BACKGROUND: Evidence for the dietary determinants of obesity in children is limited. OBJECTIVE: The objective was to identify a dietary pattern that explained dietary energy density (DED), fiber density (FD), and percentage of energy intake from fat and analyze its relation to fatness in children. DESIGN: The subjects were 521 (at ages 5 and 9 y) and 682 (at ages 7 and 9 y) children participating in the Avon Longitudinal Study of Parents and Children. Diet was assessed with the use of 3-d diet diaries at ages 5 and 7 y. Reduced rank regression derived a dietary pattern with the use of DED, fiber, and fat intake as intermediate variables. Fat mass was measured at age 9 y with the use of dual-energy X-ray absorptiometry. Fat mass index (FMI) was calculated, and excess adiposity was defined (as the top quintile of logFMI). RESULTS: Pattern score at ages 5 and 7 y was correlated with DED (r = 0.8), FD (r = -0.7), and percentage of energy intake from fat (r = 0.5). An increase of 1 SD of pattern score at ages 5 and 7 y, respectively, was associated with a 0.15-kg (95% CI: -0.1, 0.45 kg) and a 0.28-kg (95% CI: 0.05, 0.53 kg) higher fat mass at age 9 y, after controlling for confounders. The adjusted odds of excess adiposity at age 9 y for children in quintile 5 compared with quintile 1 of dietary pattern score at ages 5 and 7 y, respectively, were 2.52 (95% CI: 1.13, 6.08) and 4.18 (95% CI: 2.07, 9.38). CONCLUSION: An energy-dense, low-fiber, high-fat diet is associated with higher fat mass and greater odds of excess adiposity in childhood.


Journal article


Am J Clin Nutr

Publication Date





846 - 854


Absorptiometry, Photon, Adipose Tissue, Adiposity, Analysis of Variance, Body Composition, Child, Child, Preschool, Cohort Studies, Dietary Fats, Dietary Fiber, Energy Intake, Female, Humans, Linear Models, Longitudinal Studies, Male, Obesity, Risk Factors