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Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Dietary intake patterns of children aged 6 years and their association with socioeconomic and demographic characteristics, early feeding practices and body mass index

Authors: Leonardo Pozza Santos, Maria Cecília Formoso Assunção, Alicia Matijasevich, Iná S. Santos, Aluísio J. D. Barros

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

Dietary intake patterns of children from the 2004 Pelotas birth cohort study have been described at 12, 24 and 48 months of age, but there is no information about dietary patterns of these children at 6 years. Then, we aimed to identify and describe dietary intake patterns of children aged 6 years as well as to assess their association with socioeconomic and demographic characteristics, early feeding practices and BMI z-score at 6 years.

Methods

We used principal components analysis to identify dietary intake patterns of 3,427 children from the 2004 Pelotas (Brazil) birth cohort study. We used multiple linear regression models to evaluate whether socioeconomic and demographic characteristics (socioeconomic position, mother’s age at birth, and child’s sex and skin colour), early feeding practices (exclusive breastfeeding duration and age of introduction of complementary foods), and BMI z-score at 6 years were associated with dietary intake patterns.

Results

We identified seven dietary components of children’s dietary intake patterns, namely: fruits and vegetables, snacks and treats, coffee and bread, milk, cheese and processed meats, rice and beans and carbohydrates. Dietary patterns were socially patterned, since six dietary components were associated with socioeconomic position. Moreover, high intake of snacks and treats and less fruits and vegetables were associated with children born to teenage mothers, with those exclusively breastfed for less than one month, and with those who started on complementary feeding before 4 months. Finally, overweight and obese children at 6 years presented lower intake of four out of seven dietary components, but we need to be cautious in interpretation due to limitations on food consumption reporting and due to possible reverse causality.

