Dietary energy density, metabolic parameters, and blood pressure in a sample of adults with obesity.

BACKGROUND: Several previous studies revealed the role of dietary energy density (DED) in developing obesity and related disorders. However, the possible role of DED in triggering cardiometabolic risk factors of individuals with obesity has not been studied yet. This study aimed to evaluate the association between DED and anthropometric parameters, blood pressure, and components of metabolic syndrome (MetS) (such as glycemic markers, lipid profile, and blood pressure) among individuals with obesity. METHODS: In this cross-sectional study, we included 335 adults with obesity (BMI ≥ 30 kg/m2) aged 20-50 years in Tabriz and Tehran, Iran. Dietary intake was assessed by a validated semi-quantitative Food Frequency Questionnaire (FFQ), including 168 food items; then, DED was calculated. MetS was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). Enzymatic methods were used to assess serum lipids, glucose, and insulin concentrations. Blood pressure was measured by sphygmomanometer and body composition by bioelectrical impedance analysis (BIA). RESULTS: Participants in the higher tertiles of DED had more intake of carbohydrate, dietary fat, saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), polyunsaturated fatty acid (PUFA), and meat, fish, poultry (MFP). Increasing the DED in both methods had no association with systolic blood pressure (SBP), fasting blood sugar (FBS), low-density lipoprotein cholesterol (LDL-C), insulin, triglyceride (TG), and homeostatic model assessment of insulin resistance (HOMA-IR) even after adjustment for confounders. However, diastolic blood pressure (DBP) decreased in second tertile of DED I (ß = 0.921, P = 0.004). The quantitative insulin-sensitivity check index (QUICKI) in second tertile of both DED methods had significant positive association with DED. In the second tertile of DED II, while total cholesterol (TC) significantly decreased (P crude = 0.036, P adjusted = 0.024), high-density lipoprotein cholesterol (HDL-C) increased (ß = 1.096, p = 0.03). There was no significant changes in biochemical parameters in third tertile of DED I and II even after adjustment for covariates. Also, higher tertiles of DED was associated with reduced prevalence of MetS. CONCLUSION: High DED was associated with lower levels of blood pressure and TC but elevated levels of HDL and QUICKI independent of such confounders as age, BMI, sex, and physical activity. Further longitudinal studies are warranted to better elucidate casual associations.

The relationship between diet quality indices and odds of breast cancer in women: a case-control study.

Dietary quality is an important factor in the etiology of breast cancer (BrCa), but further studies are required to better elucidate this relationship. Accordingly, we sought to analyze if diet quality, assessed using the Diet Quality Index-International (DQI-I), Mean Adequacy Ratio (MAR), and Dietary Energy Density (DED), was related to BrCa. In this Hospital-based case-control study, 253 patients with BrCa and 267 non BrCa controls were enrolled. Individual food consumption data from a food frequency questionnaire was used to calculate the Diet Quality Indices (DQI). Employing a case-control design, odds ratios (ORs) and 95% confidence intervals (CIs) were obtained, and a dose-response analysis investigated. After adjusting for potential confounders, those in the highest quartile of the MAR index had significantly lower odds of BrCa than those in the lowest (OR = 0.42, 95% CI 0.23-0.78; P for trend = 0.007). Although there was no association between individual quartiles of the DQI-I and BrCa, there was evidence of a significant trend across all the quartile categories (P for trend = 0.030).There was no significant association was found between DED index and the odds of BrCa in the crude and fully adjusted models. We found that higher MAR indices were associated with decreased odds of BrCa, Therefore, the dietary patterns reflected by these scores may serve as a possible guide to preventing BrCa in Iranian women.

Effects of a Web-Based Lifestyle Intervention on Weight Loss and Cardiometabolic Risk Factors in Adults With Overweight and Obesity: Randomized Controlled Clinical Trial.

