Dietary patterns and associations with BMI in low-income, ethnic minority youth in the USA according to baseline data from four randomised controlled trials

Abstract

Few studies have derived data-driven dietary patterns in youth in the United States (US). This study examined data-driven dietary patterns and their associations with BMI measures in predominantly low-income, racial/ethnic minority US youth. Data were from baseline assessments of the four Childhood Obesity Prevention and Treatment Research (COPTR) Consortium trials: NET-Works (N=534; 2–4-year-olds), GROW (N=610; 3–5-year-olds), GOALS (N=241; 7–11-year-olds), and IMPACT (N=360; 10–13-year-olds). Weight and height were measured. Children/adult proxies completed 3 24-hour dietary recalls. Dietary patterns were derived for each site from 24 food/beverage groups using k-means cluster analysis. Multivariable linear regression models examined associations of dietary patterns with BMI and percentage of the 95th BMI percentile. Healthy (produce and whole grains) and Unhealthy (fried food, savory snacks, and desserts) patterns were found in NET-Works and GROW. GROW additionally had a dairy and sugar-sweetened beverage based pattern. GOALS had a similar Healthy pattern and a pattern resembling a traditional Mexican diet. Associations between dietary patterns and BMI were only observed in IMPACT. In IMPACT, youth in the Sandwich (cold cuts, refined grains, cheese, and miscellaneous [e.g., condiments]) compared to Mixed (whole grains and desserts) cluster had significantly higher BMI [β=0.99 (95% CI: 0.01, 1.97)] and percentage of the 95th BMI percentile [β=4.17 (95% CI: 0.11, 8.24)]. Healthy and Unhealthy patterns were the most common dietary patterns in COPTR youth, but diets may differ according to age, race/ethnicity, or geographic location. Public health messages focused on healthy dietary substitutions may help youth mimic a dietary pattern associated with lower BMI.

Changes in retail food environments around schools over 12 years and associations with overweight and obesity among children and adolescents in Flanders, Belgium

“…Studies have shown that children from families with low incomes generally consume less healthy diets and have higher BMI (Body Mass Index) z-scores [16,17]. Several studies emphasize the stronger impact of unhealthy food environments on the weight status of children from poor families [12,18].…”

Dietary patterns related to total mortality and cancer mortality in the United States

“…Most studies in the United States have focused on investigating associations between specific dietary factors and chronic diseases [12][13][14].The association between the adherence dietary patterns and total mortality and mortality due to cancer in the general population is still limited. Dietary patterns condense information about food consumption, reflect diet composition, and capture the overall effect of dietary exposures on health and disease.…”

“…Several studies evaluated the effect of dietary patterns and mortality in other countries [8][9][10][11]. In the United States, studies have shown the association between adherence to specific dietary patterns and chronic diseases, including obesity [12,13], cardiovascular disease, and diabetes [14]. Moreover, only a few studies have investigated the relationship between specific dietary patterns and total mortality [15][16][17][18][19][20].…”