Methodological issues in food surveys
Eur J Nutr
Methodological issues in food surveys
K. Huysentruyt 0 1
J. De Schepper 0 1
Y. Vandenplas 0 1
0 Department of Paediatric Endocrinology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB) , Brussels , Belgium
1 Department of Paediatric Gastroenterology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB) , Laarbeeklaan 101, 1090 Brussels , Belgium
2 K. Huysentruyt
-
In our 4-day food survey of Belgian 6- to 36-month-old
toddlers, we observed an average energy intake exceeding the
national reference values in two-thirds [
1
]. Alexy and
Hilbig suggested that this finding might be explained rather by
methodological issues (either in collecting the data or in the
way the reference values were constructed) than by actual
excessive intakes, since the mean weight for age z scores in
our cohort was within normal ranges. It is, however,
important to consider that our cohort study does not allow
drawing any conclusions regarding causality between the
nutritional and anthropometric data. One could argue that the
expected increase in body weight due to the excessive intake
was compensated by an increased physical activity.
Furthermore, the resulting weight gain of the observed excessive
energy intake might occur in the following months. Due
to the lack of physical activity scores in our cohort, there
is no way of knowing how active these children were. And
even though our study data provide insight into how well
recommendations are followed, it would be a step too far
to directly infer new guidelines from it. In the revision of
The original publication discussed in the Letter to the Editor
and this reply can be read here: http://link.springer.com/
article/10.1007/s00394-015-0978-y.
the nutritional recommendations, institutions like the WHO
and EFSA have moved away from using observed intakes
for their guidelines and started using a factorial method [
2,
3
]. We do agree with the statement of Alexy and Hilbig that
only a small number of infants were used to determine the
energy deposition using doubly labeled water technique.
Regardless, recommending a restrictive eating pattern in
this young age group from our findings would indeed not
be the appropriate next step, as young children seem
perfectly able to self-regulate their food intake. It is, however,
well known that already at the stage of bottle feeding,
mothers can have the tendency to overrule satiety signals of their
babies, with the risk of over-feeding [4]. That is why we
advocated an actual intervention study in our discussion, in
which it would be especially interesting to investigate the
effect of a lowered protein intake. This would take place in
controlled circumstances and would allow us to draw
conclusions regarding causality.
1. Huysentruyt K , Laire D , Van Avondt T , De Schepper J , Vandenplas Y ( 2016 ) Energy and macronutrient intakes and adherence to dietary guidelines of infants and toddlers in Belgium . Eur J Nutr 55 ( 4 ): 1595 - 1604 . doi: 10 .1007/s00394-015-0978-y
2. EFSA Panel on Dietetic Products Nutrition and Allergies (NDA) ( 2013 ) Scientific opinion on dietary reference values for energy . EFSA J 11 ( 1 ): 3005 . doi: 10 .2903/j.efsa. 2013 .3005
3. FOA/WHO/UNU (Food and Agriculture Organization of the United States/World Health Organization/United Nations University) ( 2004 ) Human energy requirements: report of a joint FAO/WHO/UNU Expert consultation . Food and Nutrition technical report series . FOA/WHO/UNU ( Food and agriculture Organization of the United states /World health Organization/ United Nations University), Rome
4. Dewey KG ( 2001 ) Nutrition, growth, and complementary feeding of the breastfed infant . Pediatr Clin North Am 48 ( 1 ): 87 - 104 (...truncated)