Concurrent validation of estimated activity energy expenditure using a 3-day diary and accelerometry in adolescents

Estimates of daily energy expenditure are important to studies of physical activity and energy balance. Objective measures are not always feasible and further research is needed to validate survey instruments and diaries. The study validates estimated activity energy expenditure (AEE) based on a 3-day diary protocol relative to AEE derived from uniaxial accelerometry in adolescents, 265 girls and 227 boys (12.5-16.4 years). Participants completed the diary and wore a GT1M Actigraph accelerometer on the same days. Height and weight were measured. Correlations between protocols were significant (P<0.001) but moderate, r=0.65 in males and r=0.69 in females. The highest correlation occurred among males on Friday, r=0.74 (P<0.01). Controlling for body mass, partial correlations between protocols decreased to 0.44 and 0.35 in males and females, respectively. About 97% of the cases fell within the limits of agreement in a Bland-Altman plot. The criterion of inclusion for the accelerometer excluded 18% of the initial sample. In summary, the 3-day diary was completed without any major problems and provided a reasonably valid alternative for assessing AEE. Concordance between methods was slightly lower for individuals with higher values of AEE.