Conclusion

Dietary intake patterns in children are strongly influenced by socioeconomic characteristics. Other factors such as younger maternal age at birth, and both early weaning and early introduction of complementary feeding appear to be related with ‘unhealthier’ patterns. Overweight and obese children presented lower intake of four out of seven dietary components, but further studies would be interesting to understand the longitudinal effect of children’s feeding practices on BMI and adiposity.
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Literature
1.
go back to reference Onis M, Blossner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr. 2010;92:1257–64.CrossRefPubMed Onis M, Blossner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr. 2010;92:1257–64.CrossRefPubMed
2.
go back to reference WHO. Population-based prevention strategies for childhood obesity. Geneva: World Health Organization; 2009. WHO. Population-based prevention strategies for childhood obesity. Geneva: World Health Organization; 2009.
3.
go back to reference Biro F, Wien M. Childhood obesity and adult morbidities. Am J Clin Nutr. 2010;91:1499–505.CrossRef Biro F, Wien M. Childhood obesity and adult morbidities. Am J Clin Nutr. 2010;91:1499–505.CrossRef
4.
go back to reference Monasta L, Batty GD, Cattaneo A, Lutje V, Ronfani L, Van Lenthe FJ, et al. Early-life determinants of overweight and obesity: a review of systematic reviews. Obes Rev. 2010;11(10):695–708.CrossRefPubMed Monasta L, Batty GD, Cattaneo A, Lutje V, Ronfani L, Van Lenthe FJ, et al. Early-life determinants of overweight and obesity: a review of systematic reviews. Obes Rev. 2010;11(10):695–708.CrossRefPubMed
5.
go back to reference Grote V, Theurich M, Koletzko B. Do complementary feeding practices predict the later risk of obesity? Curr Opin Clin Nutr Metab Care. 2012;15(3):293–7.CrossRefPubMed Grote V, Theurich M, Koletzko B. Do complementary feeding practices predict the later risk of obesity? Curr Opin Clin Nutr Metab Care. 2012;15(3):293–7.CrossRefPubMed
6.
go back to reference Hu F. Dietary patterns analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol. 2002;13:3–9.CrossRefPubMed Hu F. Dietary patterns analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol. 2002;13:3–9.CrossRefPubMed
8.
go back to reference Varraso R, Garcia-Aymerich J, Monier F. Assessment of dietary patterns in nutritional epidemiology: principal components analysis compared with confirmatory factor analysis. Am J Clin Nutr. 2012;96:1079–92.CrossRefPubMed Varraso R, Garcia-Aymerich J, Monier F. Assessment of dietary patterns in nutritional epidemiology: principal components analysis compared with confirmatory factor analysis. Am J Clin Nutr. 2012;96:1079–92.CrossRefPubMed
9.
go back to reference Lioret S, Betoko A, Forhan A, Charles M, Heude B, Lauzon-Guillain B. Dietary patterns track from infancy to preschool age: cross-sectional and longitudinal perspectives. J Nutr. 2015;145(4):775–82.CrossRefPubMed Lioret S, Betoko A, Forhan A, Charles M, Heude B, Lauzon-Guillain B. Dietary patterns track from infancy to preschool age: cross-sectional and longitudinal perspectives. J Nutr. 2015;145(4):775–82.CrossRefPubMed
10.
go back to reference Smithers L, Brazionis L, Golley R, Mittinty M, Northstone K, Emmett P, et al. Associations between dietary patterns at 6 and 15 months of age and sociodemographic factors. Eur J Clin Nutr. 2012;66:658–66.CrossRefPubMed Smithers L, Brazionis L, Golley R, Mittinty M, Northstone K, Emmett P, et al. Associations between dietary patterns at 6 and 15 months of age and sociodemographic factors. Eur J Clin Nutr. 2012;66:658–66.CrossRefPubMed
11.
go back to reference McCourt HJ, Draffin CR, Woodside JV, Cardwell CR, Young IS, Hunter SJ, et al. Dietary patterns and cardiovascular risk factors in adolescents and young adults: the Northern Ireland hearts project. Br J Nutr. 2014;112:1685–98.CrossRefPubMed McCourt HJ, Draffin CR, Woodside JV, Cardwell CR, Young IS, Hunter SJ, et al. Dietary patterns and cardiovascular risk factors in adolescents and young adults: the Northern Ireland hearts project. Br J Nutr. 2014;112:1685–98.CrossRefPubMed
12.
