The use of a dietary quality score as a predictor of childhood overweight and obesity

Catherine P Perry, Eimear Keane, Richard Layte, Anthony P Fitzgerald, Ivan J Perry, Janas M Harrington, Catherine P Perry, Eimear Keane, Richard Layte, Anthony P Fitzgerald, Ivan J Perry, Janas M Harrington

Abstract

Background: The use of dietary quality scores/indices to describe diet quality in children has increased in the past decade. However, to date, few studies have focused on the use of these scores on disease outcomes such as childhood obesity and most are developed from detailed dietary assessments. Therefore, the aims of this study were: firstly to construct a diet quality score (DQS) from a brief dietary assessment tool; secondly to examine the association between diet quality and childhood overweight or obesity; thirdly we also aim to examine the associations between individual DQS components and childhood overweight or obesity.

Methods: A secondary analysis of cross sectional data of a sample of 8,568 9-year-old children and their families as part of the Growing Up in Ireland (GUI) study. Subjects were drawn from a probability proportionate to size sampling of primary schools throughout Ireland over the school year 2007-2008. Height and weight were measured by trained researchers using standardised methods and BMI was classified using the International Obesity Taskforce cut-points. The DQS (un-weighted) was developed using a 20-item, parent reported, food frequency questionnaire of foods consumed over the past 24 h. Adjusted odds ratios for overweight and obesity were examined by DQS quintile, using the first quintile (highest diet quality) as the reference category.

Results: The prevalence of normal weight, overweight and obese was 75, 19 and 6% respectively. DQS ranged from -5 to 25, higher scores indicated higher diet quality in the continuous score. In analyses adjusted for gender, parent's education, physical activity and T.V. viewing, child obesity but not overweight was significantly associated with poor diet quality: OR of 1.56 (95% CI 1.02 2.38) in the 5th compared to the 1st DQS quintile. Findings from individual food items were inconsistent.

Conclusions: The findings suggest that diet quality may be an important factor in childhood obesity. A simple DQS developed from a short dietary assessment tool is significantly associated with childhood obesity.

