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It is now widely recognized that reported energy intakes in dietary surveys underestimate usual energy intake (Black et al., 1993). During this study specific subject characteristics contributing to underreporting and the possible association between the metabolic syndrome and underreporting were investigated. A multi-disciplinary cross-sectional case-control study was carried out with 115 apparently healthy Caucasian women. The POWIRS II (Profiles of Obese Women Suffering from the Insulin Resistance Syndrome) study was performed in the Metabolic Unit of the North-West University, Potchefstroom, South Africa. Here, dietary intake was measured using the quantitative food frequency questionnaire (QFFQ). The ratio of energy intake (EI) to basal metabolic rate (BMR) was calculated from the reported EI and BMR estimated using equations. Underreporters (URs) were identified using the Goldberg equation, which compares EI with energy expenditure (EE), both expressed as multiples of the BMR. URs had reported EI 1.27 x BMR, non-URs 1.27 x BMR. Total energy expenditure (TEE) was calculated (n=115) and measured in a subgroup (n=63) by using the Actical accelerometer.