Dietary energy density increases during early childhood irrespective of familial predisposition to obesity: Results from a prospective cohort study

Objective: This study compared 4-year changes in daily energy density (ED; kcal/g) in children born at different risk for obesity, characterized the stability of ED and examined associations between ED and child body composition. Design: Prospective cohort study to measure habitual dietary ED of children who are born at different risk for obesity. Subjects: Children who were born at high risk (n=22) or low risk (n=27) for obesity based on maternal pre-pregnancy weight. Measurements: Three-day food records were collected from children's mothers at child ages 3, 4, 5 and 6 years. Three categories of ED were computed (food only, food and milk, and food and all beverages) and body composition assessed at each year. Results: The mean (±s.e.m.) ED increased over time across all children (linear trend: P<0.003): 2.18±0.07 to 2.32±0.06 kcal/g (food only); 1.66±0.07 to 1.82±0.06 kcal/g (food and milk); and 1.24±0.04 to 1.37±0.05 kcal/g (food and all beverages). Intraindividual coefficients of variation were smaller than those previously reported for adults. Weight indices were not correlated with dietary ED (P>0.05). Conclusion: Dietary ED increased in young children, irrespective of their predisposition to obesity, between the ages of 3 and 6 years. The genes that promote childhood obesity may not exert their influence through dietary ED, which may be more strongly influenced by environmental factors.