Associations between energy density of meals and snacks and overall diet quality and adiposity measures in British children and adolescents: the National Diet and Nutrition Survey.
This cross-sectional study examined how energy density (ED) of meals and snacks are associated with overall diet quality and adiposity measures in 1617 British children aged 4-18 years from the 1997 National Diet and Nutrition Survey. On the basis of data from 7-d weighed dietary record, all eating occasions were divided into meals or snacks on the basis of time (meals: 06.00-09.00, 12.00-14.00 and 17.00-20.00 hours; snacks: all others) or contribution to energy intake (EI) (meals: ≥15 %; snacks: <15 %). ED of meals and snacks was calculated on the basis of food only. Overall diet quality was assessed using the Mediterranean diet score (range 0-8). Irrespective of the definition of meals and snacks, ≥67 % of EI was derived from meals, whereas ED of meals was lower than ED of snacks (mean: 8·50-8·75 v. 9·69-10·52 kJ/g). Both ED of meals and ED of snacks were inversely associated with total intakes of vegetables, fruits, dietary fibre and overall diet quality and positively associated with total intakes of fat. However, the associations were stronger for ED of meals. The change in the Mediterranean diet score with a 1-unit increase of ED (kJ/g) was -0·35 to -0·30 for ED of meals and -0·09 to -0·06 for ED of snacks (all P<0·0001). After adjustment for potential confounders, all measures of ED of meals and snacks did not show positive associations with adiposity measures. In conclusion, although both ED of meals and ED of snacks were associated with adverse profiles of overall diet quality (but not adiposity measures), stronger associations were observed for ED of meals.
1Department of Nutrition,School of Human Cultures,University of Shiga Prefecture,Shiga 552 8533,Japan.
Kentaro
K
Murakami
2Northern Ireland Centre for Food and Health,Ulster University,Coleraine BT52 1SA,UK.
M Barbara E
MB
Livingstone
D050154:Adiposity / Q000208:ethnology; D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena / Q000208:ethnology; D002648:Child; D002664:Child Nutritional Physiological Phenomena / Q000208:ethnology; D002675:Child, Preschool; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects* / Q000208:ethnology; D015930:Diet Records; D038441:Diet, Mediterranean; D002149:Energy Intake / Q000208:ethnology; D005260:Female; D006801:Humans; D008297:Male; D062407:Meals / Q000208:ethnology; D009749:Nutrition Surveys; D044343:Overnutrition / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control; D010349:Patient Compliance / Q000208:ethnology; D062410:Snacks / Q000208:ethnology; D006113:United Kingdom / Q000453:epidemiology
 ED energy density;  EER estimated energy requirement;  EI energy intake;  EI:EER ratio of energy intake:estimated energy requirement;  MDS Mediterranean diet score;  NDNS National Diet and Nutrition Survey;  WHtR waist:height ratio; Diet quality; Energy density; Meals; Snacks