Profile of patients with metabolic syndrome recruited for a study of an automated dietary assessment website in primary care

Background - Exclusion of under-reporters (UR) have affected conclusions in some dietary studies. Objectives - To investigate differences between non-UR (NUR) and UR in dietary quality. Design - Analysis of four day records of dietary intakes and activities in 475 non-pregnant, non-lactating female university students, studied between 1998 and 2003. Daily energy expenditure (EE) was determined using a factorial method. Subjects were classified as UR when their reported energy intake (EI) was <76% of their EE. Dietary quality was measured using three composite indexes: the Healthy Eating Index (HEI), the Dietary Quality Index Revised (DQIR) and the Dietary Guidelines for Americans Index (DGI-US). Differences between UR and NUR were evaluated using the Mann Whitney U test. Outcomes - Of the subjects, 267 were classified as NUR and 208 as UR. The total dietary quality scores and the statitstical significance of differences between NUR and UR (P value) are shown in the table. There were no differences between NUR and UR in dietary quality using the HEI or DQIR, but UR had higher dietary quality using the DGI-US. However, analysis of scores for each component of the composite indexes showed many significant differences between NUR and UR. Scores relating to total food consumption (especially grains, meat, dairy, dietary variety and nutrient adequacy) were higher in NUR than UR in all but a few instances, while scores relating to dietary balance (percentage of energy from fat and saturated fat, cholesterol, sodium and moderation) were higher in UR than NUR (data not shown). Index Maximum score NUR (mean ± SD) UR (mean ± SD) P value... Conclusions - There were no differences between NUR and UR in dietary quality using the HEI or DQIR, but UR had higher dietary quality using the DGI-US. However, total scores for composite indexes of dietary quality hide apparently different dietary patterns for NUR and UR.