methods

in nutrition

The measurement of food and energy intake man-an evaluation of some techniques3
K. J. A cheson,4
I. T. Campbell,5 0. G. Edholm,6 D. S. Miller, and M. J. Stock7

in

ABSTRACT months
were

A dietary on twelve calorimetry energy One week to determine individuals.

and

survey Three
recording

was

carried methods

out

on

an

Antarctic

base

over

a period

of 6 to intake recall,

12

of determining
as eaten

used-weighing

of food

individual in combination with food to intakes of and analysis

food and food tables, food which 1 147-1 duplicate

energy dietary meals by

Downloaded from ajcn.nutrition.org by guest on April 2, 2013

and

bomb

of duplicate intake by was found habitual

meals. 7%

Use when

of weighed compared most

composition intake should 154, 1980.

tables bomb be

underestimated calorimetry. measured

to be the food intake.

practical period over Am. J. Clin. Nutr. 33:

The measurement of habitual food and energy intake in man has been said to be one of the hardest tasks a physiologist can undertake. The two basic problems are the accurate determination ofthe subjects customary food intake, and the conversion ofthis information to energy and nutrient intakes. Any technique has to be accurate but however, should not be so intensely applied as to interfere with the subjects dietary habits and thus alter the parameter being measured. Another problem is for how long food intake should be measured before the information gleaned can be said to be a true reflection of habitual food intake, i.e., the food an individual normally consumes to provide the energy and nutrient requirements for his regular everyday activities. The standard methods of determining food intake have been discussed elsewhere (1-4) but can be summarized briefly as follows. 1 Indirect determination from information on group consumption, inspection of family budgets, larder inventories, figures for agricultural production, etc. 2) Estimation by recall of food consumed over the last day, week, or month. 3) Measurement and recording of food intake as eaten. Conversion of food intake information to energy and nutrients is done by chemical analysis or bomb calorimetry of duplicate samples (5) or the use of food tables such as those of McCance and Widdowson (6).

How accurate are these techniques? For how long should food intake be measured to determine habitual intake? To try and answer these questions a prolonged dietary survey using three different techniques for measuring food and energy intake was carried out on 12 individuals spending 1 year on an Antarctic base (Halley Bay). The survey was carried out as part of an energy balance survey and the period of investigation on different individuals varied between 6 and 12 months. Experimental The and
I

design and recording food

of Nutrition

weighing collecting

of food samples
and

intake pre-

duplicate
Departments

From

the

Physiology,

Elizabeth College, London W8 7AH and the Division of Human Physiology, National Institute for Medical Research, London NW3, England. 2 K.J.A. and I.T.C. supported by the British Antarctic Survey. 3 Address reprint requests to: Dr. M. J. Stock Department of Physiology, St Georges Hospital Medical School, London, SW17 ORE, England. 4 Present address: Institute of Physiology, University of Lausanne, Switzerland. Present address: University Department of Anaesthesia, St. James Hospital, Leeds, England. Present address: School of Environmental Studies, University College, London, England. Present address: Department of Physiology, St Georges Hospital Medical School, London, SWI7 ORE, England. Queen

The

American

Journal

ofClinical

Nutrition

33: MAY

1980,

pp.

1147-1

154.

Printed

in U.S.A.

1 147

1 148

ACHESON

ET

AL. continuously Three methods were used. for 50 weeks of determin-

sents a variety of organizational problems if carried out in a normal civilized environment and the subject carries on with his everyday life. It is a tedious job that requires a high degree ofmotivation on the part ofthe subject and often a great deal ofencouragement from the investigator. In the Antarctic these tasks are easier in that the subjects are free ranging but within a relatively confined area. Halley Bay (75#{176} 3 1S, 26#{176} 52W) is a British Antarctic Survey base on the Caird Coast of the Weddell Sea. Climatic and environmental conditions have been described previously (7). At the time ofstudy 22 men were resident there, engaged principally in the study of upper atmosphere physics, meteorology, and magnetism. Although some traveling was done, usually for recreation and holidays, the scientific programs were essentially static and the men spent the year more or less confined to the base area. All personnel had their own specific tasks to perform-tractor mechanic, cook, geophysicist, etc. In addition, all helped with the domestic chores and routine base jobs-scrubbing floors, laying tables, transporting food boxes and fuel drums, and raising buried stores. The subjects and observers lived in close contact and detailed observations that would have presented considerable practical problems elsewhere were reasonably easy to carry out. All food at Halley Bay was transported from the United Kingdom and brought by relief ship once a year. The diet consisted of tinned and dehydrated food, supplemented two or three times a week by frozen meat. Meals were eaten at regular times in a communal dining hall and were prepared by two professional cooks. Breakfast consisted of cereal and a cooked dish, lunch of bread and soup, and dinner of a main dish and a dessert. Bread was freshly baked. Cakes were usually made for the afternoon tea break. Food was also freely available at any other time of day or night for anyone wanting to prepare it for himself. Materials and methods

