Great interests have been drawn to the quality of diet. Dietary energy density is a good indicator of diet quality. In spite of the comprehensive concept of energy density rather than energy intake, no studies have evaluated the dietary energy density of lactating mothers. The purpose of the current study was to evaluate the association between dietary energy density and infants’ growth.
Dietary intake data were collected from 300 lactating mothers through the 168-item food frequency questionnaire. Data on physical activity were reported by participant’s responding International Physical Activity Questionnaire (IPAQ). The anthropometric features were taken from the health records in health centers.
Findings: Infants’ weight, height, head circumference, and weight for height at birth, and 2 and 4 months later were not significantly different within any of 4 categories of energy density.
The results of this study suggest that there is no association between quartiles of mothers’ dietary energy density and infants’ weight, length, weight for length, and head circumference growth by the age of 2 and 4 months.

Although several studies have assessed the relationship between dietary energy density and obesity, limited data are available in this regard in Iran. This study aimed to assess the association between dietary energy density and general and abdominal obesity among female students of School of Public Health, Isfahan University of Medical Sciences. In this cross-sectional study, 90 female students of School of Public Health were selected proportionally to size by cluster random sampling method. Usual dietary intakes were evaluated by the use of a 168-item semi-quantitative food frequency questionnaire. Weight, height and waist circumference were assessed. General obesity was defined as having body mass index ≥ 30 kg/m2 and abdominal obesity as having waist circumference ≥ 80 cm. Mean BMI, dietary energy density and total energy intake of participants were 21.1 kg/m2, 87.0 kcal/g and 2122 kcal, respectively. General and abdominal obesity were prevalent among 9% and 8.9% of students, respectively. A significant negative association was found between dietary energy density and BMI (β=-4.9, P=0.03), even after adjustment for potential confounders (β=5.4, P=0.04). Waist circumference was not associated with dietary energy density. Although the prevalence of obesity was not different between tertiles of dietary energy density, it seems that BMI is significantly associated with this variable.

Dietary energy density and dietary diversity score (DDS) are two representative factors of dietary quality. In the current study we evaluated these factors in Isfahanian youths.

This cross-sectional study was conducted on 289 healthy female youths who were randomly selected from students of Isfahan university of medical sciences. A validated semi quantitative food frequency questionnaire was used to assess the usual dietary intakes. Dietary energy density was calculated as each individual’s reported daily energy intake (kcal/d) into total weight of foods (excluding beverages) consumed (g/d). DDS was calculated based on scoring to the five food groups of the food guide pyramid.

Mean dietary energy density was 1.60±0.29 kcal/g. Individuals in top tertile of dietary energy density had the lowest mean of the dietary diversity score (means among tertiles:1st: 9.61±1.92, 2nd: 6.98±1.22, 3rd: 3.63±1.02; P<0.05), as well as diversity score of the vegetable (1.91±0.33, 1.54±0.26, 1.11±0.2; P<0.01) and fruit (1.98±0.72, 1.89±0.66, 1.44±0.3; P<0.05). Those in the top tertile of dietary diversity score had the lowest mean of the dietary energy density (2.08±0.36, 1.69±0.31, 1.38±0.25; P<0.05). There was an inverse and significant association between dietary energy density and DDS (r=-0.3; P=0.03).

There were inverse associations among DDS and dietary energy density in Isfahanian female youths. However further prospective investigations are needed to confirm this finding.

Mood disorders such as depression, anxiety, stresses, and low sleep quality are common among overweight / obese people. Accumulating evidence support the role of diet quality in brain function and behavior. This study was done to determine the relationship between dietary energy density and indices of mental health in overweight and obese women.

This descriptive-analytical study was performed on 301 women, referring to Tehran health centers, with mean BMI 30.7±3.7 kg/m2 aged 18-56 years during 2017-18. Based on a semi-quantitative food frequency questionnaire, dietary energy density was calculated by dividing the total dietary energy intake from consumed food (kcal/d) by the total weight (g/d) of consumed foods (excluding beverages). Physical activity was measured using International Physical Activity Questionnaire (IPAQ). The questionnaire includes 7 items to assess the intensity of activities by the vigorous, medium, and light for at least 10 minutes during the last week. Mental health was assessed using the 21-question version of the Depression Anxiety Stress Scales (DASS-21) and the Pittsburgh Sleep Quality Index was applied for screening sleep quality. Weight, height, BMI, hip, and waist circumference were measured for all participants.

Women in the highest quartile of dietary energy density had higher systolic and diastolic blood pressure but lower serum triglyceride (P<0.05), compared with subjects in the first quartile. Univariate (95% CI: 1.01-4.56, P=0.04, OR=2.15) and multivariate (95% CI: 1.13-5.79, P=0.02, OR=2.56) logistic regression analysis, adjusted for age, BMI, and physical activity, showed that dietary energy density was significantly related to increased risk of stress. No significant association was detected between dietary energy density with sleep quality, depression, and anxiety.

