Underreporting of Dietary Intake: Key Issues for Weight Management Clinicians
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OBESITY AND DIET (G. ROA, SECTION EDITOR)
Underreporting of Dietary Intake: Key Issues for Weight Management Clinicians Susan Connor 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Underreporting of dietary intake is common in obesity treatment programs. Accurate reporting through daily food diaries is essential for organizing and personalizing treatment. This review explores key concerns for clinicians, summarizes the state of research on causes of underreporting and ways to promote consistency and accuracy, and identifies areas of need for future research. Recent Findings Dietary underreporting is a cross-cultural phenomenon, and obesity is the most consistent correlate. The association with BMI may be mediated by factors like socioeconomic status, gender, and body image. People with obesity— particularly women—tend to underreport high energy foods and those considered socially undesirable. Underreporting may be due to conscious or unconscious processes and is also influenced by literacy issues and the features of reporting tools. Perceived social pressure plays a role in underreporting, as does inconvenience of reporting. Web- and smartphone-based reporting options offer alternatives to paper-based reporting, but are prone to the same underreporting issues and may not accurately capture energy and micronutrient content. Some evidence indicates frequency and consistency of reporting are more important for weight loss than accuracy. Summary Dietary underreporting remains a major issue in weight management for obesity. The majority of studies are descriptive, identifying associations but not incorporating psychometric tests or qualitative methods like interviews or focus groups to explore underlying issues. Multidisciplinary research is needed to better understand why people underreport and inform strategies to improve quality and consistency of reporting and aid patients with obesity in adhering to dietary goals. Keywords Underreporting . Misreporting . Diet . Obesity
Introduction Standard behavioral treatment in obesity includes selfmonitoring of diet through food diaries. Accurate reporting allows dietary counseling to be tailored to individual needs; underreporting undermines the effectiveness of recommended dietary modification. Frequency and consistency of dietary self-monitoring is critical for success in weight loss and weight loss maintenance [1–4], but dietary underreporting is a common cross-cultural phenomenon. While nearly all This article is part of the Topical Collection on Obesity and Diet * Susan Connor [email protected] 1
Department of Family Medicine and Community Health, Case Western Reserve University School of Medicine, Lerner Tower 1056 11100, Euclid Ave., Cleveland, OH 44106, USA
people tend to underestimate their calorie intake, underreporting is most common in people with obesity, particularly women, hindering weight management efforts and reduction of related health risks. Most research on underreporting focuses on tracking dieta
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