go back to reference Barbaresko J, Siegert S, Koch M, Aits I, Lieb W, Nikolaus S, et al. Comparison of two exploratory dietary patterns in association with the metabolic syndrome in a Northern German population. Br J Nutr. 2014;112:1364–72.CrossRefPubMed Barbaresko J, Siegert S, Koch M, Aits I, Lieb W, Nikolaus S, et al. Comparison of two exploratory dietary patterns in association with the metabolic syndrome in a Northern German population. Br J Nutr. 2014;112:1364–72.CrossRefPubMed
13.
go back to reference Morouti N, Papavagelis C, Plytzanopoulou P, Kontogianni M, Vassilakou T, Malamos N, et al. Dietary patterns and breast cancer: a case–control study in women. Eur J Nutr. 2015;54:609–17.CrossRef Morouti N, Papavagelis C, Plytzanopoulou P, Kontogianni M, Vassilakou T, Malamos N, et al. Dietary patterns and breast cancer: a case–control study in women. Eur J Nutr. 2015;54:609–17.CrossRef
14.
go back to reference Craig L, McNeill G, Macdiarmid J, Masson L, Holmes B. Dietary patterns of school-age children in Scotland: association with socio-economic indicators, physical activity and obesity. Br J Nutr. 2010;103(3):319–34.CrossRefPubMed Craig L, McNeill G, Macdiarmid J, Masson L, Holmes B. Dietary patterns of school-age children in Scotland: association with socio-economic indicators, physical activity and obesity. Br J Nutr. 2010;103(3):319–34.CrossRefPubMed
15.
go back to reference Smithers LG, Golley RK, Brazionis L, Lynch JW. Characterizing whole diets of young children from developed countries and the association between diet and health: a systematic review. Nutr Rev. 2011;69(8):449–67. Epub 2011/07/28. eng.CrossRefPubMed Smithers LG, Golley RK, Brazionis L, Lynch JW. Characterizing whole diets of young children from developed countries and the association between diet and health: a systematic review. Nutr Rev. 2011;69(8):449–67. Epub 2011/07/28. eng.CrossRefPubMed
16.
go back to reference Shroff M, Perng W, Baylin A, Mora-Plazes M, Marin C, Villamor E. Adherence to a snacking dietary pattern and soda intake are related to the development of adiposity: a prospective study in school-age children. Public Health Nutr. 2014;17(7):1507–13.CrossRefPubMed Shroff M, Perng W, Baylin A, Mora-Plazes M, Marin C, Villamor E. Adherence to a snacking dietary pattern and soda intake are related to the development of adiposity: a prospective study in school-age children. Public Health Nutr. 2014;17(7):1507–13.CrossRefPubMed
17.
go back to reference Pala V, Lissner L, Hebestreit A, Lanfer A, Sieri S, Siani A, et al. Dietary patterns and longitudinal change in body mass in European children: a follow-up study on the IDEFICS multicenter cohort. Eur J Clin Nutr. 2013;67(10):1042–9.CrossRefPubMed Pala V, Lissner L, Hebestreit A, Lanfer A, Sieri S, Siani A, et al. Dietary patterns and longitudinal change in body mass in European children: a follow-up study on the IDEFICS multicenter cohort. Eur J Clin Nutr. 2013;67(10):1042–9.CrossRefPubMed
18.
go back to reference Smith ADAC, Emmett PM, Newby PK, Northstone K. Dietary patterns and changes in body composition in children between 9 and 11 years. Food Nutr Res. 2014;58(22769)1-8. Smith ADAC, Emmett PM, Newby PK, Northstone K. Dietary patterns and changes in body composition in children between 9 and 11 years. Food Nutr Res. 2014;58(22769)1-8.
19.
go back to reference Gatica G, Barros A, Madruga S, Matijasevich A, Santos I. Food intake profiles of children aged 12, 24 and 48 months from the 2004 Pelotas (Brazil) birth cohort: an exploratory analysis using principal components. Int J Behav Nutr Phys Act. 2012;9:43–52.CrossRefPubMedPubMedCentral Gatica G, Barros A, Madruga S, Matijasevich A, Santos I. Food intake profiles of children aged 12, 24 and 48 months from the 2004 Pelotas (Brazil) birth cohort: an exploratory analysis using principal components. Int J Behav Nutr Phys Act. 2012;9:43–52.CrossRefPubMedPubMedCentral
20.
go back to reference Fitzgerald A, Heary C, Nixon E, Kelly C. Factors influencing the food choices of Irish children and adolescents: a qualitative investigation. Health Promot Int. 2010;25(3):289–98.CrossRefPubMed Fitzgerald A, Heary C, Nixon E, Kelly C. Factors influencing the food choices of Irish children and adolescents: a qualitative investigation. Health Promot Int. 2010;25(3):289–98.CrossRefPubMed
21.
