Dietary Energy–Density and Adiposity Markers Among a Cohort of Multi-ethnic Children

Background: Evidence suggests that the association between dietary energy density (DED) and body composition in children is different than in adults. The purpose of this study was to measure if DED differed by race/ethnicity and if DED was associated with adiposity markers in children. Methodology: Dietary intake and body composition were measured in a multi-ethnic sample of 307 children aged seven to 12 (39% European American, EA; 35% African American, AA; and 26% Hispanic American, HA). Dietary intake was measured by two 24-h recalls, and DED was calculated including and excluding energy-from beverages. Body composition was measured by dual-energy X-ray absorptiometry, and other measurements included height, waist circumference, and body mass index (BMI). Participants were evaluated by total sample and plausibility of reported energy intake. Analysis of variance, independence tests, and multiple regression models were performed. Results: A total of 33.5% of the children in the sample had a BMI ≥ 85 percentile. Among plausible reporters, the mean DED_SF+EB (solid food + energy-containing beverages) was ~ 128 kcal/100 g and mean DED_SF (solid food only) was 211 kcal/100 g. Pairwise comparisons among children showed that the mean of DED was higher in AA children compared to EA and HA children (p < 0.005). Regression models showed significant association (p < 0.05) between adiposity markers and DED_SF in both the total and plausible samples. Conclusion: This study provides evidence of a significant difference of DED by race/ethnicity. Increased DED showed being a significant risk factor for adiposity among children. The associations were stronger when only plausible reporters were considered.