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

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Background Dietary energy density (DED) is associated with chronic disease markers in adults. However, results in children are still controversial. Objective 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 years) from rural Mexico. Dietary intake was assessed using three 24-h recalls. DED was calculated for "foods only" (DED fo ) and for "foods and beverages" (DED fb ). 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 DED fo was 1.91±0.36 kcal/g and DED fb was 1.36±0.31 Kcal/g. Higher DED fo and DED fb were associated with higher risk to have insulin resistance (OR=3.92, 95%CI=1.66 to 9.22, p<0.01; OR=3.51, 95%CI=1.25 to 9.87, p=0.02, respectively). Higher DED fo was associated with higher risk of higher leptin levels (OR=3.17, 95%CI=1.01 to 10.23). Also, DED fo and DED fb were associated with higher concentrations of cholesterol (β=11.67, 95%C.I.= 1.81 to 19.53 p=0.03; and β=11.74, 95%C.I.= 2.69 to 20.74 p=0.01, respectively) and higher odds of having high insulin concentrations (OR=2.52, 95%CI=1.26 to 5.06 p=0.01 and OR=2.95, 95%CI=1.30 to 6.70 p=0.01). DED fo and DED fb 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 the risk of cardiovascular disease and improve insulin sensitivity in school-aged children. Statement of significance We evaluated for the association between dietary energy density with biomarkers of inflammation and chronic diseases in children and reported the dietary energy density of children from rural Mexico.

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