References

    1. Keane E, Kearney PM, Perry IJ, Kelleher CC, Harrington JM. Trends and prevalence of overweight and obesity in primary school aged children in the Republic of Ireland from 2002–2012: a systematic review. BMC Public Health. 2014;14:974. doi: 10.1186/1471-2458-14-974.
    1. Olds T, Maher C, Zumin S, Peneau S, Lioret S, Castetbon K, et al. Evidence that the prevalence of childhood overweight is plateauing: data from nine countries. Int J Pediatr Obes. 2011;6(5–6):342–60. doi: 10.3109/17477166.2011.605895.
    1. Perry IJ, Whelton H, Harrington J, Cousins B. The heights and weights of Irish children from the post-war era to the Celtic tiger. J Epidemiol Community Health. 2009;63(3):262–4. doi: 10.1136/jech.2008.079236.
    1. Starc G, Strel J. Tracking excess weight and obesity from childhood to young adulthood: a 12-year prospective cohort study in Slovenia. Public Health Nutr. 2011;14(1):49–55. doi: 10.1017/S1368980010000741.
    1. Krassas GE, Tzotzas T. Do obese children become obese adults: childhood predictors of adult disease. Pediatr Endocrinol Rev. 2004;1(Suppl 3):455–9.
    1. Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics. 1998;101(3 Pt 2):518–25.
    1. von Mutius E, Schwartz J, Neas LM, Dockery D, Weiss ST. Relation of body mass index to asthma and atopy in children: the National Health and Nutrition Examination Study III. Thorax. 2001;56(11):835–8. doi: 10.1136/thorax.56.11.835.
    1. Fagot-Campagna A, Pettitt DJ, Engelgau MM, Burrows NR, Geiss LS, Valdez R, et al. Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective. J Pediatr. 2000;136(5):664–72. doi: 10.1067/mpd.2000.105141.
    1. Safefood . The cost of overweight and obesity on the Island of Ireland. Ireland: Little Island, Cork; 2012.
    1. Butland B, Jebb S, Kopelman P, McPherson K, Thomas S, Mardell J, et al. Foresight. Tackling obesities: future choices. Project report. 2007.
    1. Reilly JJ, Ness AR, Sherriff A. Epidemiological and physiological approaches to understanding the etiology of pediatric obesity: finding the needle in the haystack. Pediatr Res. 2007;61(6):646–52. doi: 10.1203/pdr.0b013e3180536667.
    1. Alkerwi A. Diet quality concept. Nutrition. 2014;30(6):613–8. doi: 10.1016/j.nut.2013.10.001.
    1. Lazarou C, Newby PK. Use of dietary indexes among children in developed countries. Adv Nutr. 2011;2(4):295–303. doi: 10.3945/an.110.000166.
    1. Marshall S, Burrows T, Collins C. Systematic review of diet quality indices and their associations with health‐related outcomes in children and adolescents. J Hum Nutr Diet. 2014;27(6):577–98. doi: 10.1111/jhn.12208.
    1. Kant AK. Indexes of overall diet quality: a review. J Am Diet Assoc. 1996;96(8):785–91. doi: 10.1016/S0002-8223(96)00217-9.
    1. Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol. 2002;13(1):3–9. doi: 10.1097/00041433-200202000-00002.
    1. Newby PK, Tucker KL. Empirically derived eating patterns using factor or cluster analysis: a review. Nutr Rev. 2004;62(5):177–203. doi: 10.1111/j.1753-4887.2004.tb00040.x.
    1. Schulze MB, Hoffmann K, Kroke A, Boeing H. Dietary patterns and their association with food and nutrient intake in the European Prospective Investigation into Cancer and Nutrition (EPIC)–Potsdam study. Br J Nutr. 2001;85(03):363–73. doi: 10.1079/BJN2000254.
    1. Hu F. Dietary Assessment Methods. In: Hu F, editor. Obesity Epidemiology. 1. New York: Oxford University Press; 2008. pp. 108–11.
    1. Fahey MT, Ferrari P, Slimani N, Vermunt JK, White IR, Hoffmann K, et al. Identifying dietary patterns using a normal mixture model: application to the EPIC study. J Epidemiol Community Health. 2012;66(1):89–94. doi: 10.1136/jech.2009.103408.
    1. Bell LK, Golley RK, Magarey AM. Short tools to assess young children's dietary intake: a systematic review focusing on application to dietary index research. J Obes. 2013;2013:709626. doi: 10.1155/2013/709626.
    1. Williams J, Greene S, Doyle E, Harris E, Layte R, McCoy S, et al. Growing Up in Ireland. The Lives of 9-Year-Olds. Report 1. Dublin: Office of the Minister for Children and Youth Affairs; 2009.
    1. Williams J, Greene S, Doyle E, Harris E, Layte R, McCoy S, et al. Growing up in Ireland national longitudinal study of children. 2011.
    1. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ (Clinical research ed) 2000;320(7244):1240. doi: 10.1136/bmj.320.7244.1240.
    1. Consultation W. Obesity: preventing and managing the global epidemic. World Health Organ Tech Rep Ser. 2000;894.
