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.
Highlights
This study aimed to identify the predictors of dietary energy density (DED) among a sample of Australian preschool children using age-appropriate DED calculation methods
There were several significant relationships between the potential predictors and the energy density variables but the most consistent relationships were those between home availability of fruits and non-core snacks with DED, with significant associations found for DEDfood and DEDfood+dairy beverages
Mean DED values were slightly lower for children in the present study than those reported among preschool children in the United States (US) [17]
Summary
The World Health Organization estimated that 42 million children aged five years and under were overweight or obese in 2015, and these rates are expected to rise to 70 million by 2025 if current trends continue [1]. In Australia, approximately one in five children aged between two and four years is classified as overweight or obese [2]. Childhood obesity is associated with wide-ranging health and social risks [3] and it tends to track into adolescence and adulthood, with additional risks of negative health outcomes [3,4]. While the etiology of obesity is complex, energy intakes above energy requirements are a key contributor. A systematic review by the 2010 Dietary Guidelines Advisory Committee in the United States (US) concluded that
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