Dietary energy density and its association with the nutritional quality of the diet of children and teenagers

To examine the relationship between dietary energy density (DED) and the nutritional quality of the diet, using data from the Irish National Children's Food Survey (NCFS) and the National Teens' Food Survey (NTFS), two cross-sectional studies of food consumption were carried out between 2003 and 2006. Data from the NCFS and NTFS were used to examine the intakes of nutrients and foods among those with low- (NCFS <7·56, NTFS <7·65 kJ/g), medium- (NCFS 7·56-8·75, NTFS 7·66-8·85 kJ/g) and high-energy-dense diets (NCFS >8·75, NTFS >8·85 kJ/g). A 7-d food diary was used to collect food intake data from children (n 594) and teenagers (n 441). DED (kJ/g) was calculated including food alone and excluding beverages. Participants with lower DED consumed more food (weight) but not more energy. They also consumed less fat and added sugars and more protein, carbohydrates, starch and dietary fibre and had higher intakes of micronutrients. Participants with lower DED had food intake patterns that adhered more closely to food-based dietary guidelines. Low DED was associated with multiple individual indicators of a better nutritional quality of the diet, including higher intakes of dietary fibre and micronutrients and a generally better balance of macronutrients, as well as being associated with food intake patterns that were closer to healthy eating guidelines. Taken together, these findings support the conclusion that a low DED may be an indicator of a better nutritional quality of the diet.