A prospective analysis of dietary energy density at age 5 and 7 years and fatness at 9 years among UK children
Johnson L., Mander AP., Jones LR., Emmett PM., Jebb SA.
Objective: To analyse whether high dietary energy density (DED) is associated with increased fat mass and risk of excess adiposity in free-living children. Design: Longitudinal, observational cohort study. Subjects: Six hundred and eighty-two healthy children from the Avon Longitudinal Study of Parents and Children. Measurements: Diet was assessed at age 5 and 7 years using 3-day diet diaries, and DED (kJ g -1 ) was calculated excluding drinks. Fat mass was estimated at age 9 years using Dual-Energy X-ray Absorptiometry. To adjust for body size, fat mass index (FMI) wa s calculated by dividing fat mass (kg) by height (m 5.8 ). Excess adiposity was defined as the top quintile of logFMI. Results: Mean DED at age 5 years was higher among children with excess adiposity at age 9 years compared to the remaining sample (8.8±0.16 vs 8.5±0.07 kJ g -1 ), but there was no evidence of an association with excess adiposity at age 9 years (odds ratio (OR)=1.14, 95% confidence interval (CI) 0.90-1.44) after controlling for potential confounders. Mean DED at age 7 years was higher among children with excess adiposity compared to the remaining sample (9.1±0.12 vs 8.8±0.06 kJ g -1 ) and a 1 kJ g -1 rise in DED increased the odds of excess adiposity at 9 years by 36% (OR=1.36, 95% CI 1.09-1.69) after controlling for potential confounders. Conclusion: Higher DED at age 7 years, but not age 5 years, is a risk factor for excess adiposity at age 9 years, perhaps reflecting deterioration in the ability to compensate for extra calories in an energy-dense diet. DED tracks strongly from age 5 to 7 years suggesting intervention to alter dietary habits need to commence at younger ages to prevent the formation of preferences for energy dense foods. © 2008 Nature Publishing Group All rights reserved.