BACKGROUND: The high proportion of people with overweight and obesity has become a worldwide problem in recent decades, mainly due to health consequences, such as cardiovascular diseases, neoplasia, and type 2 diabetes mellitus. Regarding effective countermeasures, the digitization of health services offers numerous potentials, which, however, have not yet been sufficiently evaluated. Web-based health programs are becoming increasingly interactive and can provide individuals with effective long-term weight management support. OBJECTIVE: The purpose of this randomized controlled clinical trial was to evaluate the effectiveness of an interactive web-based weight loss program on anthropometric, cardiometabolic, and behavioral variables and to compare it with a noninteractive web-based weight loss program. METHODS: The randomized controlled trial included people who were aged between 18 and 65 years (mean 48.92, SD 11.17 years) and had a BMI of 27.5 to 34.9 kg/m2 (mean 30.71, SD 2.13 kg/m2). Participants (n=153) were assigned to either (1) an interactive and fully automated web-based health program (intervention) or (2) a noninteractive web-based health program (control). The intervention program focused on dietary energy density and allowed for dietary documentation with appropriate feedback on energy density and nutrients. The control group only received information on weight loss and energy density, but the website did not contain interactive content. Examinations were performed at baseline (t0), at the end of the 12-week intervention (t1), and at 6 months (t2) and 12 months (t3) thereafter. The primary outcome was body weight. The secondary outcomes were cardiometabolic variables as well as dietary and physical activity behaviors. Robust linear mixed models were used to evaluate the primary and secondary outcomes. RESULTS: The intervention group showed significant improvements in anthropometric variables, such as body weight (P=.004), waist circumference (P=.002), and fat mass (P=.02), compared with the control group over the course of the study. The mean weight loss after the 12-month follow-up was 4.18 kg (4.7%) in the intervention group versus 1.29 kg (1.5%) in the control group compared with the initial weight. The results of the nutritional analysis showed that the energy density concept was significantly better implemented in the intervention group. Significant differences in cardiometabolic variables were not detected between the 2 groups. CONCLUSIONS: The interactive web-based health program was effective in reducing body weight and improving body composition in adults with overweight and obesity. However, these improvements were not associated with relevant changes in cardiometabolic variables, although it should be noted that the study population was predominantly metabolically healthy. TRIAL REGISTRATION: German Clinical Trials Register DRKS00020249; https://drks.de/search/en/trial/DRKS00020249. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.3390/ijerph19031393.

Food insecurity, dietary acid load, dietary energy density and anthropometric indices among Iranian children.

OBJECTIVES: Food insecurity significantly influences diet quality which in turn has an impact on individual health. This study aimed to determine the association of food insecurity, dietary energy density (DED), dietary acid load (DAL), and the anthropometric status of children. STUDY DESIGN: A cross-sectional study. METHODS: This study was conducted in 788 6-year-old girls who were referred to health care centers affiliated with Tehran University of Medical Sciences in the south of Tehran from October 2017 to March 2018. Food frequency questionnaires (168 food items) were assessed to calculate DAL and DED. Food insecurity was assessed using the 18-item United States Department of Agriculture questionnaire. Weight and height of children were measured as anthropometric indices. RESULTS: Protein and energy intake were higher in participants with a higher DAL and DED, respectively. Energy, fat, carbohydrate, fiber, potassium, phosphorus, calcium, iron, folate, vitamin B12, mono- and poly-unsaturated fatty acid intake was inversely related to DAL. Children characterized as food insecure were more likely to be defined as thin (OR 5.36; 95% CI 3.41-8.40) than overweight (OR 0.18; 95% CI 0.12-027) and obese (OR 0.28; 95% CI 0.08-0.98, respectively). There was no significant association between DED, potential renal acid load (PRAL), and food security status. Moreover, there was no significant association between anthropometric measure and PRAL. CONCLUSION: Findings from our study revealed that there was no association between DAL and food insecurity. However, food insecure children were more likely to be characterized as thin than children categorized as food secure. More studies need to be performed in both genders to confirm our findings. LEVEL OF EVIDENCE: Level V cross-sectional descriptive study.

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 DEDSF+EB (solid food + energy-containing beverages) was ~ 128 kcal/100 g and mean DEDSF (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 DEDSF 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.