Dietary energy density was directly associated with the presence of stress, but not depression, anxiety and low sleep quality.

Although fast food consumption has drastically increased in Iran in recent years; there is a paucity of data in relation to the association between fast food consumption, dietary intake, and cardiovascular risk factors. This study aims to determine fast food consumption status among young and middle-aged Iranian adults, and to assess its impact on dietary intake and cardiovascular disease (CVD) risk factors. This cross-sectional population-based study was conducted on 1944 young and middle-aged adults (840 men and 1104 women), who participated in the Tehran Lipid and Glucose Study (2006–2008). We collected dietary data by using a validated 168 item, semi-quantitative food frequency questionnaire. Total fast food consumption was calculated by summing up weekly consumption of the most commonly consumed fast foods in Iran. Mean consumption of fast food was 161g/week (95% CI: 147–175) for young adults and 108 g/week (95% CI: 101–115) for middle-aged adults. Mean dietary intakes of energy, fat, saturated fat, cholesterol, sodium, meat, and soft drinks increased significantly (P < 0.05), while carbohydrate and refined grain consumption decreased (P < 0.01) across tertiles of fast food in both age groups. In young adults, dietary energy density and protein intake increased significantly (P < 0.01) where as intake of non-starchy vegetables and carotenoids decreased (P < 0.05). In middle-aged adults dietary intakes of fiber, folate, calcium, and fruits significantly decreased across fast food tertiles (P < 0.05). After adjustment for confounders, there was an association between fast food consumption and body mass index (BMI; β = 0.104; P < 0.01) and waist circumference (WC; β= 0.083; P < 0.01) in young adults, and serum triglycerides (β = 0.072; P < 0.05), high density lipoprotein cholesterol (HDL-C; β = -0.051; P < 0.05), and atherogenic index of plasma (β = 0.056; P < 0.05) in middle-aged adults. The results show that increased consumption of fast foods is associated with poor dietary intake and some of the CVD risk factors in Iranian adults.

Dietary energy-dense foods predispose to obesity and may be associated with risk of type 2 diabetes; therefore, the aim of our study was to investigate the association between dietary energy density (DED) and the risk of type 2 diabetes. In this matched nested case-control study, 178 new onset cases of diabetes were selected from among participants of the Tehran Lipid and Glucose Study, and followed for over 9 years. Each case was randomly matched with 3 controls from among participants who had not developed diabetes. Dietary intakes were determined using a valid and reliable food frequency questionnaire. DED was calculated as energy intakes (kcal) from foods and beverages divided by the weight (grams) of foods. The mean ages of participants were 43±6.5 and 44.5±12 years, in women and men respectively. Individuals with higher DED had higher calories, total fat, carbohydrate and processed meat intakes and lower fruit and vegetable intakes in men and women (P<0.05). Energy density was positively associated with incident diabetes in women, after adjustment for diabetes risk factors and total calorie intake (OR: 2.28, P trend=0.02) or total fat intake (OR: 2.15, P trend=0.03), an association which was not significant in men. In this nested case-control study, there was positive association between DED and risk of type 2 diabetes in women.

Dietary intake might have important role in non-alcoholic fatty liver diseases (NAFLD). Although, there are some reports on dietary intake and anthropometrics measurements, few studies have focused on the markers of assessing whole diet like dietary quality indices.. Therefore, our aim was to determine the diet quality indices and biochemical parameters among patients with NAFLD and healthy individuals..Patients and This case-control study was performed on 100 patients with NAFLD and 100 healthy subjects who were attending to Gastrointestinal Research Center, Baqiyatallah University, Tehran, Iran during the recent years. Usual dietary intake was assessed by three dietary records (one weekend and two week days). Healthy eating index (HEI), dietary diversity score (DDS), dietary energy density (DED), mean adequacy ratio of nutrients (MAR) were assessed according to the standard methods.. Patients with NAFLD had higher body mass index, weight and waist circumference compared to the healthy group (P < 0.05). Serum levels of liver enzymes, triglyceride, LDL, BUN, and uric acid were higher in patients with NAFLD (P < 0.05). Although patients with NAFLD had higher energy, carbohydrate and fat intake, their values for antioxidant vitamins, calcium and vitamin D were lower than healthy subjects (P < 0.05). HEI and MAR were higher among healthy group, and DED was lower among them. Nutrient adequacy ratio for calcium, vitamin D, and antioxidant micronutrients were lower in patients with NAFLD (P < 0.05).. It seems that dietary quality indices may be associated with NAFLD. Calcium, vitamin D, and antioxidant micronutrients intake might be lower among patients with NAFLD based on this case-control study. Further prospective studies should be conducted in this regard..

