Comparison of energy expenditure measurements by diet records, energy intake balance, doubly labeled water and room calorimetry

Objectives: The purpose of this study was to compare estimates of daily energy expenditure (EE) using energy intake from self reported diet records, metabolizable energy intake balance, doubly labeled water and room calorimetry methods. Design: Cross sectional design. Setting: Beltsville Human Nutrition Research Center, Beltsville, MD USA. Interventions: Energy intake was measured using seven-day self reported diet records (EI), and metabolizable energy (ME) intake balance. EE was measured using doubly labeled water (TEE) and 24 h indirect room calorimetry (24 EE). Body composition was measured using stable isotope dilution and DEXA. Results: EI measured by self reported diet records was 22% less than ME intake balance, 23% less than TEE by doubly labeled water and 8% less than 24 EE by room calorimetry. 24 EE was 16% less than TEE and 16% less than ME. TEE was not significantly greater than ME (0.3%). While mean ME, TEE and 24 EE measurements were significantly lower in female compared to male subjects, mean EI and the mean percent difference between measurement methods were not. Conclusions: Direct comparison of these methods indicate self reported diet records and room calorimetry underestimate daily energy expenditure. While EI balance accurately estimates energy expenditure, EE measured by doubly labeled water is a more direct approach.