Abstract
BackgroundEvidence for the effect of dietary energy on BMI z-scores in young children is limited. We aim to investigate cross-sectional and longitudinal effects of daily energy intake (EI) on BMI z-scores of European boys and girls considering growth-related height dependencies of EI using residual EI.MethodsTo investigate cross-sectional and longitudinal effects of daily energy intake (EI) on BMI z-scores of European boys and girls considering growth-related height dependencies of EI using residual EI.MethodsSubjects were children aged 2- < 10 y old (N = 2753, 48.2 % girls) participating in the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) baseline and follow-up examination. Usual EI (kcal/day) was calculated based on the National Cancer Institute-method excluding subjects with implausible reported EI. Effect of age, height and sex-adjusted residuals of EI on BMI z-score was investigated stratified by baseline age –group (2- < 4 y, 4- < 6 y, 6- < 8 y and 8- < 10 y) cross-sectionally using linear regression models adjusted for relevant confounders (crude model: age, sex, country; fully adjusted model: plus parental ISCED level, parental BMI, screen time; subgroup analysis: plus objectively measured physical activity). Longitudinal associations were estimated between changes in (Δ) residual EI per year and ΔBMI z-score per year with adjustments analogously to the cross-sectional models but with additional adjustment for residual EI at baseline.ResultsCross-sectionally, positive associations were observed between residual EI and BMI z-score for the full study sample, for boys and in older (≥6 years) but not in younger children in the crude and fully adjusted model. Longitudinally, small positive associations were observed between Δresidual EI per y on ΔBMI z-score per y for the full study sample and in 4- < 6 y olds in the crude and fully adjusted model.ConclusionIn conclusion, EI above the average intakes for a certain sex, age and height are weakly associated with BMI z-scores in European children. Residual EI may be considered as a useful exposure measure in children as it accounts for growth-related changes in usual EI during childhood.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-016-0344-3) contains supplementary material, which is available to authorized users.
Highlights
Evidence for the effect of dietary energy on Body Mass Index (BMI) z-scores in young children is limited
In conclusion, energy intake (EI) above the average intakes for a certain sex, age and height are weakly associated with BMI z-scores in European children
Residual EI may be considered as a useful exposure measure in children as it accounts for growth-related changes in usual EI during childhood
Summary
Evidence for the effect of dietary energy on BMI z-scores in young children is limited. We aim to investigate cross-sectional and longitudinal effects of daily energy intake (EI) on BMI z-scores of European boys and girls considering growth-related height dependencies of EI using residual EI. The IDEFICS (Identification and Prevention of Dietary- and Lifestyle-induced Health Effects in Children and Infants) study reported an obesity prevalence of 7 % and an overweight prevalence of 13 % among European children under 10 y of age [2]. Cross-sectional studies in children and adolescents found associations between EI and Body Mass Index (BMI) z-score [5, 6]. Data on longitudinal associations between energy intake and weight development in pre-school children and school children are scarce and inconsistent. In adolescents EI was found to be influenced by PA, whereas PA was associated with lower body fat mass/BMI. EI in childhood and youth is influenced by energy demands and varies over time depending on growth [14] such that absolute EI values cannot be directly compared between children of different ages
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