go back to reference Santos I, Barros A, Matijasevich A, Zanini R, Chrestani Cesar M, Camargo-Figuera F, et al. Cohort profile update: 2004 Pelotas (Brazil) birth cohort study. Body composition, mental health and genetic assessment at the 6 years follow-up. Int J Epidemiol. 2014;43(5):1437. a-f.CrossRefPubMedPubMedCentral Santos I, Barros A, Matijasevich A, Zanini R, Chrestani Cesar M, Camargo-Figuera F, et al. Cohort profile update: 2004 Pelotas (Brazil) birth cohort study. Body composition, mental health and genetic assessment at the 6 years follow-up. Int J Epidemiol. 2014;43(5):1437. a-f.CrossRefPubMedPubMedCentral
22.
go back to reference Barros A, Santos I, Victora C, Albernaz E, Domingues M, Timm I, et al. The 2004 Pelotas birth cohort: methods and description. Rev Saude Publica. 2006;40(3):402–13.CrossRefPubMed Barros A, Santos I, Victora C, Albernaz E, Domingues M, Timm I, et al. The 2004 Pelotas birth cohort: methods and description. Rev Saude Publica. 2006;40(3):402–13.CrossRefPubMed
23.
go back to reference Ribeiro A, Cardoso M. Development of a food frequency questionnaire as a tool form programs of chronic diseases prevention. Rev Nutr. 2002;15(2):239–45.CrossRef Ribeiro A, Cardoso M. Development of a food frequency questionnaire as a tool form programs of chronic diseases prevention. Rev Nutr. 2002;15(2):239–45.CrossRef
24.
go back to reference Barros A, Victora C. A nationwide wealth score based on the 2000 Brazilian demographic census. Rev Saude Publica. 2005;39(4):523–9.CrossRefPubMed Barros A, Victora C. A nationwide wealth score based on the 2000 Brazilian demographic census. Rev Saude Publica. 2005;39(4):523–9.CrossRefPubMed
25.
go back to reference Onis M, Onyango A, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85:660–7.CrossRefPubMedPubMedCentral Onis M, Onyango A, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85:660–7.CrossRefPubMedPubMedCentral
26.
go back to reference IBGE. Pesquisa de orçamentos familiares 2008–2009 : análise do consumo alimentar pessoal no Brasil. In: Coordenação de Trabalho e Rendimento, editor. Rio de Janeiro: IBGE; 2011. IBGE. Pesquisa de orçamentos familiares 2008–2009 : análise do consumo alimentar pessoal no Brasil. In: Coordenação de Trabalho e Rendimento, editor. Rio de Janeiro: IBGE; 2011.
27.
go back to reference Mak T, Prynne C, Cole D, Fitt E, Bates B, Stephen A. Patterns of sociodemographic and food practice characteristics in relation to fruit and vegetable consumption in children: results from the UK National diet and nutrition survey rolling programme (2008–2010). Public Health Nutr. 2013;16(11):1912–23.CrossRefPubMed Mak T, Prynne C, Cole D, Fitt E, Bates B, Stephen A. Patterns of sociodemographic and food practice characteristics in relation to fruit and vegetable consumption in children: results from the UK National diet and nutrition survey rolling programme (2008–2010). Public Health Nutr. 2013;16(11):1912–23.CrossRefPubMed
28.
go back to reference Fernández-Alvira J, Bammann K, Pala V, Krogh V, Barba G, Eiben G, et al. Country-specific dietary patterns and associations with socioeconomic status in European children: the IDEFICS study. Eur J Clin Nutr. 2014;68(7):811–21.CrossRefPubMed Fernández-Alvira J, Bammann K, Pala V, Krogh V, Barba G, Eiben G, et al. Country-specific dietary patterns and associations with socioeconomic status in European children: the IDEFICS study. Eur J Clin Nutr. 2014;68(7):811–21.CrossRefPubMed
29.
go back to reference Mayen A, Marques-Vidal P, Paccaud F, Bovet P, Stringhini S. Socioeconomic determinants of dietary patterns in low- and middle-income countries: a systematic review. Am J Clin Nutr. 2014;100:1520–31.CrossRefPubMed Mayen A, Marques-Vidal P, Paccaud F, Bovet P, Stringhini S. Socioeconomic determinants of dietary patterns in low- and middle-income countries: a systematic review. Am J Clin Nutr. 2014;100:1520–31.CrossRefPubMed
31.
go back to reference North K, Emmett P. Multivariate analysis of diet among three-year-old children and associations with socio-demographic characteristics characteristics. The Avon longitudinal study of pregnancy and childhood (ALSPAC) study team. Eu J Clin Nutr. 2000;54(1):73–80.CrossRef North K, Emmett P. Multivariate analysis of diet among three-year-old children and associations with socio-demographic characteristics characteristics. The Avon longitudinal study of pregnancy and childhood (ALSPAC) study team. Eu J Clin Nutr. 2000;54(1):73–80.CrossRef
