J Nutr Health.  2020 Oct;53(5):476-487. 10.4163/jnh.2020.53.5.476.

Accuracy of the 24-hour diet recall method to determine energy intake in elderly women compared with the doubly labeled water method

  • 1Department of Nutrition and Dietetics, Gangneung Asan Hospital, Gangneung 25457, Korea
  • 2Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung 25457, Korea
  • 3Department of Food Science and Technology, University of Rwanda, Musanze 210, Rewanda
  • 4Faculty of Applied Biosciences, Tokyo University of Agriculture, Tokyo 1568502, Japan
  • 5Department of Physical Education, Korea University, Seoul 02841, Korea


This study evaluated the accuracy of the 24-hour diet recall method for estimating energy intakes in elderly women using the doubly labeled water (DLW) method.
The subjects were 23 elderly women with a mean age of 70.3 ± 3.3 years and body mass index (BMI) of 23.9 ± 2.8 kg/m 2 . The total energy expenditure (TEEDLW ) was determined by using the DLW and used to validate the 24-hour diet recall method. The total energy intake (TEI) was calculated from the 24-hour diet recall method for three days.
TEI (1,489.6 ± 211.1 kcal/day) was significantly lower than TEEDLW (2,023.5 ± 234.9 kcal/day) and was largely under-reported by −533.9 ± 228.0 kcal/day (−25.9%). The accurate prediction rate of elderly women in this study was 8.7%. The Bland-Altman plot, which was used to evaluate the TEI and the TEEDLW , showed that the agreement between them was negatively skewed, ranging from −980.8 kcal/day to −86.9 kcal/day.
This study showed that the energy intake of elderly women was underreported. Strategies to increase the accuracy of the 24-hour diet recall methods in the elderly women should be studied through analysis of factors that affect underreporting rate. Further studies will be needed to assess the validity of the 24-hour diet recall method in other population groups.


energy intake; nutrition assessment; energy expenditure; elderly
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