Objective versus Self-Reported Energy Intake Changes During Low-Carbohydrate and Low-Fat Diets.

Abstract

This study aimed to compare self-reported with objective measurements of energy intake changes (∆EI) during a 1-year weight-loss intervention with subjects randomized to low-carbohydrate versus low-fat diets. Repeated body weight measurements were used as inputs to an objective mathematical model to calculate ∆EI_Model and to compare with self-reported energy intake changes assessed by repeated 24-hour recalls (∆EI_Recall ). ∆EI_Recall indicated a relatively persistent state of calorie restriction of ~500 to 600 kcal/d at 3, 6, and 12 months with no significant differences between the diets. ∆EI_Model demonstrated large early decreases in calorie intake > 800 kcal/d followed by an exponential return to ~100 kcal/d below baseline at the end of the year. Accounting for self-reported physical activities did not materially affect the results. Discrepancies between ∆EI_Model and ∆EI_Recall became progressively greater over time. The low-carbohydrate diet resulted in ∆EI_Model that was 162 ± 53 kcal/d lower than the low-fat diet over the first 3 months (P  =  0.002), but no significant diet differences were found thereafter. Self-reported ∆EI measurements were inaccurate. Model-based calculations of ∆EI found that instructions to follow the low-carbohydrate diet resulted in greater calorie restriction than the low-fat diet in the early phases of the intervention, but these diet differences were not sustained.