Predictors of misreporting in an elderly population: the 'Quality of life after 65' study.

OBJECTIVES: To evaluate the prevalence and identify some predictors of misreporting in an elderly Belgian population and to assess the effect of underreporting on estimated intakes of macronutrients and foods. DESIGN: A 1-day food record was completed by 2083 adult men and women aged 65 years or more. Individuals whose energy intake was lower than 0.90 x BMR (basal metabolic rate) were defined as underreporters. Overreporting was defined as energy intake greater than 2 x BMR. RESULTS: Underreporting and overreporting occurred in 13.6% and 7.9% of food records, respectively. Results from logistic regression models indicated that gender and body mass index (BMI) were predictors of misreporting. Whereas women were more likely to underreport energy intake, the prevalence of overreporting was higher in men. Underreporting was more prevalent among obese people and overreporting more prevalent in normal-weight subjects. Smoking status and education level did not predict underreporting; however, overreporting was more likely to occur in more highly educated subjects. A cultural difference in reporting of nutrient intakes was also found, with the percentage of underreporters being higher among Walloons compared with Flemish. CONCLUSION: BMI seemed to be one of the most important factors in misreporting. This calls for special attention when dietary surveys are performed on obese or lean people.

[Application of a dietary pattern approach in the Belgium context]. / Application de l'approche globale de l'alimentation dans la population belge.

BACKGROUND: Dietary pattern analysis has recently emerged as a new direction and a complementary approach to study the relationship between diet and morbidity or mortality. At present, two methods have been developed to construct dietary patterns: "a priori" method and "a posteriori" method. OBJECTIVE: This paper presents the two methods and their application based on dietary data from the "Belgium Interuniversity on Nutrition and Health Study". METHODS: A prospective study was conducted (1979-1984) in a sample of 5,225 males and 4,476 females from the Belgian population aged 25 to 74 years at the initial survey and followed for 10 years for all causes and specific mortality. Dietary data was collected by a 24-hour recall and for a sub-sample also by a 7 day-diet record. The "a priori" method was used by calculating an index based on the national dietary guidelines. We used the principal component analysis to identify dietary patterns a posteriori. We conducted a first principal component analysis using the data from the 24-hour recall and a second on the data collected by the 7 day-record. RESULTS: Both of the currently used approaches for extracting dietary patterns have advantages and limitations. We applied first the "a priori" approach by calculating an Index (IAR) which measures the adherence of the sample to the Belgian dietary guidelines. We obtained an index that ranged from 0 to 8, a higher score represented a "healthier diet". The index mean (sd) was 3.7 (+/- 1.2) for the entire sample with a significantly higher IAR for women. Using factor analysis, we identified 8 dietary patterns for men and for women. These were difficult to translate in terms of dietary intake profile. Inversely, with the factors identified with the 7 day record, we could find a "western" dietary profile and a "prudent" profile. CONCLUSION: Dietary pattern analysis offers the opportunity to evaluate the overall quality of the diet. The dietary profiles constructed by the two approaches should be related to morbidity or mortality in order to evaluate their predictive capacity.

Is obesity associated with injuries among young people?

OBJECTIVES: To look at the relationship between obesity and trauma among young people in the Hainaut Province in Belgium. DESIGN: A cross-sectional study (questionnaire and physical examination) was conduced among a sample of 2363 children of 9- to 17-year-olds (n = 2363) in 1998. RESULTS: In the past 12 months prior to the survey, 37% of the sample had at least one injury requiring treatment (with or without hospitalization), and 5% had a severe injury (with at least one night at the hospital). More than 15% were classified to be obese according to the WHO definition. We observed a significantly higher frequency of injury in obese people, in boys, in subjects playing sport intensively, with members of a sports club and in those reporting more than one physical activity per week. In multivariate analysis for injury, gender, physical activity, playing sport in a club and obesity were significant. For severe injuries, only gender and physical activity remained significant in the multivariate analysis. CONCLUSION: Our analysis shows that childhood obesity and physical activity increase the occurrence of injuries. However, we did not observe an association between obesity and severe injuries. Obesity as a risk factor for the occurrence of injuries has to be confirmed by other studies, and the understanding of the mechanism for the observed association needs more investigation.