Usual Dietary Energy Density Distribution Is Positively Associated with Excess Body Weight in Mexican Children.
BACKGROUND
Studies suggest a positive association between dietary energy density (DED) and body weight in adults, but evidence in children is inconclusive.


OBJECTIVE
The objective of this study was to compare usual DED distributions of nonoverweight vs. overweight or obese (OW/O) Mexican children.


METHODS
The study used 24-h recall (24HR) data from 2367 children aged 5-11 y from the 2012 Mexican National Health and Nutrition Survey (ENSANUT 2012). Repeated 24HR measures were obtained in a random sample (∼10%) to estimate usual intake distributions by using the Iowa State University (PC-Side) method. Implausible dietary reports were identified. Multivariate linear regression models were used to evaluate the relation between DED and body mass index status and to compare results with and without PC-Side adjustment and restriction to plausible reporters.


RESULTS
A total of 35.1% of the children in the sample were OW/O. The usual DED mean was ∼175 kcal/100 g in both the complete sample and the plausible reporters subsample. Regression models adjusted by PC-Side and for potential confounders showed higher DED in OW/O relative to nonoverweight children for both plausible reporters (9.7 kcal/100 g; n = 1452, P < 0.0001) and the complete sample (7.9 kcal/100 g; n = 2367, P < 0.0001). The DED difference in plausible reporters translates into 88 additional kilocalories in daily energy intake of OW/O children. In the absence of PC-side adjustment, the difference was significant for plausible reporters (P < 0.05) but not for the complete sample (P > 0.10).


CONCLUSIONS
A positive association between usual DED and OW/O was found in Mexican children. The association was stronger when only plausible reporters were considered. This suggests that there is a need for strategies to reduce energy density in the diet of Mexican children.
Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico; and.
Tania C
http://orcid.org/0000-0002-6932-9344
TC
Aburto
Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico; and.
Alejandra
http://orcid.org/0000-0002-1397-8476
A
Cantoral
Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico; and.
Lucia
L
Hernández-Barrera
Department of Statistics, Iowa State University, Ames, IA.
Alicia L
AL
Carriquiry
Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico; and jrivera@insp.mx.
Juan A
http://orcid.org/0000-0003-2586-4908
JA
Rivera
D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D002149:Energy Intake; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D011939:Mental Recall; D008800:Mexico; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D050177:Overweight; D063766:Pediatric Obesity; D012307:Risk Factors; D012959:Socioeconomic Factors
Mexico; childhood obesity; diet; dietary energy density; nutrition survey; usual distribution