Jacqueline A. Vernarelli

Dietary Energy Density Is Associated with Body Weight Status and Vegetable Intake in U.S. Children

The objective was to determine the relationship between dietary energy density (ED; kcal/g) and measured weight status in children. The present study used data from a nationally representative sample of 2442 children between 2 and 8 y old who participated in the 2001-2004 NHANES. Survey measures included 24-h dietary recall data, measurement of MyPyramid servings of various food groups, and anthropometry. The relationship among dietary ED, body weight status as calculated using the 2000 CDC growth charts, and food intake was evaluated using quartiles of ED. Additionally, other dietary characteristics associated with ED among children are described. Specific survey procedures were used in the analysis to account for sample weights, unequal selection probability, and the clustered design of the NHANES sample. In this sample, dietary ED was positively associated with body weight status in U.S. children aged 2-8 y. Obese children had a higher dietary ED than lean children (2.08 ± 0.03 vs. 1.93 ± 0.05; P = 0.02). Diets high in ED were also found to be associated with greater intakes of energy and added sugars, more energy from fat; and significantly lower intake of fruits and vegetables. Interventions that lower dietary ED by means of increasing fruit and vegetable intake and decreasing fat consumption may be an effective strategy for reducing childhood obesity.

Dietary Energy Density Is Positively Associated with Breast Density among Young Women

BACKGROUND Breast density is an established predictor of breast cancer risk, and there is considerable interest in associations of modifiable lifestyle factors, such as diet, with breast density. OBJECTIVE To determine whether dietary energy density (ED) is associated with percent dense breast volume (%DBV) and absolute dense breast volume (ADBV) in young women. DESIGN A cross-sectional analysis was conducted with women who participated in the Dietary Intervention Study in Children Follow-Up Study. %DBV and ADBV were measured by magnetic resonance imaging. Diet was assessed by three 24-hour recalls. Dietary ED (kilocalories/gram) was calculated using three methods: food only, food and caloric beverages, and food and all beverages. PARTICIPANTS/SETTING One hundred seventy-two women (aged 25 to 29 years) who were enrolled in the Dietary Intervention Study in Children Follow-Up Study. Participants who reported breast augmentation or reduction surgery or were pregnant or lactating within 3 months before breast density assessment were excluded. MAIN OUTCOME MEASURES ADBV and %DBV. STATISTICAL ANALYSES PERFORMED Multivariable linear mixed effects models were used. Final models were adjusted for race, smoking status, education, parity, duration of sex hormone use, whole body percent fat, childhood body mass index z score, and energy from beverages. RESULTS After adjustment, each 1 kcal/g unit increase in food-only ED was associated with a 25.9% (95% CI 6.2% to 56.8%) increase in %DBV (P=0.01). Childhood body mass index z score modified the association between food-only ED and %DBV such that a significant positive association was observed only in women who were heavier as children. Food-only ED was not associated with ADBV in all women, but a borderline significant positive association was observed in women who had higher childhood body mass index z scores. CONCLUSIONS This is the first report to suggest a potential role for dietary ED in breast density; the effects of long-term exposure to high-ED diets on breast cancer risk remain unknown.

Is Usual Dietary Pattern Related to the Risk of Developing Breast Cancer

Dietary patterns capture total diet providing a more comprehensive understanding of the effect of diet on chronic disease risk. Dietary patterns have been associated with several chronic diseases, including cardiovascular disease and selected cancers; however, the association with breast cancer remains unclear. The objective of this review was to examine critically the most recent literature on dietary patterns and breast cancer and report on current results, new developments, and future directions. Seven case–control and cohort studies from multiple countries have been published during the previous year (2011–2012). Many have analyzed a posteriori dietary patterns via factor and principal component analysis. Whereas results remain mixed, the majority of studies indicate healthier patterns decrease breast cancer risk, although patterns higher in meat and alcohol increase risk. Future studies that examine the associations between diet and tumor subtypes and collect dietary data at younger ages and, if possible, longitudinally would be beneficial.