Dietary patterns among European children and their association with adiposity-related outcomes: a multi-country study

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• dc.contributor.author Warkentin, Sarah
• dc.contributor.author Stratakis, Nikos
• dc.contributor.author Fabbri, Lorenzo
• dc.contributor.author Wright, John
• dc.contributor.author Yang, Tiffany C.
• dc.contributor.author Bryant, Maria
• dc.contributor.author Heude, Barbara
• dc.contributor.author Slama, Rémy
• dc.contributor.author Montazeri, Parisa, 1988-
• dc.contributor.author Vafeiadi, Marina, 1983-
• dc.contributor.author Gražulevičienė, Regina
• dc.contributor.author Brantsaeter, Anne Lise
• dc.contributor.author Vrijheid, Martine
• dc.date.accessioned 2025-01-16T12:28:40Z
• dc.date.available 2025-01-16T12:28:40Z
• dc.date.issued 2024
• dc.description Data de publicació electrònica: 27-10-2024
• dc.description.abstract Background/objective: Children's diets in school-age are inherently unhealthy, with few meeting dietary recommendations. Yet, little is known about similarities and differences on dietary patterns across countries and their association with obesity. We aimed to derive dietary patterns in childhood and explore their association with adiposity-related outcomes in childhood and adolescence. Subjcts/methods: This study included data from six European countries (Spain, France, UK, Greece, Lithuania and Norway) during childhood (n = 1597) and adolescence (n = 803). Using a food frequency questionnaire, we derived data-driven dietary patterns through exploratory factor analyses and calculated the Mediterranean KIDMED index. We assessed body mass index z-score (zBMI), fat mass proportion and waist-to-height ratio at both visits. Associations were estimated using generalized linear regressions, adjusted for key-confounders. Results: "Meat", "Dairy", "Western", "Healthy" and "Sweets and fats" dietary patterns were derived. Norwegian children showed better diet quality, with higher consumption of fruits and vegetables, and highest "Healthy pattern" adherence, and Lithuanian children, the worst, with higher sweets consumption, and highest "Western pattern" adherence. Children with lower intake of healthy foods (vegetables, fruits, fish) tended to have higher adiposity, e.g., children with average or low "Healthy pattern" adherence (vs. high) had higher fat mass proportion in childhood (average: β (95% CI) 1.44 (0.48; 2.39), low: 1.10 (0.09; 2.12)). Low adherence to a "Healthy pattern" (vs. high) was associated with increased adolescent zBMI, and child and adolescent waist-to-height ratio. Low "Dairy pattern" adherence (vs. high), was associated with lower zBMI and fat mass in childhood, but not in adolescence. No significant associations were seen with the KIDMED index. Conclusions: Many European children have poor diets and a low adherence to a healthy diet pattern may be of concern for adiposity-related outcomes. Assessment of children's dietary patterns can help tailor dietary advice and provide support for families aiming to prevent future excess weight gain.
• dc.description.sponsorship This project was funded by the European Union’s Horizon 2020 research and innovation programme under grant agreement No 874583 (ATHLETE project). The HELIX cohort data collection also received funding from the European Community’s Seventh Framework Programme (FP7/2007–2013) under grant agreement no. 308333. The Infancia y Medio Ambiente (INMA) study was supported by the Instituto de Salud Carlos III, Centro de Investigacion Biomedica en Red de Epidemiologia y Salud Publica (CIBERESP), and the Generalitat de Catalunya-Catalan National Science Foundation (CIRIT). The Kaunas cohort (KANC) was funded by the grant of the Lithuanian Agency for Science Innovation and Technology (6- 04- 2014_31 V- 66). For a full list of funding that supported the EDEN cohort, refer to: Heude B et al. Cohort Profile: The EDEN mother–child cohort on the prenatal and early postnatal determinants of child health and development. Int J Epidemiol. 2016 Apr;45(2):353–63. The Norwegian Mother, Father and Child Cohort Study (MoBa) is supported by the Norwegian Ministry of Health and Care Services and the Ministry of Education and Research. The Rhea project was financially supported by European projects, and the Greek Ministry of Health (Program of Prevention of Obesity and Neurodevelopmental Disorders in Preschool Children, in Heraklion district, Crete, Greece: 2011–2014; ‘Rhea Plus’: Primary Prevention Program of Environmental Risk Factors for Reproductive Health, and Child Health: 2012–2015). Born in Bradford receives funding from by a joint grant from the UK Medical Research Council (MRC) and UK Economic and Social Science Research Council (ESRC) [MR/N024391/1]; the British Heart Foundation [CS/16/4/32482]; a Wellcome Infrastructure Grant [WT101597MA]; The National Institute for Health Research under its Applied Research Collaboration for Yorkshire and Humber [NIHR200166] which also supports MB. The views expressed are those of the author(s), and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. SW acknowledges receiving the funding by the Agency for Management of University and Research Grants with a Beatriu de Pinós post-doctoral fellowship (Ref: 2021 BP 00058). NS has received funding from the European Union’s Horizon Europe research and innovation programme under the Marie Skłodowska-Curie Actions (MSCA) Postdoctoral Fellowships (grant no. 101059245). ISGlobal acknowledges support from the grant CEX2023-0001290-S funded by MCIN/AEI/ 10.13039/501100011033, and support from the Generalitat de Catalunya through the CERCA Program.
• dc.format.mimetype application/pdf
• dc.identifier.citation Warkentin S, Stratakis N, Fabbri L, Wright J, Yang TC, Bryant M, et al. Dietary patterns among European children and their association with adiposity-related outcomes: a multi-country study. Int J Obes (Lond). 2024 Oct 27. DOI: 10.1038/s41366-024-01657-6
• dc.identifier.doi http://dx.doi.org/10.1038/s41366-024-01657-6
• dc.identifier.issn 0307-0565
• dc.identifier.uri http://hdl.handle.net/10230/69161
• dc.language.iso eng
• dc.publisher Nature Research
• dc.relation.ispartof Int J Obes (Lond). 2024 Oct 27
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/874583
• dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/308333
• dc.relation.projectID info:eu-repo/grantAgreement/EC/HE/101059245
• dc.rights © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Nutrition
• dc.subject.keyword Obesity
• dc.title Dietary patterns among European children and their association with adiposity-related outcomes: a multi-country study
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion