Applied nutritional investigationEnergy density, diet quality, and central body fat in a nationwide survey of young Spaniards

ObjectivesTo determine the impact of energy density on diet quality and anthropometric proxy measures for central body fat in young Spaniards.MethodsData were obtained from a representative national sample of 2513 young Spaniards aged 10 to 24 y. Dietary assessment was performed with a 24-h recall. Adherence to the Mediterranean diet was measured by the KIDMED index. Reduced rank regression analysis was used to identify energy-density dietary patterns. Waist circumferences and height were measured.ResultsPastries and sausages showed the strongest loading for the dietary energy density factor score (DED-FS), with fruits and vegetables at the opposite end of the scale. Multiple linear regression analysis showed a positive association (P < 0.01) of dietary energy density (DED) and the DED-FS with waist circumferences regressed on height and age (WCheight+age) and waist-to-height ratio (WHtR). The adjusted odds ratio for elevated WCheight+age and WHtR increased across quartile distribution of DED (P < 0.001) and DED-FS (P < 0.05). Diet quality characterized by the KIDMED index was negatively associated (P < 0.001) with DED and the DED-FS.ConclusionsHigher DED is a risk for increased central fat distribution and is associated with low adherence to the Mediterranean diet.