the manufactures software. Each subject’s dietary intake was operationalized as a result of two separate 24-hour dietary recall interviews. The 24- hour food intake of each subject was entered into the FoodPro computer program that analyzed the intake for total energy intake (TEI) and the consumption of protein, carbohydrate, and fat. The present data was taken from the baseline assessment from a randomized clinical trial to assess the effectiveness of a case management approach to obesity treatment.Total N = 16 Male N = 7 Female n = 9 Age (yrs)10.6(1.1)11.0(1.1)10.3(1.0) BMI (kg/m 2 )31.1(3.3)32.5(3.2)30.0(3.2) Height (cm)153.7(10.9)157.6(10.3)150.7(11.0) Weight (kg)73.7(15.3)80.4(13.5)68.5(15.2) Waist (cm)92.2(10.76)96.4(9.1)88.97(11.3) TEI (kcal)2319.1(634.7)2226.4(346.7)2391.2(807.5) Protein (g)75.7(21.0)83.3(21.2)69.8(20.1) Carb (g)302.4()276.1(67.2)322.8(133.1) Fat (g)86.0(31.2)83.4(29.9)88.0(33.8) TEE (kcal) 1 2350.0(447.4)2592.6(323.7)2161.3(452.9) Misreporting 2.11(28.1)-13.3(15.4)10.5(31.9) 1.Epstein LH, Myers MD, Raynor HA, Saelens BE. Treatment of Pediatric Obesity. Pediatrics 1998;101(3):554-570. 2.Gutin B, Yin Z, Humphries MC, Barbeau P. Relations of moderate and vigorous physical activity to fitness and fatness in adolescents. American Journal of Clinical Nutrition 2005;81(4):746-750. 3.Fisher JO, Johnson RK, Lindquist C, Birch LL, Goran MI. Influence of Body Composition on the Accuracy of Reported Energy Intake in Children. Obesity Research 2000;8(8):597-603. 4.O'Connor J, Ball EJ, Steinbeck KS, Davies PSW, Wishart C, Gaskin KJ, et al. Comparison of total energy expenditure and energy intake in children aged 6-9 y. American Journal of Clinical Nutrition 2001;74(5):643-649. 5.Tooze JA, Subar AF, Thompson FE, Troiano R, Schatzkin A, Kipnis V. Psychosocial predictors of energy underreporting in a large doubly labeled water study. American Journal of Clinical Nutrition 2004;79(5):795-804. Table 1: Mean SD); 1 Sig. diff., p <.05 by sex; 2 Misreporting (%) = [(TEI – TEE)/TEE] x 100 Table 1: Mean + (SD); 1 Sig. diff., p <.05 by sex; 2 Misreporting (%) = [(TEI – TEE)/TEE] x 100 Figure 1