Impact of obesity on underreporting of energy intake in type 2 diabetic patients: Clinical Evaluation of Energy Requirements in Patients with Diabetes Mellitus (CLEVER-DM) study

Itsuko Miyazawa; Katsutaro Morino; Keiko Fuse; Keiko Kondo; Akiko Ohi; Kaori Nishida; Mika Kurihara; Shoko Yasuhara; Naoko Nakanishi; Yuki Nishida; Satoshi Nakae; Yosuke Yamada; Shigeho Tanaka; Naoyuki Ebine; Satoshi Sasaki; Fuminori Katsukawa; Masaya Sasaki; Satoshi Ugi; Hiroshi Maegawa; CLEVER-DM Study Research Group

doi:10.1016/j.clnesp.2020.07.001

Impact of obesity on underreporting of energy intake in type 2 diabetic patients: Clinical Evaluation of Energy Requirements in Patients with Diabetes Mellitus (CLEVER-DM) study

Clin Nutr ESPEN. 2020 Oct:39:251-254. doi: 10.1016/j.clnesp.2020.07.001. Epub 2020 Jul 24.

Authors

Itsuko Miyazawa¹, Katsutaro Morino², Keiko Fuse³, Keiko Kondo⁴, Akiko Ohi⁵, Kaori Nishida⁶, Mika Kurihara⁷, Shoko Yasuhara⁸, Naoko Nakanishi⁹, Yuki Nishida¹⁰, Satoshi Nakae¹¹, Yosuke Yamada¹², Shigeho Tanaka¹³, Naoyuki Ebine¹⁴, Satoshi Sasaki¹⁵, Fuminori Katsukawa¹⁶, Masaya Sasaki¹⁷, Satoshi Ugi¹⁸, Hiroshi Maegawa¹⁹; CLEVER-DM Study Research Group

Affiliations

¹ Department of Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga, 520-2192, Japan. Electronic address: [email protected].
² Department of Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga, 520-2192, Japan. Electronic address: [email protected].
³ Department of Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga, 520-2192, Japan. Electronic address: [email protected].
⁴ Department of Public Health, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga, 520-2192, Japan. Electronic address: [email protected].
⁵ Division of Clinical Nutrition, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga, 520-2192, Japan. Electronic address: [email protected].
⁶ Division of Clinical Nutrition, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga, 520-2192, Japan. Electronic address: [email protected].
⁷ Division of Clinical Nutrition, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga, 520-2192, Japan. Electronic address: [email protected].
⁸ Division of Clinical Nutrition, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga, 520-2192, Japan. Electronic address: [email protected].
⁹ Division of Clinical Nutrition, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga, 520-2192, Japan. Electronic address: [email protected].
¹⁰ Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan. Electronic address: [email protected].
¹¹ Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan. Electronic address: [email protected].
¹² Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan. Electronic address: [email protected].
¹³ Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan. Electronic address: [email protected].
¹⁴ Faculty of Health and Sports Science, Doshisha University, 1-3 Miyakodani, Tatara, Kyotanabe, Kyoto, 610-0394, Japan. Electronic address: [email protected].
¹⁵ Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. Electronic address: [email protected].
¹⁶ Sports Medicine Research Center, Keio University School of Medicine, 4-1-1 Hiyoshi, Kohoku-ku, Yokohama, 223-8521, Japan. Electronic address: [email protected].
¹⁷ Division of Clinical Nutrition, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga, 520-2192, Japan. Electronic address: [email protected].
¹⁸ Department of Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga, 520-2192, Japan. Electronic address: [email protected].
¹⁹ Department of Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga, 520-2192, Japan. Electronic address: [email protected].

PMID: 32859325
DOI: 10.1016/j.clnesp.2020.07.001

Abstract

Background & aims: Although accurate assessment of energy intake (EI) is critical in diabetes care, underreporting of EI on dietary records (DR) is often an issue. However, few studies have examined EI with doubly labeled water (DLW) in patients with diabetes mellitus. We aimed to investigate the impact of sex and obesity on the dissociation of DR from total energy expenditure (TEE) evaluated with DLW in patients with type 2 diabetes.

Methods: Fifty-two patients with type 2 diabetes aged 60-79 years were enrolled for the Clinical Evaluation of Energy Requirements in Patients with Diabetes Mellitus (CLEVER-DM) study at a single university hospital. TEE was measured over 14 days by the DLW method as standard. EI was calculated by assessment of 3-day DR by registered dietitians.

Results: The mean difference between EI and TEE was 238 ± 412 kcal/day (~10% of TEE). Neither EI nor TEE was significantly different between obese (body mass index (BMI) ≥25 kg/m²) and non-obese (BMI <25 kg/m²) patients. There was a negative correlation between EI/TEE ratio and BMI in women (R = -0.437, P = 0.033) but not in men (R = -0.174, P = 0.377). There was a significant difference in EI/TEE ratio between obese and non-obese patients among women (0.85 ± 0.15 vs. 1.01 ± 0.21, P = 0.045) but not men (0.85 ± 0.20 vs. 0.87 ± 0.17, P = 0.79).

Conclusions: EI calculated by 3-day DR may underestimate habitual intake, which is assumed to be equal to TEE measured by the DLW method except in non-obese women with diabetes.

Clinical trial registration number: UMIN000023051.

Keywords: Doubly labeled water method; Energy expenditure; Obesity; Type 2 diabetes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Diabetes Mellitus, Type 2* / complications
Diabetes Mellitus, Type 2* / epidemiology
Diet Records
Energy Intake
Energy Metabolism
Female
Humans
Male
Obesity / epidemiology

Associated data

UMIN-CTR/UMIN000023051