Longitudinal Assessment of Childhood Dietary Patterns: Associations with Body Mass Index z-Score among Children in the Samoan Ola Tuputupua'e (Growing Up) Cohort

Abstract

Background: Intervention strategies to prevent childhood obesity in the Pacific Islands encourage eating a variety of local and traditional foods, but context-specific data to support this approach are limited. The objective was to assess the association between 2-year adherence to modern and neotraditional dietary patterns and body mass index z-scores (BMIz) among Samoan children.Methods: A convenience sample of 214 Samoan biological mother-child dyads who participated in the Ola Tuputupua'e ''Growing Up'' cohort study in 2015 and 2017 was included. At each time point, modern and neotraditional dietary patterns were identified using food frequency data and factor analysis. Children were assigned to categories based on diet pattern adherence: consistently high, high to low, low to high, and consistently low. Associations between 2-year adherence to dietary patterns, BMIz (in 2017 and 2015-2017), and weight and height z-scores were examined using linear models adjusted for potential confounders.Results: Consistently high adherence to the modern pattern was associated with a 0.36 standard deviation (SD)-adjusted change in BMIz between 2015 and 2017 (95% confidence interval [CI]: 0.04-0.69, p = 0.03). While the estimates for the individual components of BMI were imprecise, on average, children with consistently high adherence to the modern pattern had a 0.13 SD greater change in weight z-score (95% CI: -0.10 to 0.37) and 0.15 SD lower change in height z-score (95% CI: -0.43 to 0.13). The change in BMIz between 2015 and 2017 did not significantly differ by adherence to the neotraditional pattern.Conclusion: A neotraditional dietary pattern, comprising local produce, should be encouraged as a possible childhood obesity prevention strategy in Samoa.

Comparability of The Netherlands Physical Activity Questionnaire with Accelerometer-Measured Physical Activity in Samoan Children: A Retrospective Analysis of Ola Tuputupua’e Data

“…These device-based measurements inform our understanding of preschool-aged children's physical activity in the Samoan context. Extensive research has been conducted on the nutritional intake and diet of Samoan children [34]; however, the quantity and intensity of physical activity is poorly understood. With additional accelerometer data being collected in this ongoing cohort study, future investigations will focus on patterns of physical activity and their association with cardiometabolic health, as well as developing new, age-appropriate questionnaire tools for the measurement of physical activity in Samoan children as they grow up.…”

Regional Research-Practice-Policy Partnerships in Response to Climate-Related Disparities: Promoting Health Equity in the Pacific

“…Nicola Hawley and colleagues at Yale University are collaborating with healthcare providers in Samoa and American Samoa to understand how maternal and child health are impacted by rising levels of obesity and diabetes in resource-poor settings [ 43 ]; determine how innovations in healthcare delivery can impact the identification and treatment of obesity-related disease during the perinatal period; and develop inter-ventions focused on pregnancy, childhood, and adolescence to prevent the intergenera-tional transmission of obesity-related disease [ 44 , 45 ]. The Obesity, Lifestyle, And Ge-netic Adaptations (OLAGA; “life” in Samoan) study group uses a life course approach to understand the origins of obesity among Samoans and other Pacific Islanders and focuses on developing culturally relevant interventions to reduce the burden of obesity and obesity-related conditions.…”

Associations of childhood BMI traits with blood pressure and glycated haemoglobin in 6–9‐year‐old Samoan children

“…14 In the context of substantial population-level adiposity, the Ola Tuputupua'e "Growing Up" cohort in Samoa is an ideal study population to pursue scientific questions about the relationships between BMI trajectories and cardiometabolic risk in childhood. We have previously reported high and increasing obesity prevalence based on World Health Organization child growth standards/references, with 16.5% of the cohort having obesity at age 2-4 years, 15 25% at age 3.8-6 years, 16 and 36% at age 5.5-11 years. 17 Here, we assess the extent to which BMI traits in early-and mid-childhood are associated with HbA1c and BP among Samoan children.…”