Relationship between dietary energy density and dietary quality in overweight young children: a cross-sectional analysis.
BACKGROUND
Observational research has found that lower energy density (ED) diets are related to reduced intake of fat and greater intake of fruits and vegetables. No study has examined the relationship between dietary ED and dietary quality, as determined by the Healthy Eating Index-2005 (HEI), in children who are overweight and obese.


OBJECTIVE
Examine the relationship between dietary ED and HEI, determined from 3-d food records, in 156 children, aged 4-9 years, who had ≥85th percentile body mass index presenting for family-based obesity treatment.


METHODS
Dietary ED, in kcal/g, was calculated using two methods: food and all beverages consumed (food+bev) and food only consumed (food). For calculation of HEI, all components of the HEI were included except oils.


RESULTS
Participants were classified as consuming a low-ED, medium-ED or high-ED diet using tertile cut-off points with ED calculated using food and beverages(food+bev) or food only(food) . After controlling for group difference in child sex and race and parent sex, LOW(food+bev) and LOWfood had significantly (P < 0.05) higher total HEI scores, and total fruit, total vegetable and saturated fat HEI scores than HIGH(food+bev) and HIGHfood , with higher scores indicating greater quality.


CONCLUSIONS
Lower dietary ED is associated with higher dietary quality in children presenting for obesity treatment. Additional research investigating an ED prescription on dietary quality in children who are overweight or obese is needed to better understand this relationship.
Department of Nutrition, University of Tennessee, Knoxville, TN, USA.
S A
SA
Poole
Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA.
C N
CN
Hart
Bradley Hasbro Children's Research Center, Providence, RI, USA.
E
E
Jelalian
Department of Nutrition, University of Tennessee, Knoxville, TN, USA.
H A
HA
Raynor
D001628:Beverages; D015992:Body Mass Index; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D003430:Cross-Sectional Studies; D015930:Diet Records; D004041:Dietary Fats / Q000008:administration & dosage; D004043:Dietary Fiber / Q000008:administration & dosage; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D014675:Vegetables
D004041:Dietary Fats; D004043:Dietary Fiber
Dietary quality; Healthy Eating Index; energy density; paediatric obesity