The current study sought to identify characteristics that may be associated with the misreporting of food energy intake (EI) in urban South African women. A total of 198 women (61 black, 76 of mixed ancestry, 61 white) completed a quantified food frequency questionnaire, from which daily energy and macronutrient intake were calculated. Body composition (body mass index [BMI], percentage of body fat), body image (Feel-Ideal Difference index and Body Shape questions) and socio-economic status (SES) (household density and asset index) were also measured. Food EI in relation to estimated basal metabolic rate ratio that was less than 1.05 represented under-reporting, whereas a ratio greater than 2.28 represented over-reporting. Results suggested that 26% of the participants under-reported, 64% adequately reported and 10% over-reported. Participants who under-reported had a higher BMI (p < 0.01) and higher percentage of body fat (p < 0.05) than those who adequately and over-reported. The majority of under-reporters were black (38%) versus 21% under-reporters of mixed ancestry and 20% white under-reporters (p < 0.01). Eighty-three per cent of black under-reporters were obese. On the other hand, a majority (63%) of overweight women of mixed ancestry and a majority (50%) of white normal-weight women under-reported their food EI. Under-reporters reported a lower intake of dietary fat (p < 0.01) and a higher intake of dietary protein (p < 0.01) than adequate or over-reporters. Food EI reporting was not influenced by SES or body image. In conclusion, results suggest that food EI reporting is influenced by body size, and may be ethnic-specific in South African women.
