Underestimation Of Total Energy Intake By Chemical Analysis And Dietary Record In Female Athletes

Adequate energy intake is essential for the health and high performance of female athletes. International consensus indicates that energy deficiency can lead to various health issues in athletes, such as an impact on reproductive function and bone health. Therefore, assessing energy intake is important to prevent or treat energy deficiency. Dietary records are often used to estimate total energy intake (TEI). However, the underestimation of TEI has been well documented by previous studies. Total energy expenditure (TEE) measured by doubly labeled water (DLW) methods can be considered as TEI if there is no change in body weight. In addition, chemical analysis, which involves the method of collecting all the food consumed, and scientific analysis are highly accurate in estimating TEI. PURPOSE: The purpose of this study was to examine TEI by chemical analysis and dietary records and compare it to TEE determined based on the DLW method. METHODS: Nineteen collegiate female athletes participated in this study. TEI was estimated by chemical analysis. All ingested food and beverages were collected. Dietary records were obtained, in which participants weighed food using a food scale and took photographs. TEE was measured by the DLW method, and body weight was measured daily during the measurement period. RESULTS: TEE was 2,842 ± 338 kcal/day. TEI, as determined by chemical analysis was 1,698 ± 496 kcal/day and 1,888 ± 432 kcal/day by the dietary records. Body weight fluctuation during the measurement period was within 2%. TEI based on both methods was significantly lower (p < 0.001) than TEE measured by DLW. CONCLUSION: The results of this study suggest that it is difficult to properly evaluate the TEI in female athletes using chemical analysis and dietary records, even if they were not in a weight loss period. One reason for underestimation was the underreporting of foods and beverages consumed by athletes in both methods. To reduce underreporting by athletes, sports dietitians may need to conduct thorough careful daily interviews. Furthermore, the assessment of nutritional status should be comprehensive, including clinical examination and assessment of body composition. Prudent estimation is needed to assess TEI for female athletes. This work was supported by the Japan sports agency Female Athlete Development and Support Project.