Forty Holstein heifers with an average age of 12-16 months (363.4 ± 32.8 kg BW) were used in a 2×2 factorial design, in which 10 heifers were allocated to four stalls. The current experiment prolonged 100 days with 10 days for adaptation period and 90 days for sampling period. The rations in this experiment had the same forage/concentrate ratio and the only difference was in the amount of dietary energy density and feed bunk space. Treatments included: 1) Small feed bunk space (24 cm) with low level of energy, 2) Small feed bunk space (24 cm) with high level of energy, 3) Large feed bunk space (48 cm) with low level of energy and 4) Large feed bunk space (48 cm)  with high level of energy. The results showed that meal frequency was affected by diet energy density as mentioned parameter was higher for treatments with low energy density in comparison with high energy density. Also, feed bunk space had significant effect on heifer feeding behavior through motivating of competition for feeding. As, the meal frequency (#/day) was higher and meal size (kg/meal) was lower for small feed bunk space in comparision with the large feed bunk space. The results clearly showed that feed bunk space is the key factor to motivate competition behavior of feeding in heifres.

Unhealthy snacks contain high amounts of calories, simple sugars, fat, cholesterol, salt, additives, and conservatives. Increased consumption of these unhealthy snacks is one of the underlying factors for the prevalence of overweight, obesity, and metabolic disorders. In this study, we investigated the effects of unhealthy snacks on diet and the risk of metabolic syndrome after 3-years of follow-up in Tehranian adults. This longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study, between 2006-2008 and 2009-2011, on men and women in Tehran, Iran. Dietary intakes of participants were measured using a validated semi-quantitative food frequency questionnaire at baseline. Biochemical and anthropometric measurements were assessed at baseline and 3 years later. Multiple logistic regression models with adjustment for confounding factors were used to estimate the occurrence of metabolic syndrome (MetS) in each quartile of unhealthy snacks. The mean age of participants was 37.8 ± 12.3 years, and the mean of body mass index was 26.0 ± 4.5 kg/m2. Moreover, 39% of the participants were male. Daily energy intake, dietary energy density, and total fat and sodium intake were higher in the fourth quartile of unhealthy snacks consumption. There was a significant decreasing trend in dietary intake of carbohydrate, calcium, zinc, selenium, and fiber parallel to increase in consumption of energy-dense snacks. Participants who were in the highest quartile of energy intake from unhealthy snacks consumed less whole grains, vegetables, and dairy products. After adjustment for potential confounders, the risk of metabolic syndrome had a significant positive association with salty snacks consumption, and a non-significant positive association with consumption of candies, chocolate, and soft drinks. Increased daily energy intake from unhealthy snacks could be a risk factor for the occurrence of metabolic syndrome.

Diabetes is considered as a major metabolic disease with high rates of mortality. This study was performed to assess the effects of low and high energy dense vs diets on anthropometric measures، glycemic index، and lipid profiles of type 2 diabetic women. In a randomized controlled parallel design clinical trial، a total of 60 diabetic women [age: 30-60 years; body mass index (BMI) > 25 kg/m2] participated. After matching for age، BMI، and menopausal status، subjects were randomly assigned to consume either a low energy dense [charbohydrate: 65% and fat: 25% of total energy]، high energy dense (charbohydrate: 55% and fat: 35%)، or normal-energy-dense diets (charbohydrate: 60% and fat: 30%) for 8 weeks. Compliance was assessed through a 3-day dietary record during the intervention. Anthropometric measures، plasma glucose and serum insulin، and lipid profiles were evaluated on fasting state at baseline and at the end of the intervention. Difference in dietary energy density did not result in different changes in weight and BMI between groups. Mean change in weight and BMI were almost -3 kg and 1-1. 5 kg/m2 for all groups. Consumption of high energy dense diet resulted in significantly lower serum triglyceride levels compared to low and normal energy dense diets (-41. 16 vs. 2. 56 and 14. 64 mg/dL، P = 0. 01). Within-group differences revealed significant effect of low energy dense diet on serum low density lipoprotein and total cholesterol levels (-13. 25 mg/dL، P = 0. 004 and -17. 68 mg/dL، P = 0. 003 respectively). No overall significant differences in fasting plasma glucose and serum insulin levels were observed between the 3 groups. Consumption of a high energy dense diet might reduce elevated serum triglyceride levels among Iranian women with type 2 diabes. However، adherence to a diet rich in fruits and vegetables might improve serum low density lipoprotein and total-cholesterol levels of these patients.