British Journal of Nutrition

Full Papers

Dietary Surveys and Nutritional Epidemiology

Macronutrient distribution over a period of 23 years in relation to energy intake and body fatness

Lando L. J. Koppesa1a2a3 c1, Niels Boona4, Astrid C. J. Nooyensa2a5, Willem van Mechelena1a2 and Wim H. M. Sarisa4

a1 EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands

a2 Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands

a3 Division of Work and Employment, TNO Quality of Life, PO Box 718, Hoofddorp 2130 AS, The Netherlands

a4 Nutrition and Toxicology Research Institute Maastricht (NUTRIM), University of Maastricht, Maastricht, The Netherlands

a5 Institute of Health Sciences, Faculty of Earth and Life Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

Abstract

The distribution of the four macronutrients is associated with energy intake and body fatness according to short-term interventions. The present study involves macronutrient distribution in relation to energy intake and body fatness over a period of 23 years in individuals who have ad libitum access to food. Eight follow-up measurements have been performed in 168 men and 182 women who participate in the Amsterdam Growth and Health Longitudinal Study. From the age of 13 years onwards, dietary intake, physical activity and the thickness of four skinfolds have been assessed. Body fatness was assessed using dual-energy X-ray absorptiometry at the age of 36 years. Generalised estimating equation regression analyses showed that energy percentages (En%) from protein and (in men) carbohydrates were inversely related to energy intake, while the En% from fat was positively related with energy intake. The men and women with high body fatness at the age of 36 years had a 1 En% higher protein intake, and the women with high body fatness had a 2 En% lower alcohol intake at the age of 32 and 36 years. The apparent inconsistent relationships between protein and energy intake and protein and body fatness can in women be explained by reverse causation and underreporting, as in women, low energy intake could not be explained by low physical activity. In conclusion, high intake of protein and (in men) carbohydrate, and low intake of fat are inversely related to total energy intake. High body fatness at the age of 36 years is related to a higher protein intake and, in women, to a lower alcohol intake.

(Received August 28 2007)

(Revised February 11 2008)

(Accepted March 25 2008)

(Online publication May 09 2008)

Correspondence:

c1 Corresponding author: Dr Lando L. J. Koppes, fax +31 23 5549394, email lando.koppes@tno.nl

Footnotes

Abbreviations: AGAHLS, Amsterdam Growth and Health Longitudinal Study; En%, energy percentage

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