Breakfast Dietary Pattern Is Inversely Associated with Overweight/Obesity in European Adolescents: The HELENA Study.

Leandro Teixeira Cacau ,Pilar De Miguel-Etayo ,Laura Censi ,Peter Stehle ,Sonia Gómez‐Martínez ,Marcela González‐Gross ,Anthony Kafatos ,Natalia Giménez-Legarre ,Dirce Maria Lobo Marchioni ,Stefaan De Henauw ,Alba M Santaliestra-Pasías ,Kurt Widhalm ,Christina Breidenassel ,Frédéric Gottrand ,Dénes Molnár ,Yannis Μanios ,Odysseas Androutsos ,Evangelia Grammatikaki ,Cristina Molina‐Hidalgo ,Mathilde Kersting ,Thaïs De Ruyter ,Luis A Moreno

doi:10.3390/children8111044

Abstract

Obesity in children and adolescents is a public health problem and diet can play a major role in this condition. We aimed to identify sex-specific dietary patterns (DP) and to evaluate the association with overweight/obesity in European adolescents. We conducted a cross-sectional analysis with 2327 adolescents aged between 12.5 to 17.5 years from a multicenter study across Europe. The body mass index was categorized in “normal weight” and “overweight/obesity”. Two non-consecutive 24-h dietary recalls were collected with a computerized self-reported software. Principal component factor analysis was used to identify DP. Mixed-effect logistic regression models were used to evaluate the association between the sex-specific DP and overweight/obesity outcome. As a result, we found three DP in boys (snacking and bread, Mediterranean diet, and breakfast) and four DP in girls (convenience, plant-based and eggs, Western, and breakfast). The association between DP and overweight/obesity highlights that those adolescents with higher adherence to the breakfast DP had lower odds for overweight/obesity, even after the inclusion of covariables in the adjustments. In European adolescents, the breakfast DP positively characterized by breakfast cereals, fruit, milk, and dairy and negatively characterized by sugar-sweetened beverages in boys and negatively characterized by cereals (pasta, rice, and others) in girls, was inversely associated with overweight/obesity.

Highlights

Worldwide, the prevalence of obesity in children and adolescents aged between5–19 years is a serious public health issue, with an increase of about 20% of prevalent cases between the years 1975 to 2016 [1]
This analysis of dietary intake data collected in a well-designed study across Europe focused on sex-specific associations between overweight/obesity and dietary patterns in adolescents
This is the first study, to our knowledge, that evaluated sex-specific dietary patterns identified by principal component factor analysis with obesity outcome in this study population

Summary

Introduction

The prevalence of obesity in children and adolescents aged between5–19 years is a serious public health issue, with an increase of about 20% of prevalent cases between the years 1975 to 2016 [1]. Several factors are known to influence the risk to develop childhood obesity, including socioeconomic, behavioral, mental, environmental, hereditary, sedentarism, and dietary habits [5], demonstrating the complexity and multifactorial process of this serious health problem. Best known approaches are a posteriori dietary patterns or multivariate statistical methods, which consists of a data reduction technique with the aim of summarizing the variation in food intakes into a small number of patterns or clusters [7,8]. The most frequently used exploratory statistical methods to derive dietary patterns are cluster analysis, factor analysis (FA), and principal component analysis (PCA) [7,8,9]

Objectives

Methods

Discussion

Conclusion