intake was measured almost and anothers for 29 weeks. ing food and energy intake

Weighed

intake

as eaten

Each week ofstudy the subjects weighed and recorded all food consumed. Energy intake was derived from the food composition tables of McCance and Widdowson (6) using the Atwater nutrient conversion factors of 4, 9, and 4 kcal/g of carbohydrate, fat, and protein, respectively. The calculations were performed by computer (8). During each week of study intake was measured in discrete periods of 24 hr starting at a time of day convenient to the subject. Subjects weighed and recorded their own food intake (food item and weight) in notebooks with which they were provided. Dietary scales
were placed at strategic points dietary around the base (dining

room,
were

kitchen,
used-a

bar,
Chatillon

laboratories,

etc).
scale

g in 2 g divisions and a Salter dietary to I kg in 5 g divisions. The accuracy checked and adjusted by the dealers United Kingdom. All items were weighed and recorded separately cxcept for discrete standard items such as cans of beer or blocks of chocolate for which an average weight was taken (the subject merely recorded the nature of the
number consumed). Subjects were issued plastic con-

of scales weighing up to 500 scale weighing up of the scales was before leaving the

Two

sorts

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tainers for butter start and fmish

were not weighed

and sugar that were weighed at the of each 24-hr period. Tea and coffee but added milk and sugar were.

Dietary
Once asked to

recall
during write each down week everything of study they the subjects were

could remember eating during the previous 24 hr. This was usually done on a printed dietary questionnaire (9) but on a number of occasions subjects were asked to provide this information on a blank sheet of paper. No attempt was made to interview them and they were left to fill in the questionnaire in their own words. The records of dietary recall were analysed indepen-

TABLE Physical occupations

Subject

1 characteristics of subjects
Height cm

and

Weight kg

Age yr

Occupation

Details of all 12 subjects are given in Table 1. Mean age was 24 years, mean weight over the year was 71.56 kg, and mean height was 179 cm. During the period of study the food intake ofeach subject was determined for an average of 1 week of each month. One subjects food

1 2 3 4 5 6 7 8 9 10 II 12
Mean

185 174 165 178 179 174 182 193 177 183 183 176 179

92.11 63.07 64.89 71.90 64.88 67.86 7 1.96 78.40 68.26 78.36 66.47 70.53 71.56

26 23 26 24 21 26 29 24 24 21 22 22 24

General assistant Tractor mechanic Medical officer Nutritionist Cook Electrician Meteorologist Geophysicist Ionosphericist Meteorologist Cook lonosphericist

FOOD

AND

ENERGY TABLE
Mean

INTAKE

1 149

dently by workers experienced in the analysis of such information using their own standard techniques. The nutrient conversion factors used for fat, carbohydrate and protein were the Atwater factors of 9, 4, and 4 kcal/ g, respectively. Analysis of 24-hr duplicate

2 24-hr weight, and days studied

Subject
.

energy number

intake, of

mean

body

Mean

24-hr

energy

in.

