Consumption of energy-dense, nutrient-poor foods and hypertension in obese children

Main Article Content

Mohammad Sulchan


Background Obesity has become an increasingly important medical
problem in children. Obesity-induced hypertension in childhood
should be considered as a chronic medical condition that is likely
to require long-term management of dietary patterns, especially for
energy-dense, nutrient-poor (EDNP) food consumption.
Objective To examine the contribution ofEDNP foods to daily
energy and macronutrient intakes and to examine the relationship
between intake of EDN P foods and the prevalence of hypertension
in children.
Methods Four hundred and forty children were randomly selected
to participate. Weight and height were measured with precision
electronic scales and fixed microtoise, respectively. Blood pressure
(BP) measurements were performed by standard procedure. A
24-hour dietary recall was obtained by a trained interviewer to
determine the intake of EDNP foods, which were clas sified to 4
major groups: visible fat, sweeteners, desserts, or salty snacks.
The difference in mean was evaluated using paired Ttest.
Logistic models were fitted to assess for an association between
hypertension and the various characteristics.
Results The proportion of children who were overweight (including
obese) was 23 .2%. The prevalence of elevated BP was 10.5%, similar
in boys and girls, with most of them having isolated elevated sys to lie
BP. There was a relationship between BP and body mass index
(BMI) in all children. Approximately 27% of total daily energy
intake was contributed by all EDNP foods. Of the EDNP food
subgroups examined, dessert and sweeteners contributed nearly
20% of total daily energy intake. In the highest one-third of subjects
who consumed EDNP food, these foods provided 49% of total daily
carbohydrate intake and 34% of total daily fat intake.
Conclusion Eating patterns ofEDNP foods provide 49% of total
daily carbohydrate intake and 34% of total daily fat intake. This
EDNP food is independently associated with hypertension in

Article Details

How to Cite
Sulchan M. Consumption of energy-dense, nutrient-poor foods and hypertension in obese children. PI [Internet]. 31Aug.2014 [cited 26Aug.2019];54(4):236-4. Available from:
Received 2016-09-20
Accepted 2016-09-20
Published 2014-08-31


1. Sorof J, Daniels S. Obesity hyperten sion in children : a problem of epidemic proportions. American Heart Associated Journal. 2002;135;441-6.
2. Hall JE, et al. Mechanism of obesity hypertension and relevance to essential hypertention. Circulation. 1998;97:2009-2100.
3. Rocchini AP. Obesity hypert ension. Am J Hypertens. 2002;15:50S-52S.
4. Verma M, Chhatwal J, George SM. Obesity and hypertension in children. Indian Pediatt. 1994;31:1065-9.
5. Gross LS, Li L, Ford ES, Liu S. Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the United States: an ecologic assessment. Am J Clin Nutr. 2004;79:774-9.
6. Bray GA, Nielsen SJ, Popkin BM. Consumption of high fructose corn syrup in beverages may play a role in the epidemic of obesity. AmJ Clin Nutt. 2004:79:537-43.
7. Bray GA, Popkin BM. Dietary fat intake does affect obesity! Am J Clin Nutr. 1998;68:1157-73.
8. Darmon N, Briend A, Drewnowski A En ergy-dense diets are associated with lower diet costs: a community study of French adults . Public Health Nutr. 2004:7:21-7.
9. Drewnowski A. Obesity and the food environment: dietary energy density and diet costs. Am J Prev Med. 2004;94:1555-9.
10. Kant AK. Consumption of energy-dense, nutrient-poor foods by adult Americans: nutritional and health implications. The third National Health and Nutrition Examination Survey, 1998-1994. Am J Clin Nutr. 2000:72:929-36.
11. Thomas JA, Call Dl. Eating between meals-a nutrition problem among teenagers? Nutr Rev. 1973;31:137-9.
12. Alexy U, Sichert-Hellert W, Kersting M. Fortification masks nutrient dilution due to added sugars in the diet of the children and adolescents. J Nutr. 2002;132:2785-91.
13. Drewnowski A. Concept of a nutritious food: toward a nutrition density score. Am J Clin Nutr. 2005:82:721-32.
14. National Center for Health Statistics. Plan and operation of the third National Health and Nutrition Examination Survey, 1998-1994. Washington, DC: US Government Printing Office; 1994. [Series 1,32. DHHS publication (PHS) 941308.]
15. Chiolero A, Cachet F, Burnier M, Paccaud F, Bovet P. Prevalence of hypertension in schoolchildren based on repeated measurements and association with overweight. J Hypertens. 2007;25:2209-17.
16. Kraumel DA. Medical nutrition therapy in hypertension. In: Mahan KL, Stump SE, editors. Krause's food, nutrition & diet therapy. 1st ed. Philadelphia: WB Saunders; 2004. p.905-9.
17. Sorof JM, Lai D, Turner J, Poffenbarger T, Portman RJ. Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics. 2004;113:475-82.
18. Ketchen TA, Kotchen JM. Nutrition, diet and hypertension. In: Shils ME, editor. Modem nutrition in health and disease. 9th ed. Philadelphia: Lippincott Williams and Wilkins; 1997. p. 1217-20.
19. Mccullough M. UN PH. Nutrition, diet and hypertension. In: Nutrition in the prevention and treatment of disease. 1st ed. United States of America: Academic Press; 2001. p.303-17.
20. Cruz ML, Weigensberg MJ, Huang TT, Ball G, Shaibi GQ, Goran MI. The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. J Clin Endocrinol Metab. 2004;89:108-13.