Nighat Farooqi, Department of Respiratory Medicine and Allergy, Umeå University Hospital, SE-901 85, Umea, Sweden; tel. + 46 90 7852269; fax. + 49 90 773817;e-mail:
J Nutr Health Aging. 2015 May;19(5):518-24. doi: 10.1007/s12603-014-0575-4.
To maintain energy balance, reliable methods for assessing energy intake and expenditure should be used in patients with chronic obstructive pulmonary disease (COPD). The purpose of this study was to validate the diet history and 7-day food diary methods of assessing energy intake (EI) using total energy expenditure (TEE) with the doubly labeled water (DLW) method (TEEDLW) as the criterion method in outpatient women with COPD.
EI was assessed by diet history (EIDH) and a 7-day food diary (EIFD) in 19 women with COPD, using TEEDLW as the criterion method. The three methods were compared using intra-class correlation coefficients (ICC) and Bland-Altman analyses. The participants were classified according to their reporting status (EI/TEE) as valid-reporters 0.79-1.21, under-reporters < 0.79 or over-reporters > 1.21.
Diet history underestimated reported EI by 28%, and 7-day food diary underestimated EI by approximately 20% compared with TEEDLW. The ICC analysis showed weak agreement between TEEDLW and EIDH (ICC=-0.01; 95%CI-0.10 to 0.17) and between TEEDLW and EIFD (ICC=0.11; 95%CI -0.16 to 0.44). The Bland-Altman plots revealed a slight systematic bias for both methods. For diet history, six women (32%) were identified as valid-reporters, and for the 7-day food diary, twelve women (63%) were identified as valid-reporters. The accuracy of reported EI was only related to BMI.
The diet history and 7-day food diary methods underestimated energy intake in women with COPD compared with the DLW method. Individuals with higher BMIs are prone to underreporting. Seven-day food diaries should be used with caution in assessing EI in women with COPD.
为了保持能量平衡，慢性阻塞性肺疾病（COPD）患者应使用可靠的方法来评估能量摄入和消耗。本研究的目的是通过双标水（DLW）法（TEEDLW）验证饮食史和 7 天食物日记法评估能量摄入（EI）的方法，以 DLW 法为标准方法，评估门诊 COPD 女性患者的 EI。
19 例 COPD 女性患者采用饮食史（EIDH）和 7 天食物日记（EIFD）评估 EI，以 TEEDLW 为标准方法。使用组内相关系数（ICC）和 Bland-Altman 分析比较三种方法。根据报告状态（EI/TEE）将参与者分类为有效报告者（0.79-1.21）、低报告者（<0.79）或高报告者（>1.21）。
与 TEEDLW 相比，饮食史低估了报告的 EI，低报了 28%，7 天食物日记低估了约 20%。ICC 分析显示，TEEDLW 与 EIDH 之间的一致性较差（ICC=-0.01；95%CI-0.10 至 0.17），TEEDLW 与 EIFD 之间的一致性较弱（ICC=0.11；95%CI-0.16 至 0.44）。Bland-Altman 图显示两种方法均存在轻微的系统偏差。对于饮食史，6 名女性（32%）被确定为有效报告者，对于 7 天食物日记，12 名女性（63%）被确定为有效报告者。报告 EI 的准确性仅与 BMI 相关。
与 DLW 方法相比，饮食史和 7 天食物日记法低估了 COPD 女性的能量摄入。BMI 较高的个体更容易低报。在评估 COPD 女性的 EI 时，应谨慎使用 7 天食物日记。