    1. Layte R, McCrory C. Growing Up in Ireland Overweight and Obesity among 9 year olds. 2011. pp. 2–65.
    1. Smith KW, Hoelscher DM, Lytle LA, Dwyer JT, Nicklas TA, Zive MM, et al. Reliability and validity of the child and adolescent trial for cardiovascular health (CATCH) food checklist: a self-report instrument to measure fat and sodium intake by middle school students. J Am Diet Assoc. 2001;101(6):635–47. doi: 10.1016/S0002-8223(01)00161-4.
    1. Dowda M, Pate RR, Sallis JF, Freedson PS, Taylor WC, Sirard JR, et al. Agreement between student-reported and proxy-reported physical activity questionnaires. Pediatr Exerc Sci. 2007;19(3):310–8.
    1. Sanson A, Nicholson J, Ungerer J, Zubrick S, Wilson K, Ainley J, et al. Introducing the longitudinal study of Australian children. 2002.
    1. Murray A, McCrory C, Thornton M, Williams J, Quail A, Swords L, et al. Growing Up in Ireland: Design, instrumentation and procedures for the child cohort. Department of Health and Children: Ireland, Dublin; 2011.
    1. Flynn MA, O'Brien CM, Faulkner G, Flynn CA, Gajownik M, Burke SJ. Revision of food-based dietary guidelines for Ireland, Phase 1: evaluation of Ireland's food guide. Public Health Nutr. 2011;15(3):518. doi: 10.1017/S1368980011002072.
    1. Espghan Committee on Nutrition. Agostoni C, Braegger C, Decsi T, Kolacek S, Koletzko B, et al. Role of dietary factors and food habits in the development of childhood obesity: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2011;52(6):662–9. doi: 10.1097/MPG.0b013e3182169253.
    1. Lioret S, Touvier M, Balin M, Huybrechts I, Dubuisson C, Dufour A, et al. Characteristics of energy under-reporting in children and adolescents. Br J Nutr. 2011;105(11):1671–80. doi: 10.1017/S0007114510005465.
    1. Bornhorst C, Huybrechts I, Ahrens W, Eiben G, Michels N, Pala V, et al. Prevalence and determinants of misreporting among European children in proxy-reported 24 h dietary recalls. Br J Nutr. 2013;109(7):1257–65. doi: 10.1017/S0007114512003194.
    1. Golley RK, Hendrie GA, McNaughton SA. Scores on the dietary guideline index for children and adolescents are associated with nutrient intake and socio-economic position but not adiposity. J Nutr. 2011;141(7):1340–7. doi: 10.3945/jn.110.136879.
    1. Feskanich D, Rockett HRH, Colditz GA. Modifying the healthy eating index to assess diet quality in children and adolescents. J Am Diet Assoc. 2004;104(9):1375–83. doi: 10.1016/j.jada.2004.06.020.
    1. Jennings A, Welch A, van Sluijs EMF, Griffin SJ, Cassidy A. Diet quality is independently associated with weight status in children aged 9–10 years. j Nut. 2011;141(3):453–9. doi: 10.3945/jn.110.131441.
    1. Lazarou C, Panagiotakos DB, Matalas A-L. Physical activity mediates the protective effect of the Mediterranean diet on children's obesity status: The CYKIDS study. Nutrition. 2010;26(1):61–7. doi: 10.1016/j.nut.2009.05.014.
    1. Magarey A, Watson J, Golley RK, Burrows T, Sutherland R, McNaughton SA, et al. Assessing dietary intake in children and adolescents: Considerations and recommendations for obesity research. Int J Pediatr Obes. 2011;6(1):2–11. doi: 10.3109/17477161003728469.
    1. Goldberg GR, Black AE, Jebb SA, Cole TJ, Murgatroyd PR, Coward WA, et al. Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording. Eur J Clin Nutr. 1991;45(12):569–81.
    1. Magarey A, Golley R, Spurrier N, Goodwin E, Ong F. Reliability and validity of the Children's Dietary Questionnaire; A new tool to measure children's dietary patterns. Int J Pediatr Obes. 2009;4(4):257–65. doi: 10.3109/17477160902846161.
    1. Thompson FE, Subar AF. Dietary assessment methodology. Nut Prev Treat Dis. 2008;2:3–39.
    1. Wilson AM, Magarey AM, Mastersson N. Reliability and relative validity of a child nutrition questionnaire to simultaneously assess dietary patterns associated with positive energy balance and food behaviours, attitudes, knowledge and environments associated with healthy eating. Int J Behav Nutr Phys Act. 2008;5:5. doi: 10.1186/1479-5868-5-5.
    1. Craigie AM, Lake AA, Kelly SA, Adamson AJ, Mathers JC. Tracking of obesity-related behaviours from childhood to adulthood: a systematic review. Maturitas. 2011;70(3):266–84. doi: 10.1016/j.maturitas.2011.08.005.
    1. Kontogianni MD, Farmaki A-E, Vidra N, Sofrona S, Magkanari F, Yannakoulia M. Associations between lifestyle patterns and body mass index in a sample of Greek children and adolescents. J Am Diet Assoc. 2010;110(2):215–21. doi: 10.1016/j.jada.2009.10.035.

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