Adherence to the Mediterranean diet was positively associated with micronutrient adequacy and negatively associated with dietary energy density among adolescents.

BACKGROUND: The possible associations between adherence to the Mediterranean diet and micronutrient and energy intakes are unknown among Israeli adolescents. METHODS: A cross-sectional, nationally representative, school-based study was conducted in Israeli adolescents. Schoolchildren (n = 5005), aged 11-18 years, who completed a food frequency questionnaire and had complete data to compose a 14-item modified KIDMED score were included. RESULTS: The nutrient intakes for all the micronutrients showed a significant monotonic increase in the poor, average and good KIDMED groups (all P < 0.001). The same monotonic increasing was also shown in nutrient densities for most micronutrients (for calcium, magnesium, potassium, copper, vitamin A, vitamin E, vitamin C, thiamin, riboflavin, vitamin B6 , folate in both genders, additionally for phosphorus in girls) (all P < 0.05). A positive association was shown between the percentages of students with adequate intakes (AIs) or recommended dietary allowances (RDAs) in micronutrients and modified KIDMED scores. The positive association also existed between the number of micronutrients with AIs or RDAs and modified KIDMED scores (r = 0.495 and 0.501, P < 0.001) for boys and girls, respectively. By contrast, dietary energy density (calibrated by 1000 kcal) was negatively linearly associated with modified KIDMED scores, and a significant monotonic decrease in energy density was shown among the poor, average and good KIDMED groups (all P < 0.001). CONCLUSIONS: The modified KIDMED score was positively associated with better micronutrient profile and negatively associated with dietary energy density in Israeli adolescents, indicating that the KIDMED index is a useful tool for combating the malnutrition of micronutrient deficiency and overweight/obesity.

Dietary energy density is associated with body mass index-for-age in Mexican adolescents.

Dietary energy density (DED) has been widely considered a risk factor for weight gain. In adolescents, however, the evidence is inconclusive, and in Mexico, the ways in which DED is associated with overweight and obesity are unknown. Our study analysed the association of DED with overweight or obesity (OW-O) in Mexican adolescents included in the National Health and Nutrition Survey 2012 (ENSANUT 2012). We analysed the data from a 7-day Food Frequency Questionnaire administered to 2,203 Mexican adolescents aged 12-19 years. DED was calculated excluding all beverages. Plausible and implausible reporters were identified based on the relationship between the reported energy intake and the estimated energy requirement. The association of DED with body mass index (BMI)-for-age and OW-O was analysed using multivariate statistical models restricted to plausible reporters. The combined prevalence of overweight and obesity was 35.4% in the complete sample and 27.8% in the sample of plausible reporters. Mean DED was 177 kcal/100 g, with higher DED in the north of the country. The proportion of plausible reporters was 38.5%. We found a positive association between high DED and the BMI-for-age z-score (ß = 0.347; 95% CI [0.101, 0.594]; P = 0.006), controlling for sociodemographic and dietary variables, but no significant association with OW-O. It is necessary to consider the DED in the design and implementation of strategies to reduce energy density in the diets of young Mexicans.

Effect of reduced energy density of close-up diets on metabolites, lipolysis and gluconeogenesis in Holstein cows.

