Inaccuracies in food and physical activity diaries of obese subjects: complementary evidence from doubly labeled water and co-twin assessments
2010
Pietiläinen, K.H. | Korkeila, M. | Bogl, L.H. | Westerterp, K.R. | Yki-Järvinen, H. | Kaprio, J. | Rissanen, A.
Objective: To study whether eating or physical-activity (PA) habits differ between obese and non-obese monozygotic (MZ) co-twins independent of genetic effects. Methods: Rare MZ pairs discordant for obesity (n=14, body mass index difference 5.2±1.8 kg m–2) and weight-concordant control pairs (n=10, 1.0±0.7 kg m–2), identified through a population-based registry of 24–28-year-old twins (n=658 MZ pairs), completed 3-day food and PA diaries and eating behavior questionnaires. Each twin was asked to compare his/her own eating and PA patterns with the co-twin's behavior by structured questionnaires. Accuracy of energy intake was validated by doubly labeled water. Results: Non-obese co-twins consistently reported that their obese twin siblings ate more food overall, consumed less healthy foods and exercised less than the non-obese co-twins do. However, no differences in energy intake (9.6±1.0 MJ per day vs 9.8±1.1 MJ per day, respectively) in the food diaries or in the mean PA level (1.74±0.02 vs 1.79±0.04, respectively) in the PA diaries were found between obese and non-obese co-twins. A considerable underreporting of energy intake (3.2±1.1 MJ per day, P=0.036) and overreporting of PA (1.8±0.8 MJ per day, P=0.049) was observed in the obese, but not in the non-obese co-twins. Conclusions: On the basis of rare MZ twin pairs discordant for obesity, the co-twin assessments confirmed substantial differences in eating and PA behavior between obese and non-obese persons. These may be overlooked in population studies using food and PA diaries because of considerable misreporting by the obese.
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