An international comparison of dietary patterns in 9–11-year-old children

Abstract

OBJECTIVES: Dietary pattern is defined as a combination of foods and drinks and the frequency of consumption within a population. Dietary patterns are changing on a global level, which may be linked to an increased incidence of chronic diseases. The aim of this study was to identify and compare the dietary patterns among 9-11-year-old children living in urban regions in different parts of the world. METHODS: Participants were 7199 children (54% girls), aged 9-11 years, from 12 countries situated in all major world regions. Food consumption was assessed using a 23-item Food Frequency Questionnaire (FFQ). To identify dietary patterns, principal components analyses (PCA) were carried out using weekly portions as input variables. RESULTS: Both site-specific and pooled PCA resulted in two strong components. Component 1 ('unhealthy diet pattern') included fast foods, ice cream, fried food, French fries, potato chips, cakes and sugar-sweetened sodas with 40.6 loadings. The loadings for component 2 ('healthy diet pattern') were slightly weaker with only dark-green vegetables, orange vegetables, vegetables in general, and fruits and berries reaching a 40.6 loading. The site-specific diet pattern scores had very strong correlations with the pattern scores from the pooled data: r = 0.82 and 0.94 for components 1 and 2, respectively. CONCULSIONS: The results suggest that the same 'healthier' and 'unhealthier' foods tend to be consumed in similar combinations among 9-11-year-old children in different countries, despite variation in food culture, geographical location, ethnic background and economic development.

The reliability and validity of a short food frequency questionnaire among 9–11-year olds: a multinational study on three middle-income and high-income countries

“…Besides individual food groups, FFQs can be used for compiling diet scores and indices as has been done in the ISCOLE study. 20 To conclude, the reliability of the I-FFQ was moderate. Its validity was acceptable for assessing the consumption of most food groups among the 9-11-year-old participants in our international sample.…”

Association between home and school food environments and dietary patterns among 9–11-year-old children in 12 countries

“…Detailed information on the dietary assessment methods and the identification of dietary patterns can be found elsewhere. 15,19 In brief, for each site we chose two components, which were rotated with an orthogonal varimax transformation to enhance the interpretation, and based on food group loadings labeled them as 'unhealthy diet pattern' (characterized by high intakes of, for example, fast foods, ice cream, fried food, French fries and potato chips) and 'healthy diet pattern' (including, for example, dark-green vegetables, orange vegetables, vegetables in general and fruits and berries). In the present paper, we use standardized principal component scores for these two patterns as the dependent variables (unhealthy and healthy diet pattern scores).…”

“…Earlier, we identified two dietary patterns and named them 'unhealthy diet pattern' and 'healthy diet pattern'. 15 In the statistical models, we use the availability of empty-calorie and wholesome foods in the home and at school as exposures. Conversely, principal component scores for the two dietary patterns (unhealthy and healthy diet pattern scores) are used as dependent variables.…”

“…As it has been suggested that dietary patterns among 10-year-old children are quite similar across the globe, 15 we wanted to examine whether food environments are similarly associated with dietary patterns in different cultural settings. Accordingly, in the present paper, we investigated the associations between food environments and dietary patterns among 9-11-year-old children in 12 culturally different sites around the globe.…”

Birth weight and childhood obesity: a 12-country study

“…Two diet scores which represented an 'unhealthy diet pattern' (with positive loadings for fast food, hamburgers, soft drinks, sweets, fried food, and so on) and a 'healthy diet pattern' (with positive loadings for vegetables, fruit, whole grains, lowfat milk, and so on) were obtained using principal components analyses. 25 Anthropometry measurement. Height and weight were measured using standard procedures across all study sites.…”