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Wolters M¹, Joslowski G², Plachta-Danielzik S³, Standl M⁴, Müller MJ³, Ahrens W¹, Buyken AE^2,5

¹Leibniz Institute for Prevention Research and Epidemiology-BIPS, Department: Epidemiological Methods and Etiologic Research, Bremen, Germany; ²IEL-Nutritional Epidemiology, University of Bonn, DONALD Study, Dortmund, Germany; ³Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany; ⁴Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany; ⁵Institute of Nutrition, Consumption and Health, Faculty of Natural Science, University Paderborn, Paderborn, Germany

Nutrients 2018;5:10:1442

Abstract: This study performed comparative analyses in 2 pediatric cohorts to identify dietary patterns during primary school years and examined their relevance to body composition development. Nutritional and anthropometric data at the beginning of primary school and 2 or 4 years later were available from 298 and 372 participants of IDEFICS-Germany (Identification and prevention of Dietary-induced and lifestyle-induced health Effects In Children and infants Study) and the KOPS (Kiel Obesity Prevention Study) cohort, respectively. Principal component analyses (PCA) and reduced rank regression (RRR) were used to identify dietary patterns at baseline and patterns of change in food group intake during primary school years. RRR extracted patterns explaining variations in changes in body mass index (BMI), fat mass index (FMI), and waist-toheight-ratio (WtHR). Associations between pattern adherence and excess gain in BMI, FMI, or WtHR (>75th percentile) during primary school years were examined using logistic regression. Among PCA patterns, only a change towards a more Mediterranean food choice during primary school years were associated with a favorable body composition development in IDEFICS-Germany (p < 0.05). In KOPS, RRR patterns characterized by a frequent consumption of fast foods or starchy carbohydrate foods were consistently associated with an excess gain in BMI and WtHR (all p < 0.005). In IDEFICS-Germany, excess gain in BMI, FMI, and WtHR were predicted by a frequent consumption of nuts, meat, and pizza at baseline and a decrease in the consumption frequency of protein sources and snack carbohydrates during primary school years (all p < 0.01). The study confirms an adverse impact of fast food consumption on body composition during primary school years. Combinations of protein and carbohydrate sources deserve further investigation.

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Comments

Consumption of some food groups and nutrients has been independently associated to excess adiposity in children. However, the independent effects were not very strong. More and more studies are considering dietary patterns, that is, the frequent combination of some foods in the diet of certain individuals. In order to identify dietary patterns, different methods are available.The most widely used method is principal component analysis. In this study, reduced rank regression (RRR) was also used. Obtained results were different in IDEFICS-Germany and KOPS and they were also different depending on the method used to derive dietary patterns.In IDEFICS-Germany, a change toward a more Mediterranean food choice, identified using PCA, during primary school years, were associated with a favorable body composition development; however, in KOPS, a pattern characterized by consumption of fast foods or starchy carbohydrate foods, identified using RRR, was associated with an excess gain in BMI and WtHR.Until now, few studies examined the prospective association of dietary patterns and body composition and most of them were performed in adolescents. Such studies often consider BMI alone; however, considering other adiposity-specific measures such as fat mass or waist circumference is, therefore, recommended.In a previous study, considering the complete IDEFICS sample, from 8 European countries, and using cluster analysis as the method to identify dietary patterns, it was observed that children consistently showing a processed dietary pattern or changing from a processed pattern to a sweet pattern presented the most unfavorable changes in fat mass and abdominal fat [15].Further exploration of changes in children’s diet over time may help to identify changes in dietary patterns and/or children changing their dietary patterns, thus allowing a better understanding of the impact of diet on body composition.

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