Over- and under-reporting of energy intake by patients with metabolic syndrome using an automated dietary assessment website

Background: Under- and overreporting of dietary intake in a face-to-face context is related to age, gender and body

mass index. The use of computer technology in dietetic practice is restricted to analysis of nutrient data rather than

assessment of the diet. DietAdvice, a website developed to allow patients with metabolic syndrome to self-report

their dietary intake, has been developed in the Illawarra region of New South Wales, Australia. Patients are recruited

by their general practitioner, and use the website, and the data are electronically fed to a dietitian for an

individualised dietary prescription.

Aim: To describe the reporting status of patients using a pilot test of the website from November 2004 to October

2005, and determine relationships to body mass index, gender and age.

Methods: Reported energy intake (EI) was compared with predicted basal metabolic rate (BMR). Patients were

classified as underreporting if EI : BMR <1.35 and overreporting if EI : BMR >2.4. Chi-square and ordinal regression

analyses were used to determine relationships to patient characteristics.

Results: Two hundred patients were recruited, of whom 57 had missing data or did not complete the assessment.

Of the remaining 143 patients, 32.3% underreported their intakes, 21.7% overreported their intakes, and 46.2% were

on target with their reporting. No relationships were found for age, gender or body mass index.

Conclusion: Findings suggest that computerised dietary assessment may encourage patients to report with less

bias than in a verbal dietary assessment when compared with the literature.