OBJECTIVE: An experiment was conducted to determine the effect of reduced energy density of close-up diets on metabolites, lipolysis and gluconeogenesis in cows during the transition period. METHODS: Thirty-nine Holstein dry cows were blocked and assigned randomly to three groups, fed a high energy density diet (HD, 1.62 Mcal of net energy for lactation [NEL]/kg dry matter [DM]), a medium energy density diet (MD, 1.47 Mcal NEL/kg DM), or a low energy density diet (LD, 1.30 Mcal NEL/kg DM) prepartum; they were fed the same lactation diet to 28 days in milk (DIM). All the cows were housed in a free-stall barn and fed ad libitum. RESULTS: The reduced energy density diets decreased the blood insulin concentration and increased nonesterified fatty acids (NEFA) concentration in the prepartum period (p<0.05). They also increased the concentrations of glucose, insulin and glucagon, and decreased the concentrations of NEFA and ß-hydroxybutyrate during the first 2 weeks of lactation (p<0.05). The plasma urea nitrogen concentration of both prepartum and postpartum was not affected by dietary energy density (p>0.05). The dietary energy density had no effect on mRNA abundance of insulin receptors, leptin and peroxisome proliferator-activated receptor-γ in adipose tissue, and phosphoenolpyruvate carboxykinase, carnitine palmitoyltransferase-1 and peroxisome proliferator-activated receptor-α in liver during the transition period (p>0.05). The HD cows had higher mRNA abundance of hormone-sensitive lipase at 3 DIM compared with the MD cows and LD cows (p = 0.001). The mRNA abundance of hepatic pyruvate carboxykinase at 3 DIM tended to be increased by the reduced energy density of the close-up diets (p = 0.08). CONCLUSION: The reduced energy density diet prepartum was effective in controlling adipose tissue mobilization and improving the capacity of hepatic gluconeogenesis postpartum.

Dietary energy density is positively associated with body composition of adults in Southwest China.

OBJECTIVE: Dietary energy density (ED) might have influences on body composition. We therefore examined whether ED is associated with body composition among Chinese adults. DESIGN: We collected dietary data through validated two-day 24 h recalls. ED, defined as the amount of energy per unit weight of food consumed, was calculated based on five methods. Multiple linear regression analyses were performed to explore the associations between ED and body composition parameters, including BMI, fat mass index (FMI), fat-free mass index (FFMI), percentage body fat (%BF) and waist circumference (WC). SETTING: Southwest China. SUBJECTS: Chinese adults (n 1933) in 2013. RESULTS: After adjusting the covariates, all ED definitions were positively associated with BMI, FMI, FFMI, %BF and WC among women (P<0·01). In men, however, ED with foods only was positively associated with BMI, FMI, FFMI and %BF (P<0·05), but not with WC (P=0·07); we also found null associations between ED with foods and all beverages and body composition among men. Additionally, ED contributed to higher increases of body composition in women than in men (P<0·01). CONCLUSIONS: The present study supports the positive association between ED and body composition among adults in Southwest China, in which beverages may play an important role.

Short sleep duration is related to kidney-related biomarkers, but not lipid profile and diet quality in diabetic nephropathy patients.

Objectives: Diabetic nephropathy may adversely influence on sleep duration. The quality of diet may also be affected by both sleep duration and diabetes nephropathy. Therefore, lower diet quality in short sleepers-diabetic nephropathy patients might be related to higher metabolic abnormalities. In the present study, we investigated if sleep duration is related to diet quality indices and biochemical markers in diabetic nephropathy patients. Method: This cross-sectional study was conducted among 237 diabetic nephropathy patients, randomly selected from patients attending in the Alzahra University Hospital, Isfahan, Iran. Usual dietary intake was assessed using validated food frequency questionnaire. Diet quality indices (including diet diversity score, dietary energy density, mean adequacy ratio, and nutrient adequacy ratio) were calculated based on standard definitions. Sleep duration was estimated using self-reported nocturnal hours of sleep. Results: Short sleepers (5-6 h) had higher blood urea nitrogen and creatinine compared with those who slept more than 7.5 h (20.26 + 0.23 mg/dl vs. 17.61 + 0.30 mg/dl, P < 0.0001, and 1.98 + 0.27 mg/dl vs. 1.90 + 0.24 mg/dl, P = 0.03, respectively). Serum triglyceride levels were positively correlated with sleep duration (P = 0.02). Diet quality indices were not significantly associated with sleep duration. Conclusion: Higher sleep duration is significantly related to lower kidney-related biomarkers in diabetic nephropathy patients. Diet quality indices were not associated with sleep duration in diabetic nephropathy patients. More longitudinal studies are required to evaluate the associations of sleep duration, diet quality and biochemical markers in diabetic nephropathy patients.

Dietary patterns by reduced rank regression are associated with obesity and hypertension in Australian adults.

