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Inaccuracies in food and physical activity diaries of obese subjects: complementary evidence from doubly labeled water and co-twin assessments

International Journal of Obesity volume 34, pages 437–445 (2010)Cite this article

Abstract

Objective:

To study whether eating or physical-activity (PA) habits differ between obese and non-obese monozygotic (MZ) co-twins independent of genetic effects.

Methods:

Rare MZ pairs discordant for obesity (n=14, body mass index difference 5.2±1.8 kg m–2) and weight-concordant control pairs (n=10, 1.0±0.7 kg m–2), identified through a population-based registry of 24–28-year-old twins (n=658 MZ pairs), completed 3-day food and PA diaries and eating behavior questionnaires. Each twin was asked to compare his/her own eating and PA patterns with the co-twin's behavior by structured questionnaires. Accuracy of energy intake was validated by doubly labeled water.

Results:

Non-obese co-twins consistently reported that their obese twin siblings ate more food overall, consumed less healthy foods and exercised less than the non-obese co-twins do. However, no differences in energy intake (9.6±1.0 MJ per day vs 9.8±1.1 MJ per day, respectively) in the food diaries or in the mean PA level (1.74±0.02 vs 1.79±0.04, respectively) in the PA diaries were found between obese and non-obese co-twins. A considerable underreporting of energy intake (3.2±1.1 MJ per day, P=0.036) and overreporting of PA (1.8±0.8 MJ per day, P=0.049) was observed in the obese, but not in the non-obese co-twins.

Conclusions:

On the basis of rare MZ twin pairs discordant for obesity, the co-twin assessments confirmed substantial differences in eating and PA behavior between obese and non-obese persons. These may be overlooked in population studies using food and PA diaries because of considerable misreporting by the obese.

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Acknowledgements

We wish to thank all the volunteers, and Erjastiina Heikkinen, Taija Kivimäki and Anna-Maija Tiainen. The study was supported by the National Institute on Alcohol Abuse and Alcoholism (grants AA-08315, AA-00145 and AA-12502), the European Union Fifth Framework Program (QLRT-1999-00916, QLG2-CT-2002-01254), DiOGenes project, the Academy of Finland (Grant 44069, 100499 and 201461), the Academy of Finland Centre of Excellence in Complex Disease Genetics, Helsinki University Central Hospital grants, and grants from Yrjö Jahnsson Foundation, Jalmari and Rauha Ahokas Foundation, Juho Vainio Foundation, Finnish Cultural Foundation, Finnish Medical Foundation and Research Foundation of the Orion Corporation. DiOGenes is the acronym of the project ‘Diet, Obesity and Genes’ supported by the European Community (Contract no. FOOD-CT-2005-513946).

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Authors and Affiliations

  1. Department of Psychiatry, Obesity Research Unit, Helsinki University Central Hospital, Helsinki, Finland

    K H Pietiläinen, M Korkeila & A Rissanen

  2. Department of Public Health, The Finnish Twin Cohort Study, University of Helsinki, Helsinki, Finland

    K H Pietiläinen, M Korkeila, L H Bogl & J Kaprio

  3. Division of Diabetes, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland

    K H Pietiläinen & H Yki-Järvinen

  4. Department of Human Biology, University of Maastricht, Maastricht, The Netherlands

    K R Westerterp

  5. Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland

    J Kaprio

  6. Institute for Molecular Medicine FIMM, Helsinki, Finland

    J Kaprio

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  1. K H Pietiläinen
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Correspondence to K H Pietiläinen.

Appendix

Appendix

Which of you, you or your co-twin… Eats more Eats healthier food Eats more snacks Eats more regularly Eats more slowly Eats more fatty foods Eats more sweet and fatty delicacies (chocolate, pastries, ice cream) Eats more sweets (candies or jellies) Is more worried about appearance Goes on diets more often Exercises more Walks instead of taking a car or elevator, or makes other ‘active’ choices in daily life Makes more movement during normal non-exercise activities (that is fidgeting) Response alternatives were ‘me, my co-twin, there is no difference between us, do not know’

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Pietiläinen, K., Korkeila, M., Bogl, L. et al. Inaccuracies in food and physical activity diaries of obese subjects: complementary evidence from doubly labeled water and co-twin assessments. Int J Obes 34, 437–445 (2010). https://doi.org/10.1038/ijo.2009.251

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