Dietary energy density in young children across Europe

Abstract

,10 on behalf of the IDEFICS consortium OBJECTIVES: To describe energy density (ED; kcal g − 1 ) of dietary intake of European children. METHODS: From 16 228 children who participated in the IDEFICS (Identification and prevention of Dietary-and lifestyle-induced health EFfects In Children and infantS) baseline examination, 8551 children with 24-h dietary recalls (24-HDR), with plausible reported energy intakes and complete covariate information were included in the present analysis. ED was calculated using two methods: (1) ED including solid foods (ED F ) and (2) ED including solid foods and energy-containing beverages (ED F&B ). Beverage energy was calculated in kcal per day. Dietary characteristics and body mass index (BMI) z-score of children aged 2 to o 6 years and 6 to o 10 years were compared between children with an overall ED F below the o 25th percentile, between the 25th and 75th percentile as well as above the 475th percentile. Standardised regression coefficients were estimated to assess the association between dietary characteristics, BMI z-score and ED of the diet. RESULTS: Children with low ED F and ED F&B diets consumed less energy but higher quantity of food and beverages than children with high ED F and ED F&B diets. Consumption of caloric beverages decreased with increasing ED F&B of the diet owing to the relatively low ED of the beverages, in relation to solid foods. Generally, children with low ED F and ED F&B diets showed healthier food choices than peers with higher ED F and ED F&B diets. In this sample, ED F and ED F&B were not associated with BMI z-score. CONCLUSION: Health promotion strategies should proclaim lower ED diets by means of foods with high water and low fat content and mainly fruit and vegetable components. Excluding caloric beverages from ED F calculation is a useful method to avoid misinterpretation of true exposure to a high energy dense diet. We recommend excluding caloric beverages from ED F calculation when investigating the effect of ED on a certain (health) outcome.International Journal of Obesity (2014) 38, S124-S134; doi:10.1038/ijo.2014.143 BACKGROUND High energy density of the diet was found to be associated with obesity in humans.1 In adults, there is strong evidence that diets high in energy density (ED, kcal g − 1 ) are associated with increased body weight, whereas diets low in ED encourage weight maintenance or even weight loss.2 The body of evidence for an association between high dietary ED and obesity is less strong in children and adolescents.3,4 High ED was found to be associated with greater intakes of energy, fat and added sugars, and with significantly lower intakes of fruits and vegetables.

Dairy Consumption at Snack Meal Occasions and the Overall Quality of Diet during Childhood. Prospective and Cross-Sectional Analyses from the IDEFICS/I.Family Cohort

“…This study is based on the "Pan-European IDEFICS/I.Family children cohort", which can be found at the ISRCTN registry under the ID ISRCTN62310987. The "Identification and prevention of Dietaryand lifestyle induced health EFfects In Children and infantS" (IDEFICS) cohort comprised a total of 16,228 children aged between 2 and 9.9 years (y) old at baseline (T0) [11][12][13]. They were examined from autumn 2007 to spring 2008 in a community based baseline survey (T0) in eight European countries and also in a follow-up performed in 2009-2010 (T1) and from 2013 to 2014 in the "Investigating the determinants of food choice, lifestyle and health in European children, adolescents and their parents" (I.Family) (T3) study.…”

“…SACINA was based on the previous HELENA-DIAT ("HELENA-DIetary Assessment Tool") software [15] developed within the HELENA Study (http://www.helenastudy.com) for adolescents. The absolute validity of proxy-reported energy intakes from SACINA [16] was investigated based on comparison with total energy expenditure measured using the doubly labeled water technique. SACANA was validated twice.…”

Desaturase Activity Is Associated With Weight Status and Metabolic Risk Markers in Young Children

“…Since energy intake is a determinant of BMI in children (40,44), BMI z-score as outcome was also adjusted for energy intake (kcal/d) measured based on a single 24h dietary recall. To control for misreporting variables indicating underand overreports derived based on adapted Goldberg cut-offs (see (44)) were used.…”

“…Questionnaires were used to collect parental information such as the educational level of both parents. The dietary intake of the previous 24 hours was assessed with a computer-assisted 24 hour dietary recall as described in detail elsewhere (39,40).…”

A within-sibling pair analysis of lifestyle behaviours and BMI z-score in the multi-centre I.Family study

“…Standardized food images were used to assist portion size estimation as well as probing questions regarding usual combinations of foods such as bread and bread spreads. Country-specific food composition tables (FCT) were used to match simple foods or European homogeneous multi-ingredient foods typically consumed in the different countries [23]. Children 11 years and above completed a self-administered 24HDR whereas parents were asked to proxy report the intake for younger children and/or assist children in filling in the 24HDR [24].…”