Misreporting of energy intake estimated by food records among adolescents in Lao People's Democratic Republic: a cross-sectional study.

Abstract

Background: Accurate dietary assessment data is vital for understanding dietary patterns and the associated nutrition and health outcomes. However, research on misreporting from self-reported dietary assessment tools has remained limited in low- and middle-income countries. Our study aims to investigate energy intake misreporting and its determinants among adolescents in Lao People's Democratic Republic (PDR).

Methods: We conducted a cross-sectional secondary analysis of seven-day estimated food records collected from 405 adolescents aged 10-18 years attending secondary schools in Vientiane Province, Lao PDR, between March and April 2019. We identified energy intake misreporting using the Goldberg cut-off method, and analyzed factors associated with energy intake underreporting using multivariable logistic regression analyses. We compared the percentage energy intake from each food group between plausible reporters and underreporters, using the Mann-Whitney U-test.

Results: Approximately 61.2% of participants underreported and 0.3% overreported their energy intake. Older adolescents (15-18 years) were 50% less likely to be classified as underreporters than younger adolescents (10-14 years) (Adjusted Odds Ratio [AOR] = 0.54, 95% CI: 0.34-0.88). Higher Body Mass Index was associated with higher odds of underreporting (AOR = 1.09, 95% CI: 1.01-1.18), whereas higher number of reported snacks between meals was associated with lower odds of underreporting (AOR = 0.81, 95% CI: 0.76-0.86). Underreporting increased over the seven-day period (51.4% on day 1 to 65.9% on day 7).

Conclusions: This study highlights a high prevalence of energy intake underreporting among Lao PDR adolescents when using the seven-day estimated food record method. While this prospective method has advantages, its accuracy depends on sustained participant engagement and motivation. Future research is needed to develop, adapt and validate tools, such as technology-assisted tools, for use among adolescents in Lao PDR.