Dietary Patterns and Cardiovascular Risk Factors in Spanish Adolescents: A Cross-Sectional Analysis of the SI! Program for Health Promotion in Secondary Schools

Abstract

Previous studies on the association between dietary habits and cardiovascular risk factors (CVRF) in adolescents have generated conflicting results. The aim of this study was to describe dietary patterns (DP) in a large sample of Spanish adolescents and to assess their cross-sectional relationship with CVRF. In total, 1324 adolescents aged 12.5 ± 0.4 years (51.6% boys) from 24 secondary schools completed a self-reported food frequency questionnaire. DPs were derived by cluster analysis and principal component analysis (PCA). Anthropometric measurements, blood pressure, lipid profile, and glucose levels were assessed. Linear mixed models were applied to estimate the association between DPs and CVRF. Three DP-related clusters were obtained: Processed (29.2%); Traditional (39.1%); and Healthy (31.7%). Analogous patterns were obtained in the PCA. No overall differences in CVRF were observed between clusters except for z-BMI values, total cholesterol, and non-HDL cholesterol, with the Processed cluster showing the lowest mean values. However, differences were small. In conclusion, the overall association between DPs, as assessed by two different methods, and most analyzed CVRF was weak and not clinically relevant in a large sample of adolescents. Prospective analysis may help to disentangle the direction of these associations.

Dietary Patterns and Their Association with Body Composition and Cardiometabolic Markers in Children and Adolescents: Genobox Cohort

“…Specifically, in Spain, there have been four previous studies including large samples of children or adolescents, which also found healthy dietary patterns in their study populations by using different approaches, labeling them as "healthy" (enKID [13,30] and SI! [16]), or "Mediterranean-like" (ANIBES [14,31,32] and EsNuPi [15]), including a high intake of vegetables, fruits and fish, similar to our HC.…”

“…The World Health Organization (WHO) stated that the prevalence of overweight and obesity has risen dramatically worldwide from 1975 to 2016, as it has nearly triplicated among adults, and even more among children and adolescents (aged [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19], increasing from 4% to 18% [1]. WHO also highlighted Spain among the European countries with the highest prevalence [1], and although national studies suggested that it has stabilized in the last few years, it continues to be high in this country, at over 40% (for children seven and eight years old) [2].…”

“…Indeed, in Spain the enKid [13], the ANIBES [14], the EsNuPi [15], and the SI! [16] studies had large sample sizes (n > 400), and all considered BMI exclusively as an obesity phenotype indicator in relation to dietary patterns (except SI! [16], which also included a few other parameters but in participants of a very small age range) and were not performed in a clinical care environment.…”

“…[16] studies had large sample sizes (n > 400), and all considered BMI exclusively as an obesity phenotype indicator in relation to dietary patterns (except SI! [16], which also included a few other parameters but in participants of a very small age range) and were not performed in a clinical care environment. Hence, there is little information available on dietary patterns related to obesity phenotype among children and adolescents.…”

Polyphenols in Urine and Cardiovascular Risk Factors: A Cross-Sectional Analysis Reveals Gender Differences in Spanish Adolescents from the SI! Program

“…The parental education level was categorized as low (families without studies or with primary studies), medium (secondary studies and professional training), and high (university studies), according to the International Standard Classification of Education (ISCED) [ 25 ]. As in the study by Bodega et al [ 26 ], the highest parental education level was considered as a covariate in this study. House income was categorized into three levels (low, medium, and high) based on the annual survey of salary for the Spanish population [ 27 ].…”