Abstract
Dietary patterns (DPs) are known to be tied to lifestyle behaviors. Understanding DPs and their relationships with lifestyle factors can help to prevent children from engaging in unhealthy dietary practices. We aimed to describe DPs in Spanish children aged 1 to <10 years and to examine their associations with sociodemographic and lifestyle variables. The consumption of toddler and young children milk formulas, enriched and fortified milk within the Spanish pediatric population is increasing, and there is a lack of evidence whether the consumption of this type of milk is causing an impact on nutrient intakes and if they are helping to reach the nutrient recommendations. Within the Nutritional Study in the Spanish Pediatric Population (EsNuPI), we considered two study cohorts and three different age groups in three year-intervals in each of them. The study cohort included 740 children in a representative sample of the urban non-vegan Spanish population and 772 children in a convenience cohort of adapted milk consumers (AMS) (including follow-on formula, toddler’s milk, growing up milk, and fortified and enriched milks) who provided information about sociodemographics, lifestyle, and dietary habits; a food frequency questionnaire was used for the latter. Principal component analysis was performed to identify DPs from 18 food groups. Food groups and sociodemographic/lifestyle variables were combined through a hierarchical cluster algorithm. Three DPs predominated in every age group and study sample: a palatable energy-dense food dietary pattern, and two Mediterranean-like DPs. However, children from the AMS showed a predominant dietary pattern markedly related to the Mediterranean diet, with high consumption of cereals, fruits and vegetables, as well as milk and dairy products. The age of children and certain lifestyle factors, namely level of physical activity, parental education, and household income, correlated closely with the dietary clusters. Thus, the findings provide insight into designing lifestyle interventions that could reverse the appearance of unhealthy DPs in the Spanish child population.
Highlights
Infancy is a stage characterized by high nutrient requirements and rapid conversion from a primarily milk-based diet to a diverse diet with the ingestion of numerous food groups
The main goals of this study were to determine the Dietary patterns (DPs) in a representative SRS in three different age groups of Spanish children and in a convenience cohort of Adapted Milk Consumers Cohort (AMS) of the same age groups, and to examine how several sociodemographic and lifestyle factors are clustered within the DPs and among the three age groups
Our study population had a number of specific features, we found that poorer lifestyle and unhealthy dietary patterns were grouped together
Summary
Infancy is a stage characterized by high nutrient requirements and rapid conversion from a primarily milk-based diet (breast milk or infant formula) to a diverse diet with the ingestion of numerous food groups. Parental food choice and the family and school environments mainly interact to shape young children’s eating behavior [3], which may have consequences for the incidence of overweight and obesity and derived non-communicable chronic diseases (NCCDs). Poor dietary habits are associated with a higher prevalence of NCCDs and increased mortality in both developing and developed countries [4]. Unhealthy dietary and lifestyle behaviors—such as sedentarism, mainly associated with increased screen-time, and low physical activity time—are established in childhood and tend to track throughout adolescence and into adulthood [5,6,7]. In Spanish children aged three to five years, dietary and other lifestyle habits appear to be influenced by their parents’ health awareness and other socio-economic characteristics [8]
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