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Int J Obes (Lond). Author manuscript; available in PMC 2015 July 08. Published in final edited form as: Int J Obes (Lond). 2015 July ; 39(7): 1175–1176. doi:10.1038/ijo.2015.81.

Authors’ response to LTE for ‘Energy Balance Measurement: When Something is Not Better than Nothing’ Nikhil V. Dhurandhar, Department of Nutritional Sciences, Texas Tech University, Lubbock, TX. 79409, USA

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Dale Schoeller, Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA Andrew W. Brown, Nutrition Obesity Research Center & Office of Energetics, The University of Alabama at Birmingham, Birmingham, Alabama, USA Steven B. Heymsfield, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA Diana Thomas, Department of Mathematical Sciences, Montclair State University, Montclair, New Jersey, USA

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Thorkild I.A. Sørensen, The Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark and Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals – Part of Copenhagen University Hospital, The Capital Region, Denmark John R. Speakman, Institute of Biological and Environmental Sciences, University of Aberdeen, United Kingdom and Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China Madeline Jeansonne, Nutrition Obesity Research Center, The University of Alabama at Birmingham, Birmingham, Alabama, USA David B. Allison*, and Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, Alabama, USA

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the Energy Balance Measurement Working Group

*

Author for correspondence and reprint requests, David B. Allison, University of Alabama at Birmingham, 1665 University Boulevard, RPHB 140J, Birmingham, AL 35294-0022, Phone (205) 975-9167; Fax (205) 975-7536, [email protected]. Conflicts of Interest Dr. Schoeller reports a patent, Methods of determining energy balance using breath carbon isotope ratios, pending. All other authors declare no potential conflict of interest.

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Dear Editor We believe that the twin questions of whether self-report based estimates of energy intake (EI) and physical activity energy expenditure (PAEE) have sufficient validity to merit use in scientific research or should simply be abandoned are important ones that, for too long have been the elephant in the room. Therefore, we are delighted that Dr. Frazier-Wood and Dr. Satija and colleagues have come to the table to engage in scholarly dialogue on this topic. Here, we address the points they raise. Dr. Frazier-Wood endorses our remarks and we thank her.

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Dr. Satija and Colleagues state “Although improvement in diet and physical activity assessment is a worthy pursuit, the proposal to abandon validated [emphasis added] and informative self-reported tools is misleading and non-constructive.” This statement is based on the false premise that we are suggesting abandoning validated tools. On the contrary, we are suggesting abandoning invalidated tools. Dr. Satija and Colleagues critique objective methods of assessment for their high cost and inconvenience. We agree that these measures have limitations, which we also acknowledged in the original article. Nevertheless, these limitations do not negate our point that self-report based estimates of EI and PAEE are invalid. The [presumed] fact that there is no alternative to self-report based measures of EI and PAEE does not make self-report based measures of EI and PAEE any more valid. As the title of our article indicated, something is not always better than nothing.

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Concerning their third point, Dr. Satija and Colleagues discuss alternative uses for selfreported EI unrelated to its use as a surrogate of actual intake. Although questions of the validity of self-report for other outcomes and exposures are still outstanding, their points about other uses of self-reported EI are tangential to the purpose of our paper: “the use of decidedly inaccurate instruments to accurately measure EI or PAEE needs to be discontinued.” Regardless, they argue that self-reported EI is useful for estimating constructs like self-reported nutrient density. They support this contention by pointing to a study1 in which a self-reported measure of protein intake only shares about 8% of its variance with the ‘gold standard’ intake determined by biomarker recovery, but when protein density was considered the amount of shared variance increases to roughly 17%. We concede that this is a numerical improvement, but it is unclear whether it is an important scientific improvement. They further support self-report by noting that asking individuals what they eat in one way (food frequency questionnaires) is highly correlated with asking individuals what they eat in another way (diet records). Checking one subjective method against another subjective method may yield reproducible results, but that does not imply accuracy or subsequent validity – errors may be correlated. Finally, Dr. Satija and Colleagues state that self-report “methods have been instrumental in adding to knowledge on the relation of diet to health, and informing timely policy that has averted preventable death and disability”. Our reply to this point is, as the barristers say, “Objection. Assumes facts not in evidence.”

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We would very much like to be wrong in our statements that self-report based measures of EI and PAEE are not sufficiently valid for use in scientific research about actual EI and PAEE expenditure. Yet, to our disappointment, neither Dr. Satija and Colleagues nor decades of research have persuaded us that we are.

Acknowledgments Dr. Allison, Dr. Brown, and Ms. Jeansonne are supported in part by grant P30DK056336 from the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases. The opinions expressed are those of the authors and not necessarily those of the NIH or any other organization.