take (SE)
kcal

Mean

weight kg

Total

no. of days studied

For one period of 24 hr during each week of study a duplicate sample was taken of every item consumed including alcoholic and nonalcoholic drinks other than water, and placed in a plastic container. At the end of 24 hr the entire 24-hr duplicate was homogenized and the homogenate weighed to the nearest 2 g. A 300- to 400-g sample of the homogenate was taken, weighed, and frozen to await analysis in the United Kingdom. Eventually the sample was thawed then dried to constant weight in an oven at 105 C for a period of48 to 72 hr. The dried sample was ground to a fine powder initially with a pestel and mortar, then in a coffee grinder, and finally placed in the oven for a further 24 hr to evaporate moisture absorbed during the grinding process. The resulting powder was analyzed for gross energy in the ballistic bomb calorimeter (5). Analyses were performed in triplicate or until the standard error of the mean was less than 1%. Pulvenised dried sucrose was used as the standard. A correction for alcohol lost in the drying process was made using the alcoholic content of drinks given in the food tables (6) and taking 7 kcal/g as the energy value of alcohol. The metabolizable energy ofthe entire duplicate samplc was calculated using the equation of Miller and Payne (5); metabolizable energy = 0.95 gross energy (kilocalorie) 7.5 nitrogen (gram). Since the nitrogen correction is small, it was calculated from the total weight of ingested nitrogen provided by food tables.

I 2 3 4 5 6 7 8 9 10 II 12 Mean
a

2430 3270 2730 3370 2580 318090 3470 3730 333090 3970 3410 3050 3210 intakes nutrient

130 120 50 40 130 120 160 90 140 90 derived conversion from

92.11 63.07 64.89 7 1.90 64.88 67.86 71.96 78.40 68.26 78.36 66.47 70.53 71.56 weighed factors.

42 52 173 313 69 70 42 35 101 63 42 83 90 food

intake

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Energy Atwater

and

TABLE 3 Coefficient of variation of energy intakes over periods of 1 day and I, 2, 3, and 4 weeks
-

Subject

I Day

I Wk

2 Wk

3 Wk

4 Wk

Results Mean 24 hr energy intakes (SD) computed from the weighed intake using the Atwater factors are given in Table 2 along with the mean body weight and the total number of individual days each subject was studied. Mean intake was 3210 kcal with a range of 2430 to 3970 kcal. Table 3 shows the coefficient of variation ofthe mean 24-hr intake ofeach subject. This gives a measure of the variability of day to day intake and in order to provide a measure of the variability of intake from week to week and longer periods, the following procedure was adopted. For each subject mean daily intakes were calculated for periods of one week, and the coefficient of variation of these means is given in Table 3 and indicates the variation in intake from week to week. This procedure was then used to calculate coefficients of variation for means determined over periods of 2, 3, and 4 weeks.

I 2 3 4 S 6 7 8 9 10 11 12
a

34.6 25.7 24.9 18.2 42.1 23.8 21.9 25.5 26.2 18.2 27 26.7
%.

17.3 14.6 13.6 10.5 28.9 8.1 13.1 6.6 10.1 8.8 20.5 5.9

12.1 8.1 28.1 3.1

11.7 7.3 25.1 5.4

9.5 6.9

8.2 7.3 5.6

6.5 9.1 6.5

SD/mean,

Enough data were available to complete this analysis for 4 weeks on only two subjects, for 3 weeks on five subjects, and for only 1 week on the remaining subject. In all cases the coefficient ofvariation dropped markedly when going from daily intakes to weekly intakes, i.e., the variability of energy intake was much less from week to week than it was from day to day. When intake was considered in periods of 2, 3, and 4 weeks the subjects on whom enough data were available showed only a very small decrease in the coefficient of variation as the period of observation increased. Values for energy intake derived from 24hr dietary recall are given in Table 4 along

1150 TABLE Comparison and dietary 4 of energy recall intakes derived from

ACHESON

ET

AL.

weighed

food

intake

En ergy Subject Weighed intake kcal (W)

intakes Recall kcal (R) R-W kcal

Error n R/W range

1 2 3 4 5 6 7 8 9 10 11 12
a Dietary recall previous days food

2550 2650 3050 3230 3210 2224 3372 2296 3021 2895 3390 3890 3787 3196 3797 3755 2665 2468 methods intake. involved
bNo.

