Comparing self-reported energy intake using an online dietary tool with energy expenditure by an activity tracker.

OBJECTIVE: The aim of this study was to compare self-reported total energy intake (TEI) collected using an online multiple-pass 24-h dietary recall tool (Intake24) with total energy expenditure (TEE) estimated from Fitbit Charge 2-improved algorithms in adults from the NoHoW trial (12-mo weight maintenance after free-living weight loss). METHODS: Bland-Altman plots were used to assess the level of agreement between TEI and TEE at baseline and after 12 mo. The ratio of TEI to TEE was also calculated. RESULTS: Data from 1323 participants (71% female) was included in the analysis (mean ± SD: age 45 ± 12 y, body mass index 29.7 ± 5.4 kg/m2, initial weight loss 11.5 ± 6.5 kg). The TEI was lower than TEE on average by 33%, with limits of agreement ranging from -91% to +25%. Men, younger individuals, those with higher body mass index, those with the greater weight loss before enrollment, and those who gained weight during the study underestimated to a greater extent. CONCLUSIONS: These findings contribute to the ongoing research examining the validity of technology-based dietary assessment tools.

Estimating the Prevalence of Knee Pain and the Association between Illness Perception Profiles and Self-Management Strategies in the Frederiksberg Cohort of Elderly Individuals with Knee Pain: A Cross-Sectional Study.

Knee pain is an early sign of later incident radiographic knee osteoarthritis (OA). However, the prevalence of knee pain in the general population is unknown. Additionally, it is unknown how people with knee pain choose to self-manage the condition and if the perception of the illness affects these choices. In this study, 9086 citizens between 60-69 years old in the municipality of Frederiksberg, Copenhagen, Denmark, were surveyed, of which 4292 responded. The prevalence of knee pain was estimated, and associations between illness perceptions (brief illness perception questionnaire [B-IPQ]), self-management strategies, and knee symptoms were assessed. The prevalence of knee pain was 21.4% of which 40.5% reported to use no self-management strategies (non-users). These non-users perceived their knee pain as less threatening and reported less severe symptoms than users of self-management strategies. Further, we found that a more positive illness perception was associated with less severe knee symptoms. In conclusion, among Danes aged 60-69 years, the knee pain prevalence is 21.4%, of which 40.5% use no treatment and perceive the condition as non-threatening. These non-users with knee pain represent a subpopulation being at increased risk of developing knee OA later in life, and there is a potential preventive gain in identifying these persons.

Associations between adolescent and adult socioeconomic status and risk of obesity and overweight in Danish adults.

BACKGROUND: It has been suggested that socioeconomic status (SES) may influence the risk of obesity; however it is important to consider individual changes in SES over the life-course in addition to SES at specific time-points to better understand the complex associations with obesity. We explored the relationship between lifetime-specific and life-course SES and risk of obesity and overweight in Danish adults. METHODS: Data were used from the Danish Youth and Sports Study (DYSS) ­ a 20­22 year follow-up study of Danish teenagers born between 1964 and 1969. Baseline data gathered in 1983 and 1985 included self-reported BMI, SES and physical activity. The follow-up survey (2005) repeated these assessments in addition to an assessment of diet. Complete data on adolescent and adult SES and BMI were available for 623 participants. RESULTS: Following adjustments, adolescent SES had no significant association with overweight/obesity in this sample, however females of low or medium adult SES were significantly more likely to be overweight/obese compared to those of high SES (low SES: OR: 2.7; 95% CI: (1.3­5.8); p = 0.008; medium SES: OR: 4.0, 95% CI (1.6­10.2); p = 0.003). Females who decreased in SES during adulthood were significantly more likely to be overweight/obese compared to those who remained of high SES (OR: 3.1; 95% CI (1.1­9.2); p = 0.04). CONCLUSION: Effects of early life-factors may be conditional upon the environment in adulthood, particularly for the women. Further research should consider the timing of SES exposure and the mechanisms which may be responsible for the socioeconomic gradients in prevalence of obesity and overweight.

Past and current body size affect validity of reported energy intake among middle-aged Danish men.

