Comparison of energy intake by semiquantitative food-frequency questionnaire with total energy expenditure by the doubly labeled water method in young children

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Abstract
We assessed the validity of a semiquantitative food-frequency questionnaire to estimate energy intake in young children by comparison with total energy expenditure (TEE). TEE was measured in 45 children (22 males and 23 females; 4.2–6.9 y of age) by the doubly labeled water method and body composition was estimated from bioelectrical resistance (20.2 ± 4.0 kg body weight, 4.6 ± 2.1 kg fat mass, and 15.6 ± 3.1 kg fat-free mass). The sample included 36 white children and 9 Mohawk Native American children. The children's mothers completed one Willett food-frequency questionnaire to reflect the child's usual dietary intake over the last year. Total energy intake by food-frequency questionnaire (9.12 ± 2.28 MJ/d) was significantly higher than TEE (5.74 ± 1.13 MJ/d; P < 0.001). Misreporting of intake by food-frequency questionnaire ranged from 9.57 MJ/d overestimation to 1.58 MJ/d underestimation and was not significantly influenced by sex or body composition of the children. We conclude that use of the food-frequency questionnaire significantly overestimates energy intake in children.