2370 (Q) 1875 (P) 2300 (Q) 1825 (P) 21 15 (Q) 1276 (P) 2627 (Q) 2014(Q) 2111 (Q) 2425 (Q) 2505 (P) 3600 (Q) 2327 (P) 2048(Q) 3424(Q) 3140(Q) 2305 (P) 2153 (Q) either of 24-hr a printed observations. questionnaire

-180 -775 -750 -1405 -1095 -948 -745 -282 -910 -470 -885 -290 -1460 -1148 -373 -615 -360 -315

0.66-1.32 0.61-0.81 0.65-0.70 0.53-0.66 0.56-0.71 0.33-0.76 0.62-1.06 0.75-1.26 0.51-0.90 0.72-1.06 0.63-0.94 0.98 0.45-0.85 0.49-0.84 0.68-1.03 0.63-0.96 0.69-1.10 0.77-0.98

2 2 3 4 2 5 15 5 9 4 2 1 3 10 9 4 2 4 (P) to record the

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(Q)

or a blank

sheet

of paper

with the 24-hr energy values computed from the weighed intake for the same days. The same nutrient conversion factors, 4, 9, and 4 kcal!g for protein, fat, and carbohydrate, respectively, were used in the calculation of energy content in both cases, so any difference between the two groups of values is purely a function of the subjects ability to remember what he ate in the previous 24 hr. It should be remembered that the subject had also weighed and recorded each item consumed. Table 4 gives the dietary recall values when the printed questionnaire was used and also when some subjects were asked to write down on a blank sheet of paper what they could remember eating over the preceding 24 hr. In terms ofenergy, subjects underestimated their food intake by 21% using the printed dietary questionnaire. On only six out of the 68 occasions did recall overestimate food consumption. Some subjects showed a greater facility for remembering what they had eaten than others, but the performance of most was rather erratic. It would appear, however, that the questionnaire produced the best resultsan underestimate of mean intake by 2 1% as against 33.6% when the blank sheet of paper was used-a difference that was statistically

significant (P 0.05). Inspection of the recall records to determine the cause of the discrepancy between recall and records of weighed intake showed that the subjects usually left out one complete food item and tended to underestimate the size of their portions. In Table 5 values are given for daily metabolizable energy intake calculated using the energy factors of Atwater (4, 9, and 4 kcal,g) and those used by McCance and Widdowson (3.75, 9.3, and 4.1 kcal!g ofcarbohydrate, fat, and protein, respectively) compared with metabolizable energy derived from bomb cabrimetry measurements. Means are presented for a total of 96 comparisons. Use of Atwater factors overestimated metabolizable energy content by a mean of 6.7% compared with direct analysis and the McCance and Widdowson factors overestimated energy by 4.6%. Of the results based on Atwater factors, 52% were within 10% ofthe bomb figure, 31% within 10 to 20%, 15% between 20 and 30%. Using a paired t test the difference between the analytical figure and that derived using Atwater factors were significant (P 0.00001) but both figures showed a high correlation (r = 0.926, P 0.00001). An analysis of the nutrient intakes of six of the subjects during the year showed that
< < <

FOOD

AND

ENERGY

INTAKE

1151

32.4% of the energy 56.4% from carbohydrate, tein. The mean intake Discussion Energy intake

intake was from fat, and 1 1% from proof nitrogen was 15.2 g.

in Antarctica

Both Pekkarinen (10) and Marr (3) claim there is no absolute method of measuring energy intake, but agree that taking a duplicate sample of all the food eaten and analyzing the duplicate in a laboratory is likely to provide the most accurate information. Unfortunately it is a technique that is expensive, time consuming, and in a normal environment would be impracticable for any length of time, except perhaps in hospitals 1 1 ). The method that has normally been used in detailed studies of food and energy intake has been the recording of individual weighed intakes in conjunction with food composition tables. This latter method produced a figure of 3210 kcal for mean 24-hr intake over the year. Mean body weight was 7 1.56 kg. This compares with 3610 kcal!day derived from data quoted by Edholm and Goldsmith (12) who reviewed energy intake from work done at British polar bases in the Antarctic and Greenland. The mean body weight of their subjects was 77.3 kg. Corresponding values for a Japanese Antarctic base was 2815 kcal,/ day with a mean body weight of 66.9 kg (13) and for the Russians 3653 kcal/day and a

mean body weight of 79.4 kg (14). Milan and Rodahls work (15) on an American base produced intakes of 4250 kcal!day with a mean body weight of 81.3 kg. Their subjects showed higher weight gains than did the subjects of the other investigations. The values from the present survey are comparable with those of normal adult male intakes in the United Kingdom and lower than those found in most previous polar bases with the exception of the Japanese, but mean body weight of the present population was also lower. No satisfactory relationship has yet been found between body weight and habitual energy intake although intuitively one would think that they must somehow be related, and hence body weights have been presented with the energy intake data. As well as energy intakes being comparable to that of the average male population in the United Kingdom, the contribution made by fat to the diet was also similar (33%). Thus there was no evidence of the increased fat consumption that is apocryphally associated with Arctic diets. Variation in energy intake