References

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1. Freedman LS, Commins JM, Moler JE, Arab L, Baer DJ, Kipnis V, et al. Pooled results 75 from 5 validation studies of dietary self-report instruments using recovery biomarkers for 76 energy and protein intake. Am J Epidemiol. 2014; 180(2):172–88. Epub 2014/06/12. [PubMed: 24918187]

The ‘Energy Balance Measurement Working Group’ members listed alphabetically

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Arne Astrup, Richard L. Atkinson, Martin Binks, George Blackburn, John E. Blundell, Michelle M Bohan Brown, Nuala M. Byrne, Lawrence J. Cheskin, Richard Cooper, Barbara E. Corkey, John P. Foreyt, Paul Franks, Yoni Freedhoff, Michael Goran, Barbara C. Hansen, Johannes Hebebrand, Berit Lilienthal Heitmann, James O. Hill, Andrew P. Hills, Gary R. Hunter, Theodore Kyle, David A. Levitsky, Amy Luke, Ian Macdonald, Robert Matthews, Corby K. Martin, Ann Y. McDermott, Timothy Moran, Stephen O’Rahilly, Angelo Pietrobelli, Stephan Rössner, Wim H.M. Saris, Arya Sharma, Judith Stern, Luc Van Gaal, S. Stanley Young, Shankuan Zhu

Author Affiliations David B. Allison, PhD, Distinguished Professor, Quetelet Endowed Professor of Public Health, Associate Dean for Science, Director of the Office of Energetics, Director of the Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, USA [email protected] Arne V. Astrup, MD, DMSc, Head, Professor, and Faculty of Science, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark [email protected]

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Richard L. Atkinson, MD, Chief Executive Officer, Virginia Obesity Research Institute, Richmond, VA, USA. [email protected] Martin Binks, PhD, FTOS, Associate Professor, Nutritional Sciences, Texas Tech University, Lubbock, TX, USA. [email protected] George L. Blackburn, MD, PhD, S. Daniel Abraham Chair in Nutrition Medicine Harvard Medical School and Director, Center for the Study of Nutrition Medicine Beth Israel Deaconess Medical Center, Boston, MA, USA [email protected]

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John E Blundell, Professor and Chair, PsychoBiology, Institute of Psychological Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK [email protected] Michelle M Bohan Brown, PhD, Assistant Professor, Department of Food, Nutrition, and Packaging Sciences, Clemson University, Clemson, SC, USA [email protected] Andrew W Brown, PhD, Scientist, Nutrition Obesity Research Center and Office of Energetics, University of Alabama at Birmingham, Birmingham, AL, USA [email protected] Nuala M Byrne, BHMS, MAppSc, PhD, Program Head of Exercise and Sports Science, Director of CRN for Advancing Exercise and Sports Science, Faculty of Health Sciences & Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, QLD, Australia [email protected]

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Lawrence J. Cheskin, MD, FACP, Associate Professor, Health, Behavior & Society; Medicine (GI); Human Nutrition; Public Health Studies; Director, Johns Hopkins Weight Management Center; Director, Rapid Response Project Core; Co-Associate Director, Johns Hopkins Global Center on Childhood Obesity, Johns Hopkins School of Public Health, Baltimore, MD, USA [email protected] Richard Cooper, MD, Professor and Chair, Public Health Sciences, Loyola University Chicago Stritch School of Medicine, Chicago, IL, USA [email protected] Barbara E. Corkey, PhD, Zoltan Kohn Professor of Medicine and Vice Chair for Research, Obesity Research Center, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA [email protected]

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Nikhil V. Dhurandhar, PhD, Department of Nutritional Sciences, Texas Tech University, Lubbock, TX. 79409, USA. [email protected] John P. Foreyt, PhD, Professor and Director of the Behavioral Medicine Research Center, Baylor College of Medicine, Houston, Texas, USA [email protected] Paul Selberg-Franks, PhD, Adjunct Professor of Nutrition, Department of Nutrition, Harvard School of Public Health, Boston, MA, USA [email protected] Yoni Freedhoff, MD, CCFP, Medical Director, Bariatric Medical Institute, Ottawa, ON, Canada [email protected]

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Michael I. Goran, PhD, Dr Robert C and Veronica Atkins Endowed Chair in Childhood Obesity and Diabetes, Co-Director, USC Diabetes and Obesity Research Institute and Professor of Preventive Medicine, Director, Childhood Obesity Research Center (CORC), USC Keck School of Medicine, Los Angeles, California, USA [email protected] Barbara C. Hansen, PhD, Professor of Internal Medicine and Director of Center for Preclinical Research, Department of Internal Medicine & Pediatrics, University of South Florida, Tampa, FL, USA [email protected]

