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A prospective analysis of dietary energy density at age 5 and 7 years and fatness at 9 years among UK children

Abstract

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) was calculated by dividing fat mass (kg) by height (m5.8). 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.

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Acknowledgements

We are extremely grateful to all the families who took part in this study, the midwives for their help in recruiting them and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists and nurses. The UK Medical Research Council, the Wellcome Trust and the University of Bristol provide core support for the Avon Longitudinal Study of Parents and Children. This study was funded by a PhD studentship awarded to Laura Johnson by the UK Medical Research Council. The funding body had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript. This publication is the work of the authors, and Laura Johnson and Susan A Jebb will serve as guarantors for the contents of this paper.

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Correspondence to L Johnson.

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Competing interests

LJ and SAJ had the idea for the analysis and wrote the report. LJ analysed data and APM provided statistical expertise. LRJ entered, collated and cleaned the dietary data. PME designed and managed the collection and entering of the dietary data. All authors were responsible for critical revisions and final approval of the manuscript. MRC Human Nutrition Research is a member of a number of advisory boards for the food and pharmaceutical industry. No external organizations were involved in any part of this analysis. The authors have no personal financial interest in these links.

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Johnson, L., Mander, A., Jones, L. et al. A prospective analysis of dietary energy density at age 5 and 7 years and fatness at 9 years among UK children. Int J Obes 32, 586–593 (2008). https://doi.org/10.1038/sj.ijo.0803746

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