title: Evaluating the effect of energy-dense foods consumption on preschool children's body mass index: a prospective analysis from 2 to 4 years of age.
abstract: OBJECTIVE
  The aim of this study was to study the association between the consumption of energy-dense foods at 2 years and body mass index (BMI) at 4 years, using a cross-lagged panel design.
  
  
  METHODS
  The present study included 589 children evaluated at 2 and 4 years of age, as part of the birth cohort generation XXI. Information was obtained by face-to-face interviews. Consumption of energy-dense foods (salty snacks, soft drinks, cakes, and sweets) was measured using a food frequency questionnaire. Children's weight and height were measured by standard procedures, and BMI standard deviation scores (BMI z-scores) were calculated according to the World Health Organization. Linear regression and cross-lagged panel design models were fitted to estimate the associations between the consumption of energy-dense foods and BMI z-scores (controlled for maternal age, education and prepregnancy BMI, and children's exact age at 2 years).
  
  
  RESULTS
  The consumption of energy-dense foods at 2 years was significantly associated with their consumption at 4 years (β = 0.522, 95% CI 0.432-0.612). Children's BMI z-scores at 2 years were associated with posterior BMI z-scores (β = 0.747, 95% CI 0.688-0.806). In the cross-lagged analysis, consumption of energy-dense foods at 2 years had no effect on subsequent BMI z-scores (β = -0.030, 95% CI -0.095 to 0.035) and BMI z-scores at 2 years were not significantly associated with the consumption of energy-dense foods at 4 years (β = -0.012, 95% CI -0.086 to 0.062).
  
  
  CONCLUSIONS
  Consumption of energy-dense foods and BMI tracked over time, but the consumption of energy-dense foods at 2 years was not associated with BMI z-scores at 4 years.
authors.affiliation: EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.
authors.forename: Catarina
authors.initials: C
authors.lastname: Durão
authors.forename: Milton
authors.initials: M
authors.lastname: Severo
authors.forename: Andreia
authors.initials: A
authors.lastname: Oliveira
authors.forename: Pedro
authors.initials: P
authors.lastname: Moreira
authors.forename: António
authors.initials: A
authors.lastname: Guerra
authors.forename: Henrique
authors.initials: H
authors.lastname: Barros
authors.forename: Carla
authors.initials: C
authors.lastname: Lopes
mesh_terms: D015992:Body Mass Index; D001835:Body Weight; D002253:Carbonated Beverages; D002675:Child, Preschool; D004032:Diet; D002149:Energy Intake; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D011446:Prospective Studies; D062410:Snacks