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The length of time that food intake should be measured to determine habitual intake has been a subject of some debate. Widdowson (16) from her work on children thought I week was enough; an opinion echoed by Walker (1 7). Yudkin (1 8) from work on fe-

TABLE Estimation compared

Subject

5 of energy intake to bomb calorimetry

No. ofsainples

using

nutrient

conversion

factors

Atwater (A)

factors

McCance dowson

and Wid. factors (B) kcal

A Bomb value kcal (C) C

C %

B C

C %

kcal

I 2 3 4 5 6 7 8 9 10 11 12
Mean
a Weighed

7 8 10 15 6 9 6 5 10 9 6 5

2510 3070 2490 3370 2620 3020 3120 3690 3190 3800 3470 2630

2460 3010 2450 3300 2540 2970 3060 3600 3150 3720 3390 2560

2330 2800 2350 3120 2530 2970 2880 3470 2830 3640 3230 2590

7.7 9.6 6.0 8.0 3.6 1.7 8.3 6.3 12.7 4.4 7.4 1.5 6.7 conversion
calorimetry.

5.6 7.5 4.3 5.8 0.4 0.0 6.3 3.8 11.3 2.2 4.9 -1.2 4.6 factors of Atwater or

food
and

intakes

were
and

converted
compared

to energy
to analytical

intakes
values

using
determined

the

nutrient
by bomb

McCance

Widdowson

1152

ACHESON

ET

AL.

male students noted variations in intake from week to week and thought 1 week would be insufficient. Morris et al. (19), however, working with bank employees found consistency of intake from day to day. If an individual lives by a regular activity pattern, e.g., 5 days work and 2 days leisure at the weekend it would seem reasonable to suppose that his social and dietary habits determined by this pattern of activity. Measurement of habitual intake should include samples of his workday and weekend intake, and it would of course be preferable to measure intake for the whole week. An analysis of the dietary data from Halley Bay where subjects worked a continuous 7-day week, showed that variability for all subjects decreased markedly for weekly intakes compared to those of daily intakes. The higher variability of daily intakes was probably due in part to differing intakes during weekdays and weekends. There was for example a significantly higher intake on Saturdays compared to Tuesdays (P 0.05). When variation of intake was compared among periods of 1, 2, 3, and 4 weeks, the coefficient of variation did not improve significantly for periods longer than 1 week and in fact increased between the 3- and 4-week periods for some subjects. It would appear, therefore, from these results that the period of measurement for the determination of habitual intake should be 1 week. There is little to be gained, in proportion to the work involved, in measuring intake for periods longer than this, although the greater number of weekly cycles measured or at least sampled, the more accurately habitual intake would be known.
<

Dietary

recall

Dietary recall as a technique has several variations, from a detailed searching interview about an individuals dietary habits to determine habitual intake (20), to postal questionnaires enquiring about intake in the immediate past (1 1) or interviews to determine intakes during the previous day or few days. The success of the technique depends on the subjects memory, his ability to convey estimates of quantity to the investigator, his degree of motivation, and the persistence of an interviewer. In the present survey no at-

