Associations of dietary energy density with body composition and cardiometabolic risk in children with overweight and obesity: role of energy density calculations, under-reporting energy intake and physical activity

Abstract

This study examined (1) the association of dietary energy density from solid (EDS) and solid plus liquids (EDSL) with adiposity and cardiometabolic risk factors (CRF) in children with overweight and obesity, (2) the effect of under-reporting on the mentioned associations and (3) whether the association between ED and body composition and CRF is influenced by levels of physical activity. In a cross-sectional design, 208 overweight and obese children (8–12-year-old; 111 boys) completed two non-consecutive 24 h recalls. ED was calculated using two different approaches: EDS and EDSL. Under-reporters were determined with the Goldberg method. Body composition, anthropometry and fasting blood sample measurements were performed. Moderate to vigorous physical activity (MVPA) was registered with accelerometers (7-d-register). Linear regressions were performed to evaluate the association of ED with the previously mentioned variables. Neither EDS nor EDSL were associated with body composition or CRF. However, when under-reporters were excluded, EDS was positively associated with BMI (P=0·019), body fat percentage (P=0·005), abdominal fat (P=0·008) and fat mass index (P=0·018), while EDSL was positively associated with body fat percentage (P=0·008) and fat mass index (P=0·026). When stratifying the group according to physical activity recommendations, the aforementioned associations were only maintained for non-compliers. Cluster analysis showed that the low-ED and high-MVPA group presented the healthiest profile for all adiposity and CRF. These findings could partly explain inconsistencies in literature, as we found that different ED calculations entail distinct results. Physical activity levels and excluding under-reporters greatly influence the associations between ED and adiposity in children with overweight and obesity.

Negative Association in Reported Dietary Energy Intake and Physique in Japanese Schoolchildren

“…These results were similar to the results of previous studies highlighting negative relationship between BMI and EI, among western and Japanese children and adolescents (13)(14)(15)(16)(17), young Japanese women (27), and other Japanese adults over the age of 30 y who were assessed by various methods (28,29). Overweight and obese children were seen to under-reporting their dietary intake (30).…”

“…A number of reports have been published concerning the elementary cause of under-reporting of dietary EI, other than physique, including sex, age, excessive weight gain and diet trials (12), smoking, psychological state, socioeconomic status, self-image, and lifestyle (30)(31)(32)(33)(34). However, there are few studies concerning over-reporting in lean females.…”

Validity of the Polar H7 Heart Rate Sensor for Heart Rate Variability Analysis during Exercise in Different Age, Body Composition and Fitness Level Groups

“…Following the methodology described in previous studies [35,36], two types of cluster analyses were combined: hierarchical clustering (Ward's method) and k-means clustering. First, individual and multivariate outliers (according to Mahalanobis distance) were detected to reduce the sensitivity of the Ward's method to outliers.…”

The association of dietary energy density and the risk of obesity, type 2 diabetes and metabolic syndrome: A systematic review and meta‐analysis of observational studies

“…16,[25][26][27][28] There were seventeen studies on children and adolescents (≤18 years). 17,[25][26][27][34][35][36][37][38][39][40][41][42][43][44][45][46][47] The studies had different cross-sectional 9,10,14,[16][17][18][26][27][28]33,34,36,[41][42][43][48][49][50][51][52][53][54][55][56][57][58][59][60] and cohort design. 25,…”

“…25,35,[37][38][39][40][44][45][46][47][61][62][63][64][65][66][67][68][69][70] Seven studies were performed on women only. 14,54,60,61,63,68,69 Various methods such as dietary recall, 9,10,16,17,28,34,38,41,46,[48][49][50]52,54,59,69 dietary record, 25,[35][36][37]40,44,47,51,53,57,…”