Evidence linking dietary patterns (DP) and obesity and hypertension prevalence is inconsistent. We aimed to identify DP derived from energy density, fibre and sugar intakes, as well as Na, K, fibre, SFA and PUFA, and investigate associations with obesity and hypertension. Adults (n 4908) were included from the cross-sectional Australian Health Survey 2011-2013. Two 24-h dietary recalls estimated food and nutrient intakes. Reduced rank regression derived DP with dietary energy density (DED), fibre density and total sugar intake as response variables for obesity and Na:K, SFA:PUFA and fibre density as variables for hypertension. Poisson regression investigated relationships between DP and prevalence ratios (PR) of overweight/obesity (BMI≥25 kg/m2) and hypertension (blood pressure≥140/90 mmHg). Obesity-DP1 was positively correlated with fibre density and sugars and inversely with DED. Obesity-DP2 was positively correlated with sugars and inversely with fibre density. Individuals in the highest tertile of Obesity-DP1 and Obesity-DP2, compared with the lowest, had lower (PR 0·88; 95 % CI 0·81, 0·95) and higher (PR 1·09; 95 % CI 1·01, 1·18) prevalence of obesity, respectively. Na:K and SFA:PUFA were positively correlated with Hypertension-DP1 and inversely correlated with Hypertension-DP2, respectively. There was a trend towards higher hypertension prevalence in the highest tertile of Hypertension-DP1 compared with the lowest (PR 1·18; 95 % CI 0·99, 1·41). Hypertension-DP2 was not associated with hypertension. Obesity prevalence was inversely associated with low-DED, high-fibre and high-sugar (natural sugars) diets and positively associated with low-fibre and high-sugar (added sugars) diets. Hypertension prevalence was higher on low-fibre and high-Na and SFA diets.

Using reduced rank regression methods to identify dietary patterns associated with obesity: a cross-country study among European and Australian adolescents.

This study aims to examine repeatability of reduced rank regression (RRR) methods in calculating dietary patterns (DP) and cross-sectional associations with overweight (OW)/obesity across European and Australian samples of adolescents. Data from two cross-sectional surveys in Europe (2006/2007 Healthy Lifestyle in Europe by Nutrition in Adolescence study, including 1954 adolescents, 12-17 years) and Australia (2007 National Children's Nutrition and Physical Activity Survey, including 1498 adolescents, 12-16 years) were used. Dietary intake was measured using two non-consecutive, 24-h recalls. RRR was used to identify DP using dietary energy density, fibre density and percentage of energy intake from fat as the intermediate variables. Associations between DP scores and body mass/fat were examined using multivariable linear and logistic regression as appropriate, stratified by sex. The first DP extracted (labelled 'energy dense, high fat, low fibre') explained 47 and 31 % of the response variation in Australian and European adolescents, respectively. It was similar for European and Australian adolescents and characterised by higher consumption of biscuits/cakes, chocolate/confectionery, crisps/savoury snacks, sugar-sweetened beverages, and lower consumption of yogurt, high-fibre bread, vegetables and fresh fruit. DP scores were inversely associated with BMI z-scores in Australian adolescent boys and borderline inverse in European adolescent boys (so as with %BF). Similarly, a lower likelihood for OW in boys was observed with higher DP scores in both surveys. No such relationships were observed in adolescent girls. In conclusion, the DP identified in this cross-country study was comparable for European and Australian adolescents, demonstrating robustness of the RRR method in calculating DP among populations. However, longitudinal designs are more relevant when studying diet-obesity associations, to prevent reverse causality.

Dietary energy density and body weight changes after 3 years in the PREDIMED study.

The association of dietary energy density (ED) and overweight is not clear in the literature. Our aim was to study in 4259 of the PREDIMED trial whether an increase in dietary ED based on a higher adherence to a Mediterranean dietary pattern was associated with 3-year weight gain. A validated 137-item food-frequency questionnaire was administered. Multivariable-adjusted models were used to analyze the association between 3-year ED change and the subsequent 3-year body weight change. The most important weight reduction after 3-year follow-up was observed in the two lowest quintiles and the highest quintile of ED change. The highest ED increase was characterized by an increased intake of extra virgin olive oil (EVOO) and nuts and a decreased intake of other oils, vegetable and fruit consumption (p < .001). In conclusion, increased 3-year ED in the PREDIMED study, associated with a higher EVOO and nuts consumption, was not associated with weight gain.