Our objectives were to estimate the degree of misreporting energy intake (EI) and analyze associations with previous BMI, current BMI, or both. The study was part of the Adiposity and Genetics Study follow-up study including 309 Danish men (age 40-65 y) originally sampled from the obligatory draft board examination. Height and weight were measured at the mean ages of 20 (draft board), 33, 44, and 49 y (current age). Obesity was categorized as BMI >or= 31 kg/m(2). Dietary intake for 7 d and physical activity (PA) level (PAL) were self-reported. Resting metabolic rate (RMR) was measured in a ventilated hood system. By comparing EI with energy expenditure and assuming energy balance, reporting accuracy (RA) was estimated as EI/(RMR.PAL). A plausibility interval was calculated to encompass specific variation components of EI, RMR, and PAL; the specific 95% plausibility interval was 1.00 +/- 0.35. Participants were categorized as underreporters (RA 1.35) of EI. The relation between RA and BMI was studied through linear regression analysis. Overall, the RA was (mean +/- SE) 0.76 +/- 0.01. Of 309 participants, 35% underreported and 7% overreported. Whether stratified for current BMI or draft board BMI, the obese men were more likely to underreport than those who were not obese. Among those currently not obese, underreporting was more prevalent among those who were obese at the draft board examination (44%) than among those who were not (21%). Regression analysis showed that both previous and current BMI and their combination were significantly associated with RA. Thus, underreporting of dietary intake seems to be associated with not only current BMI but also with current BMI in combination with previous BMI.

[The cost of obesity on the Danish health care system]. / Sygehusomkostninger i forbindelse med svaer overvaegt.

INTRODUCTION: The prevalence of obesity and obesity-related co-morbidities in the Danish adult population is continuously rising and demands on the Danish health care system are consequently increasing. Quantitative measures of the economic costs related to obesity constitute a necessary basis for the organization of treatments, health promotion and for health policies. MATERIALS AND METHODS: On the basis of studies of the prevalence of obesity in the Danish adult population and estimates of the increased risk of co-morbidity among obese, the number (and a sensitivity-interval) of hospital contacts in 2003 was calculated. Based on the results of these calculations and on treatment rates for the identified diagnosis-groups, the costs related to the treatment of obesity and obesity-related co-morbidities were estimated. RESULTS: In 2003 177,703 hospital contacts in Denmark were related to obesity. The costs related to these contacts summed up to euro 137.3 mill. (euro 88.8-174.0 mill.), corresponding to 2.8% (1.8-3.6%) of the running costs at Danish hospitals. CONCLUSION: The results of this analysis are equivalent to the results from similar analyses from other European countries with comparable health care systems. The health-economic costs related to obesity in Denmark depend on the prevalence of obesity and as a consequence are expected to rise as the current obesity epidemic further develops.

Consistency of food intake factors by different dietary assessment methods and population groups.

Several studies have used factor analysis to identify food intake patterns in epidemiological studies as an alternative to nutrient-based analyses, but few have validated the factors in a larger population. Our present objectives were: to compare the factor scores based on a food-frequency questionnaire (FFQ) with scores based on a 7 d diet record; to examine the consistency of the factor score correlations across strata of age, BMI, energy intake, education, physical activity and smoking and to compare factors identified in two sub-populations. In 879 men and 927 women, of the total population sample of 3785, scores on food intake factors, three for men ('green', sweet' and 'traditional') and two for women ('green' and 'sweet-traditional'), identified in data from the FFQ and the diet record, were compared. The loadings of foods on the factors were very similar and the correlations between the corresponding factor scores, based on the two dietary assessment methods, were: for men 'green' 0.61, 'sweet' 0.55, 'traditional' 0.34; for women, 'green' 0.61, 'sweet-traditional' 0.57. Stratification did not significantly modify the correlations, with a few inconsistent exceptions. Factors obtained in a different subsample of the population, for which there was only data from the FFQ, were almost identical to the factors found in the subsample, who provided both FFQ and diet record information with regard to food loadings and model fit. In conclusion, the food intake factors identified were reproducible using two different dietary assessment methods and, furthermore, independent of stratification.