Predictors of Dietary Energy Density among Preschool Aged Children

Abstract

Childhood obesity is a global problem with many contributing factors including dietary energy density (DED). This paper aims to investigate potential predictors of DED among preschool aged children in Victoria, Australia. Secondary analysis of longitudinal data for 209 mother–child pairs from the Melbourne Infant Feeding, Activity and Nutrition Trial was conducted. Data for predictors (maternal child feeding and nutrition knowledge, maternal dietary intake, home food availability, socioeconomic status) were obtained through questionnaires completed by first-time mothers when children were aged 4 or 18 months. Three 24-h dietary recalls were completed when children were aged ~3.5 years. DED was calculated utilizing three methods: “food only”, “food and dairy beverages”, and “food and all beverages”. Linear regression analyses were conducted to identify associations between predictors and these three measures of children’s DED. Home availability of fruits (β: −0.82; 95% CI: −1.35, −0.29, p = 0.002 for DEDfood; β: −0.42; 95% CI: −0.82, −0.02, p = 0.041 for DEDfood+dairy beverages) and non-core snacks (β: 0.11; 95% CI: 0.02, 0.20, p = 0.016 for DEDfood; β: 0.09; 95% CI: 0.02, 0.15, p = 0.010 for DEDfood+dairy beverages) were significantly associated with two of the three DED measures. Providing fruit at home early in a child’s life may encourage the establishment of healthful eating behaviors that could promote a diet that is lower in energy density later in life. Home availability of non-core snacks is likely to increase the energy density of preschool children’s diets, supporting the proposition that non-core snack availability at home should be limited.

Energy, Macronutrient Intake, and Anthropometrics of Vegetarian, Vegan, and Omnivorous Children (1–3 Years) in Germany (VeChi Diet Study)

“…Total energy and nutrient intake were calculated as individual means of the three recorded days. Dietary energy density (DED) was calculated excluding non-caloric beverages according to [46]. Protein intake was expressed as g/kg BW and fiber intake as g/1,000 kcal.…”

Whole Fruits and Fruit Fiber Emerging Health Effects

“…For example, the substitution of ≥2 servings fresh fruit for higher ED snacks or desserts typical in Western diets can help to reduce total dietary ED to <1.75 kcal/g needed to better support weight control or promote modest weight loss. Providing fresh fruit early in a child’s life is one of the best healthful eating behaviors that is predictive of lower energy intake later in life [133]. A cross-sectional study of weight loss maintainers who lost >10% of their body weight and maintained that loss for ≥5 years reported that they consumed diets with ≤1.4 kcal/g compared to those with weight re-gain who consumed a diet with ≥1.8 kcal/g [134].…”

Obesogenic home food availability, diet, and BMI in Pakistani and White toddlers

“…All regression models were adjusted for the following covariates: child's sex, child's age at time of HFA data collection, mother's age at baseline, mother's education, mother's employment, child's ethnicity and number of individuals in household. These covariates were selected a priori based on previous studies of HFA and diet in children between 18 and 36 months of age (Bryant et al, 2011;Collins, Lacy, Campbell, & McNaughton, 2016;Fernando, Campbell, McNaughton, Zheng, & Lacy, 2018). Models examining prospective associations were additionally adjusted for the child's age at the time of outcome assessment.…”

“…Only two previous studies, both conducted using data from the Melbourne Infant Feeding, Activity and Nutrition Trial in Australia, have explored the relationship between HFA during the first 1000 days and later dietary intake, but neither examined HFA quantities. They found that having snack foods in the home more frequently at 18 months of age was associated with greater overall dietary energy density at 3.5 years of age (Fernando, Campbell, McNaughton, Zheng, & Lacy, 2018) and that increased frequency of having fruits available in the home was linked to a lower overall dietary energy density (Fernando, Campbell Public Health England, 2019). Additionally, serving sizes for 1-to 3-year-olds are approximately a quarter of those for adults (American Academy of Pediatrics: Committee on Nutrition, 2016), with one serving equalling one half to two biscuits (6-23 g) or 100-120 ml of SSBs (Infant and Toddler Forum, 2014).…”

“…Few studies have characterized HFA during the first 1000 days, with only two, to our knowledge, examining the relationship between snack food and SSB HFA and diet during later childhood (Collins, Lacy, Campbell, & McNaughton, 2016;Fernando, Campbell, McNaughton, Zheng, & Lacy, 2018). However, none of these studies examined a South Asian population, and HFA has been shown to vary according to race/ethnicity (Bryant, Sahota, Santorelli, & Hill, 2015;Larson, Eisenberg, Berge, Arcan, & Neumark-Sztainer, 2015;Ranjit, Evans, Springer, Hoelscher, & Kelder, 2015;Skala et al, 2012).…”