White Rice Consumption, Body Mass Index, and Waist Circumference among Iranian Female Adolescents.

OBJECTIVE: Refined grains consumption is positively associated with obesity. White rice is the most usual refined grain in Iran. However, few studies have assessed the association between rice intake and anthropometric measures among adolescents. Therefore, we aimed to compare anthropometric measures as well as the diet quality indices across the tertiles of white rice consumption among Iranian adolescents. METHODS: This cross-sectional study was conducted on 415 female adolescents who were chosen by using a systematic cluster random sampling. Dietary intake assessment was done using a validated semiquantitative food frequency questionnaire. Anthropometric measures were done according to the standard protocols. Diet quality indices (including dietary energy density [DED], nutrient adequacy ratio [NAR], and mean adequacy ratio [MAR]) were calculated using standard definitions. RESULTS: The prevalence of overweight across the tertiles of rice consumption was 11.6, 17.8, and 24.6%, respectively (p = 0.03). Corresponding values for obesity were 2.1, 5.7, and 8.6%, respectively (p = 0.04). A significant positive association was observed for the prevalence of central obesity across the tertile of rice intake (13.1, 21.4, and 28.1%; p = 0.02). Dietary fiber and energy intake and diet quality indices were significantly different among different tertiles of white rice intake. Those in the highest tertiles of white rice intake had the lowest scores for MAR and NAR and highest scores for DED. CONCLUSION: There was significant association between rice consumption and obesity as well as diet quality indices among Iranian adolescents.

The independent prospective associations of activity intensity and dietary energy density with adiposity in young adolescents.

There is limited evidence on the prospective association of time spent in activity intensity (sedentary (SED), moderate (MPA) or vigorous (VPA) physical activity) and dietary intake with adiposity indicators in young people. This study aimed to assess associations between (1) baseline objectively measured activity intensity, dietary energy density (DED) and 4-year change in adiposity and (2) 4-year change in activity intensity/DED and adiposity at follow-up. We conducted cohort analyses including 367 participants (10 years at baseline, 14 years at follow-up) with valid data for objectively measured activity (Actigraph), DED (4-d food diary), anthropometry (waist circumference (WC), %body fat (%BF), fat mass index (FMI), weight status) and covariates. Linear and logistic regression models were fit, including adjustment for DED and moderate-to-vigorous physical activity. Results showed that baseline DED was associated with change in WC (ß for 1kJ/g difference: 0·71; 95% CI 0·26, 1·17), particularly in boys (1·26; 95% CI 0·41, 2·16 v. girls: 0·26; 95% CI -0·34, 0·87), but not with %BF, FMI or weight status. In contrast, baseline SED, MPA or VPA were not associated with any of the outcomes. Change in DED was negatively associated with FMI (ß for 1kJ/g increase: -0·86; 95% CI -1·59, -0·12) and %BF (-0·86; 95% CI -1·25, -0·11) but not WC (-0·27; 95% CI -1·02, 0·48). Change in SED, MPA and VPA did not predict adiposity at follow-up. In conclusion, activity intensity was not prospectively associated with adiposity, whereas the directions of associations with DED were inconsistent. To inform public health efforts, future studies should continue to analyse longitudinal data to further understand the independent role of different energy-balance behaviours in changes in adiposity in early adolescence.

Dietary energy density was associated with diet quality in Brazilian adults and older adults.

