Abstract
BackgroundSince there is no evidence demonstrating the relationship between dietary patterns and subclinical atherosclerosis in children and adolescents, we aimed to examine the association between dietary patterns and carotid intima-media thickness (cIMT) in children and adolescents with overweight and obesity.MethodsData were collected on individuals, aged 6–13 years (n = 339) recruited from primary schools with age- and sex-specific body mass index (BMI) Z-score > 1, based on WHO criteria. Dietary intake was assessed using a valid and reliable food frequency questionnaire and dietary patterns were derived by factor analysis. Measurement of cIMT was performed by means of ultrasonography for the wall of common carotid artery.ResultsThe mean ± SD age, BMI Z-score and cIMT of study participants were 9.3 ± 1.7 years, 2.5 ± 0.7 and 0.403 ± 0.057 mm, respectively. Three dietary patterns were identified, which accounted for 23.0% of the total variance, including the healthy, the traditional, and the unhealthy patterns. After adjusting for age, sex, pubertal status, smoking exposure, physical activity, body fat percentage, and intake of magnesium and energy, a significant inverse association was observed between the healthy dietary pattern and cIMT (β = − 0.131, P = 0.019), whereas none were found between cIMT and the traditional (β = − 0.004, P = 0.932) and the unhealthy dietary (β = 0.004, P = 0.942) patterns.ConclusionsResults of the present study indicate that adherence to healthy dietary pattern could prevent increased cIMT in children and adolescents with overweight and obesity. Further cohort design research is required to elucidate the association between dietary patterns and cIMT in children and adolescents.
Highlights
Since there is no evidence demonstrating the relationship between dietary patterns and subclini‐ cal atherosclerosis in children and adolescents, we aimed to examine the association between dietary patterns and carotid intima-media thickness in children and adolescents with overweight and obesity
Ethics approval The protocol of this study was approved by the ethics committee of the Research Institute for Endocrine Sciences, affiliated with the Shahid Beheshti University of Medical Sciences. This cross-sectional study included 339 children and adolescents, 17.4% of whom were in Tanner stage I; mean ± standard deviation (SD) age of the participants was 9.3 ± 1.7 years; the average body mass index (BMI) Z-score was 2.55, and the mean ± SD of 0.403 ± 0.057 mm was obtained for carotid intima-media thickness (cIMT)
Factor loadings for each food group are presented in Table 1; the healthy pattern was highly correlated with an intake of fruits and dried fruits, vegetables, fruit juices, low-fat dairy, legumes, and corn
Summary
Since there is no evidence demonstrating the relationship between dietary patterns and subclini‐ cal atherosclerosis in children and adolescents, we aimed to examine the association between dietary patterns and carotid intima-media thickness (cIMT) in children and adolescents with overweight and obesity. Evidence showed that excess weight in childhood has a positive Modifiable lifestyle factors, such as diet and physical activity, play important roles in obesity-related artery damage and dysfunction [7]. All aforementioned studies indicate that dietary intake could influence cIMT and artery structure. These studies did not consider dietary patterns based on principal components analysis (PCA), which is a required approach to overcome the interaction and synergistic effects of nutrients and foods. Dietary patterns as a better choice rather than the assessment of a single or few nutrients or foods in examining the association between diet and chronic diseases, makes utilizing dietary patterns easy for the public in dietary guidelines [14]
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