Implausible energy intake reporting in overweight women throughout a weight loss trial

Research suggests implausible energy intake reporting increases during weight loss trials, but estimates that ignore energy deficits linked to weight loss may be inflated. We identified implausible reporters in a weight loss trial incorporating measured weight changes. 240 women in Cuernavaca, Mexico were enrolled in a randomized weight loss trial with two arms: dietary counseling only and counseling plus provision of bottled drinking water. Women were 18–45y, with BMIs >;25kg/m2, no chronic diseases, and baseline intakes of sugar sweetened beverages ≥250 kcals/day. Measures were obtained at baseline, 3, 6, and 9 mos. Implausible reporting was identified by the disparity between reported energy intakes (EIs) vs. predicted energy requirements (pER) from doubly‐labeled water equations adjusted for energy deficits based on weight changes and TEE (actigraph). Implausible EIs were defined as intakes exceeding estimated ±1.5 SD limits around pERs. The baseline prevalence of underreporting was 10.8%, increasing to 31.3–35.5% post‐intervention, lower than estimates of 41.3–45.0% which overlooked weight changes. Underreporters had higher baseline BMIs than those with plausible intakes. Underreporting adjustment enhanced diet‐weight loss associations. Underreporting was prevalent even after accounting for weight changes, and should be considered when analyzing dietary changes patterns and weight loss. Funded by: Danone Research, UNC‐CH and NIPH