Poole S A, Hart C N, Jelalian E, Raynor H A
Department of Nutrition, University of Tennessee, Knoxville, TN, USA.
Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA.
Pediatr Obes. 2016 Apr;11(2):128-35. doi: 10.1111/ijpo.12034. Epub 2015 Apr 24.
Observational research has found that lower energy density (ED) diets are related to reduced intake of fat and greater intake of fruits and vegetables. No study has examined the relationship between dietary ED and dietary quality, as determined by the Healthy Eating Index-2005 (HEI), in children who are overweight and obese.
Examine the relationship between dietary ED and HEI, determined from 3-d food records, in 156 children, aged 4-9 years, who had ≥85th percentile body mass index presenting for family-based obesity treatment.
Dietary ED, in kcal/g, was calculated using two methods: food and all beverages consumed (food+bev) and food only consumed (food). For calculation of HEI, all components of the HEI were included except oils.
Participants were classified as consuming a low-ED, medium-ED or high-ED diet using tertile cut-off points with ED calculated using food and beverages(food+bev) or food only(food) . After controlling for group difference in child sex and race and parent sex, LOW(food+bev) and LOWfood had significantly (P < 0.05) higher total HEI scores, and total fruit, total vegetable and saturated fat HEI scores than HIGH(food+bev) and HIGHfood , with higher scores indicating greater quality.
Lower dietary ED is associated with higher dietary quality in children presenting for obesity treatment. Additional research investigating an ED prescription on dietary quality in children who are overweight or obese is needed to better understand this relationship.
观察性研究发现，较低能量密度（ED）的饮食与脂肪摄入量减少以及水果和蔬菜摄入量增加有关。尚无研究探讨超重和肥胖儿童的饮食ED与由2005年健康饮食指数（HEI）所确定的饮食质量之间的关系。
在156名4至9岁、体重指数处于≥第85百分位数且前来接受家庭肥胖治疗的儿童中，研究通过3天食物记录确定的饮食ED与HEI之间的关系。
采用两种方法计算以千卡/克为单位的饮食ED：食用的所有食物和饮料（食物+饮料）以及仅食用的食物（食物）。在计算HEI时，除油脂外，纳入了HEI的所有组成部分。
使用三分位数切点将参与者分为低ED、中ED或高ED饮食组，ED分别采用食物和饮料（食物+饮料）或仅食物（食物）来计算。在控制了儿童性别、种族以及父母性别的组间差异后，低（食物+饮料）组和低食物组的总HEI得分、水果总量、蔬菜总量和饱和脂肪HEI得分显著高于高（食物+饮料）组和高食物组（P<0.05），得分越高表明质量越高。
接受肥胖治疗的儿童中，较低的饮食ED与较高的饮食质量相关。需要进一步开展研究，调查针对超重或肥胖儿童的饮食质量的ED处方，以更好地理解这种关系。