Cross-sectional and longitudinal studies present association of low dietary energy density with higher intake of vitamins, minerals and dietary fiber, lower intake of fat, and better balance of macronutrients. The objective of this study was to verify the relationship between dietary energy density and diet quality measured by an index of diet quality. This study used data from 496 adults and 445 older adults of cross-sectional population-based survey from São Paulo conducted in 2008-2009, Brazil. Dietary intake data was assessed by two 24-h dietary recalls. Dietary energy density values were calculated based on foods only method. Dietary energy density and revised Brazilian Health Eating Index and its components, were estimated by usual intake using Multiple Source Method. The relationship between dietary energy density and the total revised Brazilian Health Eating Index and its components were assessed by Gaussian family log-link model for each age group. The analyses showed an inverse association between dietary energy density and total revised Brazilian Health Eating Index in adults (T2:ß = 0.96, p < 0.001; T2:ß = 0.86, p < 0.001) and older adults (T2:ß = 0.96, p < 0.001; T2:ß = 0.90, p < 0.001), and an inverse association between dietary energy density and nine of twelve revised Brazilian Health Eating Index components in adult and/or older adults groups. Dietary energy density was associated with diet quality in Brazilian adults and older adults regardless of sex, per capita household income, body mass index, physical activity level, current smoking habits status, alcohol beverage drinking status and usual energy intake (kilocalories) from beverages.

Usual Dietary Energy Density Distribution Is Positively Associated with Excess Body Weight in Mexican Children.

BACKGROUND: Studies suggest a positive association between dietary energy density (DED) and body weight in adults, but evidence in children is inconclusive. OBJECTIVE: The objective of this study was to compare usual DED distributions of nonoverweight vs. overweight or obese (OW/O) Mexican children. METHODS: The study used 24-h recall (24HR) data from 2367 children aged 5-11 y from the 2012 Mexican National Health and Nutrition Survey (ENSANUT 2012). Repeated 24HR measures were obtained in a random sample (∼10%) to estimate usual intake distributions by using the Iowa State University (PC-Side) method. Implausible dietary reports were identified. Multivariate linear regression models were used to evaluate the relation between DED and body mass index status and to compare results with and without PC-Side adjustment and restriction to plausible reporters. RESULTS: A total of 35.1% of the children in the sample were OW/O. The usual DED mean was ∼175 kcal/100 g in both the complete sample and the plausible reporters subsample. Regression models adjusted by PC-Side and for potential confounders showed higher DED in OW/O relative to nonoverweight children for both plausible reporters (9.7 kcal/100 g; n = 1452, P < 0.0001) and the complete sample (7.9 kcal/100 g; n = 2367, P < 0.0001). The DED difference in plausible reporters translates into 88 additional kilocalories in daily energy intake of OW/O children. In the absence of PC-side adjustment, the difference was significant for plausible reporters (P < 0.05) but not for the complete sample (P > 0.10). CONCLUSIONS: A positive association between usual DED and OW/O was found in Mexican children. The association was stronger when only plausible reporters were considered. This suggests that there is a need for strategies to reduce energy density in the diet of Mexican children.

Dietary Energy Density Is Associated with Biomarkers of Chronic Diseases-A Cross-Sectional Study of School-Aged Children in Rural Mexico.

Background: Dietary energy density (DED) is associated with chronic disease markers in adults. However, results in children are still controversial. Objective: To evaluate the DED of children and its association with obesity and biomarkers of chronic disease. Methods: In this cross-sectional study, we recruited 284 children (6-10 y) from rural Mexico. Dietary intake was assessed using three 24-h recalls. DED was calculated for "foods only" (DEDfo) and for "foods and beverages" (DEDfb). Weight, height, and body fat percent (dual-energy X-ray absorptiometry) were measured. Inflammatory cytokines, lipid profile, leptin, and insulin resistance were determined from a fasting blood sample. Results: DEDfo was 1.91 ± 0.36 kcal/g and DEDfb was 1.36 ± 0.31 kcal/g. Higher DEDfo and DEDfb were associated with higher risk to have insulin resistance [odds ratio (OR) = 3.92, 95% confidence interval (CI): 1.66, 9.22, P < 0.01; OR = 3.51, 95% CI: 1.25, 9.87, P = 0.02, respectively]. Higher DEDfo was associated with higher risk of higher leptin levels (OR = 3.17, 95% CI: 1.01, 10.23). Also, DEDfo and DEDfb were associated with higher concentrations of cholesterol (ß = 11.67, 95% CI: 1.81, 19.53, P = 0.03; and ß = 11.74, 95% CI: 2.69, 20.74 P = 0.01, respectively) and higher odds of having high insulin concentrations (OR = 2.52, 95% CI: 1.26, 5.06, P = 0.01; and OR = 2.95, 95% CI: 1.30, 6.70, P = 0.01). DEDfo and DEDfb were not associated with any measure of obesity and inflammatory cytokines in the adjusted models. Conclusions: DED was associated with higher leptin and cholesterol concentrations, and having insulin resistance, but not with any measure of obesity or inflammation. Reducing DED may reduce risk of cardiovascular disease and improve insulin sensitivity in school-aged children.

