Dietary energy density in young children across Europe

• Published in: International Journal of Obesity Vol. 38; no. Suppl 2; pp. S124 - S134
• Main Authors: Hebestreit, A, Börnhorst, C, Pala, V, Barba, G, Eiben, G, Veidebaum, T, Hadjigergiou, C, Molnár, D, Claessens, M, Fernández-Alvira, J M, Pigeot, I
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.09.2014; Nature Publishing Group
• Subjects: 692/700/1720; 692/700/2814; 692/700/478/174; Beverages; Body Composition; Body Mass Index; Child; Child Nutritional Physiological Phenomena; Child, Preschool; Children; Cohort Studies; Diet; Energy; Energy consumption; Energy Intake; Epidemiology; Europe; Europe - epidemiology; European Continental Ancestry Group; European Continental Ancestry Group - statistics & numerical data; Feeding Behavior; Female; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi; Food; Food Habits; Fruits; Health aspects; Health Promotion; Health Promotion and Disease Prevention; Humans; Infants; Internal Medicine; Kindergarten; Life Style; Male; Measurement; Medicine; Medicine & Public Health; Metabolic Diseases; Nutrition research; Obesity; original-article; Preschool; Prevention; Public Health; Public Health, Global Health, Social Medicine and Epidemiology; Standard scores; statistics & numerical data; Vegetables; Weight control; Europe; Sweden; Hungary; United Kingdom > UK; Belgium; Cyprus; Italy; Germany; Estonia; Spain
• ISSN: 0307-0565; 1476-5497; 1476-5497
• DOI: 10.1038/ijo.2014.143

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 <6 years and 6 to <10 years were compared between children with an overall ED F below the <25th percentile, between the 25th and 75th percentile as well as above the >75th 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.