Energy balance measurement: when something is not better than nothing

Area of Science:

• Nutrition Science
• Exercise Physiology
• Biostatistics

Background:

• Energy balance is crucial for health, influenced by energy intake (EI) and physical activity energy expenditure (PAEE).
• Traditional assessment methods rely on self-report, which has known limitations and inaccuracies.
• The scientific community has long acknowledged but continued to use these imperfect self-report measures.

Purpose of the Study:

• To argue for the discontinuation of self-reported EI and PAEE in scientific research.
• To highlight the unacceptability of inaccurate self-report data for guiding health policies and clinical decisions.
• To advocate for the development and adoption of objective measures for assessing energy balance.

Main Methods:

• This study presents a critical review and argument based on existing evidence regarding the accuracy of self-reported EI and PAEE.
• It synthesizes findings demonstrating the significant inaccuracies inherent in self-report methods.
• It contrasts these with the need for objective measurement strategies.

Main Results:

• Self-reported EI and PAEE are demonstrably so inaccurate that they are wholly unacceptable for scientific research.
• Continued reliance on these methods risks misguiding health-care policies, future research directions, and clinical judgment.
• Objective strategies for determining energy balance, while nascent, are essential.

Conclusions:

• The scientific and medical communities must cease reliance on self-reported EI and PAEE.
• Researchers and funding bodies should prioritize the development and implementation of objective energy balance assessment tools.
• Adopting objective measures is critical for advancing accurate understanding and effective interventions in energy balance research.