Effects of feeding high-energy diet on growth performance, blood parameters, and carcass traits in Hanwoo steers.

OBJECTIVE: Our study aimed to investigate the effects of a 2% increase in dietary total digestible nutrients (TDN) value during the growing (7 to 12 mo of age) and fattening (13 to 30 mo of age) period of Hanwoo steers. METHODS: Two hundred and twenty Hanwoo steers were assigned to one of two treatments: i) a control group (basal TDN, BTDN, n = 111 steers, growing = 70.5%, early fattening = 71.0%, late fattening = 74.0%) or high TDN (HTDN, n = 109 steers, growing = 72.6%, early = 73.1%, late = 76.2%). Growth performance, carcass traits, blood parameters, and gene expression of longissimus dorsi (LD) (7, 18, and 30 mo) were quantified. RESULTS: Steers on the BTDN diets had increased (p≤0.02) DMI throughout the feeding trial compared to HTDN, but gain did not differ appreciably. A greater proportion of cattle in HTDN received Korean quality grade 1 (82%) or greater compared to BTDN (77%), while HTDN had a greater yield grade (29%) than BTDN (20%). Redness (a*) of LD muscle was improved (p = 0.021) in steers fed HTDN. Feeding the HTDN diet did not alter blood parameters. Steers fed HTDN diet increased (p = 0.015) the proportion of stearic acid and tended to alter linoleic acid. Overall, saturated, unsaturated, monounsaturated, and polyunsaturated fatty acids of LD muscle were not impacted by the HTDN treatment. A treatment by age interaction was noted for mRNA expression of myosin heavy chain (MHC) IIA, IIX, and stearoyl CoA desaturase (SCD) (p≤0.026). No treatment effect was detected on gene expression from LD muscle biopsies at 7, 18, and 30 mo of age; however, an age effect was detected for all variables measured (p≤0.001). CONCLUSION: Our results indicated that feeding HTDN diet could improve overall quality grade while minimum effects were noted in gene expression, blood parameters, and growing performance. Cattle performance prediction in the feedlot is a critical decisionmaking tool for optimal planning of cattle fattening and these data provide both benchmark physiological parameters and growth performance measures for Hanwoo cattle feeding enterprises.

Longitudinal Association of Dietary Energy Density with Abdominal Obesity among Chinese Adults from CHNS 1993-2018.

Few studies have explored the longitudinal association between dietary energy density and waist circumference and abdominal obesity in adults in China. This study aimed to analyze the relationship between dietary energy density and waist circumference and abdominal obesity in Chinese residents aged 18-64. Using data from the CHNS from 1993 to 2018, 25,817 adult residents aged 18 to 64 were selected for the study. Three consecutive 24-h dietary recalls and home-weighed seasonings were used to assess food intake. A multilevel model was used to analyze the relationship between dietary energy density and waist circumference and abdominal obesity. The results showed that compared with the lowest dietary energy density group, females had an increased risk of abdominal obesity (OR = 1.16, 95% CI: 1.05, 1.29), and females' waist circumference increased significantly by 0.24 cm (95% CI: 0.39-1.09) in the highest dietary energy density group. No association between dietary energy density and waist circumference and abdominal obesity was observed in males. This study shows that higher dietary energy density is significantly associated with females' waist circumference and abdominal obesity. Further research on high dietary energy density and abdominal obesity will provide scientific basis for the effective control of abdominal obesity.