Validation of a dietary record routine in geriatric patients using doubly labelled water

OBJECTIVE: To validate a 7-day estimated dietary record routine with standardized portion sizes and household measuring in a clinical setting with the doubly labelled water (DLW) method as the reference method. DESIGN: Energy expenditure was measured with deuterium ((2)H) and oxygen-18 ((18)O), and water loss was estimated by 2H dilution as part of the DLW measurements. Energy and water intake was measured with a 7 day dietary record. SETTING: Five nursing home wards in Sweden. SUBJECTS: Thirty-one geriatric patients with a mean age of 86 y. Inclusion criteria were stable body weight, defined as a maximum change of +/-4% during the last 4 months of +/-2% during the last 2 months and without any acute illness. RESULTS: The mean daily energy intake was 7.2 MJ (1727 kcal) and the mean daily energy expenditure was 6.7 MJ (1595 kcal). The mean daily water intake was 1787 ml and mean daily water loss assessed by labelled water was 1774 ml. Using the dietary record routine, the staff overestimated the patients' energy intake by 8% and water intake from food and beverages by <1% compared to DLW. CONCLUSION: The 7 day dietary record routine based on standardized portion sizes and household measuring seems to be a valid method for assessing the intake of energy and fluids by geriatric patients.