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Johannes Hebebrand, MD, Professor, Department of Psychiatry, Psychosomatics and Psychotherapy for Children and Adolescents, Institute of the University of Duisburg-Essen, NW, Germany [email protected] Berit Lilienthal Heitmann, PhD, Professor and Director for Research, Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals, Frederiksberg, Denmark [email protected] Steven B. Heymsfield, MD, George A. Bray, Jr. Endowed Super Chair in Nutrition and Executive Director of the Pennington Biomedical Research Center, Baton Rouge, LA, USA [email protected]

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James O. Hill, PhD, Executive Director, Anschutz Health and Wellness Center, Anschutz Professor of Health and Wellness, Professor of Pediatrics, Medicine, and Physiology & Biophysics, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA [email protected] Andrew P Hills, PhD, FSAMF, Professor of Allied Health Research – Maternity & Neonatology, Mater Mothers’ Hospital Director – Centre for Nutrition and Exercise, Mater Research - University of Queensland Conjoint Professorial appointment: Centre for Musculoskeletal Research, Griffith Health Institute, South Brisbane, QLD, Australia [email protected] Gary Hunter, PhD, Professor of Kinesiology, Department of Human Studies, School of Education, and the Nutrition Obesity Research Center, Birmingham, AL, USA [email protected]

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Ted Kyle, RPh, MBA, ConscienHealth, Pittsburgh, PA, USA [email protected] David A. Levitsky, PhD, Weiss Presidential Fellow and Professor of Nutrition and Psychology, Cornell University, Ithaca, NY, USA [email protected] Amy Luke, PhD, Professor, Department of Public Health Sciences, Loyola University Chicago, Maywood, IL, USA [email protected] Ian Macdonald, PhD, Head of School of Life Sciences, Professor of Metabolic Physiology, Faculty of Medicine & Health Sciences, University of Nottingham Medical School, Nottingham, UK [email protected]

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Robert A. J. Matthews, MA, CPhys, FRAS, Visiting Reader in Science, Aston University, Birmingham, UK [email protected] Corby K. Martin, PhD, Associate Professor, Director of Behavioral Science and Epidemiology, Director of Ingestive Behavior Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA [email protected]

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Ann Yelmokas McDermott, PhD, MS, LDN, Associate Scientist, Department of International Health and Assistant Director, Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA [email protected] Timothy H. Moran, PhD, Paul R. McHugh Professor, Vice Chair, Director of Research, Director of the Behavioral Neuroscience Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA [email protected] Sir Stephen O’Rahilly, MD, FRS, FMSci, Professor of Clinical Biochemistry and Medicine, University of Cambridge and Director, MRC Metabolic Diseases Unit, Cambridge, UK [email protected] Angelo Pietrobelli, MD, Associate Professor, Pediatric Section of the Department of Life and Reproduction Sciences, Verona University Medical School, Verona, Italy [email protected]

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Stephan Rössner, MD, Professor emeritus, Karolinska Institutet, Apple Bay Obesity Research Centre, Bromma, Sweden [email protected] Wim H. M. Saris MD, PhD, Professor of Human Nutrition, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands [email protected] Dale A. Schoeller, PhD, Professor of Nutritional Sciences, University of WisconsinMadison, Madison, WI, USA [email protected] Arya M. Sharma, MD, PhD, Professor of Medicine, Chair in Obesity Research & Management, University of Alberta, Edmonton, AB, Canada [email protected]

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Diana Thomas, PhD, Professor of Mathematical Sciences, Montclair State University, Montclair, NJ, USA [email protected] Thorkild I.A. Sørensen, PhD, Professor, The Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark and Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals – Part of Copenhagen University Hospital, The Capital Region, Denmark [email protected] John R. Speakman, DSc, Institute of Biological and Environmental Sciences, University of Aberdeen, Scotland, UK and 1000 talents Professor, State key laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China [email protected]

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Judith S. Stern, ScD, Distinguished Professor Emerita, Department of Nutrition, University of California, Davis, CA, USA [email protected] Luc Van Gaal, MD, PhD, Associate Professor, Diabetes and Metabolic Disorders, Universiteit Antwerpen, Antwerp, Belgium [email protected] S. Stanley Young, PhD, Assistant Director of Bioinformatics, National Institute of Statistical Science, Research Triangle Park, NC, USA [email protected] Int J Obes (Lond). Author manuscript; available in PMC 2015 July 08.

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Shankuan Zhu, MD, PhD, Qiushi Chair Professor, CMB Distinguished Professor, Obesity and Body Composition Research Center, Chronic Disease Research Institute Zhejiang University School of Public Health, School of Medicine, Hangzhou, China [email protected]

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