Association between major patterns of dietary intake and weight status in adolescents

Abstract

The relationship between dietary intake and obesity is complex, and dietary pattern analysis may offer new insight. We examined associations between dietary patterns identified in a diverse cohort of adolescents and weight status cross-sectionally and over a 5-year period. Project EAT (Eating Among Teens) (Time 1) collected data on 4746 middle (younger cohort) and high school (older cohort) students in 1998 -9. EAT-II (Time 2) resurveyed 2516 of the original cohort in 2003-4. All analyses were run separately by age cohort and sex. The relationship between dietary patterns identified previously (vegetable, fruit, vegetable & fruit, starchy food, sweet & salty snack food, and fast food) and weight status was examined using logistic regression. All analyses were adjusted for socioeconomic status, race/ethnicity and activity level (longitudinal analyses were also adjusted for baseline weight status). In crosssectional analyses, higher adherence to dietary patterns loading heavily on vegetables was associated with lower risk of overweight/ obese weight status in older and younger girls, whereas higher adherence to a 'sweet & salty snack food' pattern was associated with lower risk in older and younger boys. These associations were found prospectively in older boys and girls, but were no longer significant in analyses adjusting for baseline weight status. We did not find consistent or intuitive associations between dietary patterns and weight status. Identified patterns may not capture the elements of diet that are truly important in determining adolescent weight, or diet may not be the primary driver in determining weight status at this age. Methodological difficulties in assessing diet must also be taken into consideration.

Diet and body fat in adolescence and early adulthood: a systematic review of longitudinal studies

“…The first study investigated the adherence to habitual DP, snacks DP, meals DP and sweet products and cheese DP by female adolescents and found no relationship with BMI after ten years of follow-up 14 . The second study found that young males who adhered to a DP rich in starch food sources at the age of fifteen had a 30% (p < 0.05) lower chance of being obese five years later 30 . There was no evidence of association between BMI and consumption of macronutrients (carbohydrate, protein and fat -% calories/ day) 15 , intake of dietary salt 16 , energy intake 29 and the habit of consuming milk, dairy products and calcium 10,22,23 .…”

“…by six studies 10,12,19,[21][22][23] , specific food (sugar-sweetened beverages, soft drink, fast food, etc.) by seven 11,[16][17][18][24][25][26] , macronutrients (carbohydrate, protein and fat) by three 15,27,28 , total energy intake by one 29 , dietary index by one 13 and DP by three investigations 14,20,30 . The tools used for estimating food consumption were the food frequency questionnaire (FFQ) in ten studies [10][11][12]19,22,25,26,[28][29][30] , food record (FR) in nine [14][15][16][17]20,21,23,27 and 24-hour recall (R24h) in three studies 12,18,24 .…”

“…The BF outcome was evaluated based on BMI in fifteen studies 10,11,[14][15][16][17][18][19]22,23,25,26,[28][29][30] , %BF in thirteen [10][11][12][13][14][16][17][18]21,24,26,28,29 , BF kg in two 23,25 , FMI or AI in two 20,27 and skinfold -tricipital (TS) and subscapular (SS) -thickness in one study 15 . Analyzed at in young adulthood.…”

“…Of the 21 studies that evaluated the relationship between diet and BF, only ten found evidence of an association [11][12][13]17,20,[25][26][27][28]30 . The findings of these studies will be described in the following sections, according to the method used for estimating body fat.…”

“…The main variables used for adjustment were: age 13,14,[16][17][18]20,21,23,25,26,28,29 , physical activity [10][11][12][18][19][20][21]23,26,28,30 , maternal education [12][13][14][18][19][20][21]23,27,28 , BF (BMI, FM, FMI, adiposity or weight) at baseline 14,19,21,23,26,27,30 and energy intake 10,[15][16][17][18]22,24,[26][27][28] .…”