tempt was made to interview the subjects, but their weighing and recording of food intakes should have increased their level of recall. When the printed questionnaire was used, intake in terms of energy was underestimated by an average of 21%. Writing down on a blank sheet of paper what they could remember eating produced an underestimate of 33.6%. This suggests that a printed questionnaire is better, but it is possible that the difference was due to the fact that the two groups of subjects were not identical. On 79 of 86 occasions intake was underestimateda fmding in agreement with most other investigations of dietary recall. Morrison et al. (21) measured the food intake of eight scientists living in a residential club and did so without their knowledge. At the end of the 24-hr measurement period, the subjects were asked to recall what they had eaten during that period. Very few were able to do so with any degree of accuracy. Thomson (22) working with pregnant women found an underestimate of 17% in food intake when recall was used and food portions described in household measures. Keen and Rose (9) used a postal questionnaire to estimate carbohydrate intake in a group of subjects during the 24 hr before the subjects received the questionnaire (i.e., recall) and in the ensuing 24 hr (i.e., food recorded as eaten). They found close agreement between the two estimates, although Mayer (23) commented that dietary surveys produced smaller errors when intake of individual nutrients was considered than when energy content was being investigated. Beaudoin and Mayer (24) found the more persistent a dietary interviewer was in questioning obese women about their dietary habits, the higher the food intake became. Campbell and Dodds (25) found that women had better rememberance for what they had eaten than men, and younger people better than old. Thomson (22) remarks that less exacting techniques produce less accurate results. He also emphasized the importance of cooperative and intelligent subjects. All our subjects were cooperative and, as most had a University degree or equivalent, could be assumed to be intelligent. Nevertheless, errors of over 20% were found in the determination of energy intake and this is unacceptable, particularly in an energy balance survey. If the subjects

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FOOD

AND

ENERGY

INTAKE

1153

had been interviewed by sistent interviewer perhaps would have been smaller. Bomb calorimetry

a skilled and perthe discrepancy

The use of food tables has obvious limitations in that they are averages of the analysis of food samples from various sources and as such have only a limited accuracy when applied in any particular case. They are however easy to use compared with chemical analysis or bomb calorimetry of duplicate food samples, particularly when put into a computer program (8). Corrections of these inaccuracies are necessary for energy balance surveys. In the present survey, bomb calorimetry with a reported accuracy of 1% (5) was regarded as the standard. This method requires the least number of assumptions when calculating metabolizable energy (i.e., 95% absorption of foodstuffs and a correction for incomplete oxidation of protein). Use of Atwater factors in the calculations produced an overestimate of metabolizable energy content of 6.7% compared with bomb calorimetry. When McCance and Widdowsons factors were used (nutrient conversion factors of 4. 1 9.3, and 3.75 kcal/g of protein, fat, and carbohydrate, respectively) the mean error was 4.6% of the bomb value. These errors compare with overestimates of up to 20% for diets in an institution (26), 2% for domestic diets (27), and 10. 1% in a detailed

metabolic study done in a laboratory using food tables, the name of which was not actually specified (28). For individual nutrients McCance and Widdowson (6) have found that agreement between analyzed values and values given in food tables can be as good as 0.5% (for protein) or as bad as 22% (for fat). In an effort to find the source of some of the errors from the use of food tables, one of the duplicate days, which showed an error of 32%, was made up again in the United Kingdom using the same foods as were used at Halley Bay. Details of the analysis have been published elsewhere (29) but in summary, 10% of the error was due to differences in the water content of duplicate food items and 20% was due to the values from food tables being inappropriate because of the wide vanation in fat content of different samples of the same type of food, particularly of composite dishes. These energy intake data were corrected by using the bomb calorimeter results for comparison with energy expenditure measurements. The corrected estimates of mean energy intake of the 12 subjects are given in Table 6.

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The authors thank their cooperation and described in this paper.

the British assistance

Antarctic in making

Survey for the study

References
I. J. S. Energy Balance and Obesity in Man. North Holland Publishing Company, 47-91. MILLER, D. S. Evaluation of diets in relation to nutritional status. Proc. Nutr. Soc. 29: 191, 1970. MARR, J. W. Individual dietary surveys: purposes and methods. World. Rev. Nutr. Dietet. 13: 105, 1971. DAVIDSON, S., R. PASSMORE AND J. F. BROCK. Human Nutrition and Dietetics (5th ed). Edinburgh: Churchill Livingstone, 1972. MILLER, D. S., AND P. R. PAYNE. A ballistic bomb calorimeter. Brit. J. Nutn. 13: 501, 1959. MCCANCE, R. A., AND E. M. WIDDOWSON. The Composition of Foods. London: Medical Research Council, HMSO. 1969. NORMAN, J. N. Cold exposure and patterns of activity at a polar station. Brit. Antartic Surv. Sci. Bull. 6: 1, 1965. MILLER, D. S., AND P. MUMFORD. Diet assessment and form in human nutrition. Proc. Nutr. Soc. 29: 116, 1970. KEEN, H., AND G. RosE. Diet and arterial diseases in a population sample. Brit. Med. J. 1: 1508, 1958. PEKKARINEN, M. Major methodology in the collection of food consumption data. World Rev. Nutr.
GARROW,

Amsterdam: 1974, pp.

TABLE Corrected

6 mean
Subject

2. daily energy intakes

Energy intake

3.

kcal/dar

1 2 3 4 5 6 7 8 9 10 11 12
a

2280 3060 2560 3160 2420 2980 3250 3500 3120 3720 3200 2860 derived from weighed food intake

4.

5. 6.

7.

8.

Energy

intakes

over the year of study have been calculated using Atwater nutrient conversion factors. These were reduced by 6.7% to correct for the discrepancy between this method and direct analysis by bomb calorimetry.

9. 10.

1154 Dietet.
PLATF,

ACHESON

ET

AL. A one day 5, 1949. survey of eight subjects. Brit. J. Nutr. 3:

12: 145, 1970. B. S., T. P. EDDY AND P. L. PELLET. Food in Hospitals. Oxford: Oxford University Press. 1963. 12. EDHOLM, 0. G., AND R. GOLDSMITH. Food intakes and weight changes in climatic extremes. Proc. Nutr. Soc. 25: 1 13, 1966. 13. OHKUBO, Y. Basal metabolism and other physiological changes in wintering members of Japanese Antartic Research Expedition 1968-69. Bull. Tokyo Med. Dental Univ. 19: 245, 1972. 14. GARSHENIN, V. E. Nutrition of polar explorers at Soviet Antartic Stations. Voprosy Pitaniya 5: 32, 1971. 15. MILAN, F. A., AND K. RODAHL. Calorie requirements of man in Antarctica. J. Nutr. 75: 152, 1961. 16. WIDDOWSON, E. M. Individual variation, nutritional individuality. Proc. Nutr. Soc. 14: 142, 122, 1962. 17. WALKER, S. E. A five year study of the daily food consumption of South African University Students. Brit. J. Nutr. 19: 1, 1965. 18. YUDKIN, J. Dietary surveys: variation in the weekly intake ofnutrients. Brit. J. Nutr. 5: 177, 1951. 19. MORRIS, J. N., J. W. MARR, J. A. HEADY, G. L. MILLS AND T. R. E. PILKINGTON. Diet and plasma cholesterol in 99 bankmen. Brit. Med. J. I: 571, 1963. 20. BURKE, B. S. The dietary history as a tool in research. J. Am. Dietet. Assoc. 23: 1041, 1947. 2 1 . MoRRISoN, S. D., F. C. RUSSELL AND F. STEVENSON. Estimating food intake by questioning and weighing. 11.

22.

23.

24.

25.

26.

27.

A. M. Diet in pregnancy. Dietary survey and the nutritive value of diets taken by pnimigravidae. Brit. J. Nutr. 12: 446, 1968. MAYER, J. Food composition tables and assessment of the caloric content of diets. J. Am. Dietet. Assoc. 28: 308, 1952. BEAUDOIN, R., AND J. MAYER. Food intakes of obese and nonobese women. J. Am. Dietet. Assoc. 29: 29a, 1956. CAMPBELL, V. A., AND M. L. D0DD5. Collecting dietary information from groups of older people. J. Am. Dietet. Assoc. 51: 29, 1967. STocK, A. L., AND E. F. WHEELER. Evaluation of meals cooked by lange scale methods: a comparison of chemical analysis and calculation from food tables. Brit. J. Nutr. 27: 439, 1972. BRANSBY, E. R., C. G. DAUSNEY AND J. KING.
THoMSoN,

technique

Comparison found by

of calcium

nutrient from

values

of

individual

diets

28.

29.

food tables and by chemical analysis. Brit. J. Nutr. 2: 232, 1948. BERNSTEIN, L. M. Comparison of various methods for the determination of the metabolizable energy of a mixed diet. United States Army Medical Research Laboratory Report No. 168, 1955. ACHESON, K. J. The assessment of techniques for measuring energy balance in man. Ph.D. Thesis, University of London, 1974.

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