32.
go back to reference Aranceta J, Perez-Rodrigo C, Ribas L, Serra-Majem L. Sociodemographic and lifestyle determinants of food patterns in Spanish children and adolescents: the enKid study. Eur J Clin Nutr. 2003;57:S40–4.CrossRefPubMed Aranceta J, Perez-Rodrigo C, Ribas L, Serra-Majem L. Sociodemographic and lifestyle determinants of food patterns in Spanish children and adolescents: the enKid study. Eur J Clin Nutr. 2003;57:S40–4.CrossRefPubMed
33.
go back to reference Northstone K, Emmett P. Multivariate analysis of diet in children at four and seven years of age and associations with socio-demographic characteristics. Eur J Clin Nutr. 2005;59:751–60.CrossRefPubMed Northstone K, Emmett P. Multivariate analysis of diet in children at four and seven years of age and associations with socio-demographic characteristics. Eur J Clin Nutr. 2005;59:751–60.CrossRefPubMed
34.
go back to reference Mensink G, Kleiser C, Richter A. Food consumption of children and adolescents in Germany. Results of the German health interview and examination survey for children and adolescents. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2007;50:609–23.CrossRefPubMed Mensink G, Kleiser C, Richter A. Food consumption of children and adolescents in Germany. Results of the German health interview and examination survey for children and adolescents. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2007;50:609–23.CrossRefPubMed
35.
go back to reference Novotny R, Boushey C, Bock M, Peck L, Auld G, Bruhn C, et al. Calcium intake of Asian, Hispanic and white youth. J Am Coll Nutr. 2003;22:64–70.CrossRefPubMed Novotny R, Boushey C, Bock M, Peck L, Auld G, Bruhn C, et al. Calcium intake of Asian, Hispanic and white youth. J Am Coll Nutr. 2003;22:64–70.CrossRefPubMed
36.
go back to reference Green B, Turner L, Stevenson E, Rumbold P. Short communication: patterns of dairy consumption in free-living children and adolescents. J Dairy Sci. 2015;98:3701–5.CrossRefPubMed Green B, Turner L, Stevenson E, Rumbold P. Short communication: patterns of dairy consumption in free-living children and adolescents. J Dairy Sci. 2015;98:3701–5.CrossRefPubMed
37.
go back to reference Cooke LJ, Wardle J. Age and gender differences in children’s food preferences. Br J Nutr. 2007;93(05):741.CrossRef Cooke LJ, Wardle J. Age and gender differences in children’s food preferences. Br J Nutr. 2007;93(05):741.CrossRef
38.
go back to reference Ranijt N, Evans A, Springer A, Hoelscher D, Kelder S. Racial and ethnic differences in the home food environmemnt explain disparities in dietary practices of middle school children in Texas. J Nutr Educ Behav. 2015;47(1):53–60.CrossRef Ranijt N, Evans A, Springer A, Hoelscher D, Kelder S. Racial and ethnic differences in the home food environmemnt explain disparities in dietary practices of middle school children in Texas. J Nutr Educ Behav. 2015;47(1):53–60.CrossRef
39.
go back to reference Harris T, Ramsey M. Paternal modeling, household availability, and paternal intake as predictors of fruit, vegetable, and sweetened beverage consumption among African American children. Appetite. 2015;85:171–7.CrossRefPubMed Harris T, Ramsey M. Paternal modeling, household availability, and paternal intake as predictors of fruit, vegetable, and sweetened beverage consumption among African American children. Appetite. 2015;85:171–7.CrossRefPubMed
40.
41.
go back to reference Grieger J, Scott J, Cobiac L. Dietary patterns and breast-feeding in Australian children. Public Health Nutr. 2011;14(11):1939–47.CrossRefPubMed Grieger J, Scott J, Cobiac L. Dietary patterns and breast-feeding in Australian children. Public Health Nutr. 2011;14(11):1939–47.CrossRefPubMed
42.
go back to reference Menella J, Beuchamp G. Mother’s milk enhances the acceptance of cereals during weaning. Pediatr Res. 1997;41:188–92.CrossRef Menella J, Beuchamp G. Mother’s milk enhances the acceptance of cereals during weaning. Pediatr Res. 1997;41:188–92.CrossRef
43.
go back to reference Menella J, Forestell C, Morgan L, Beuchamp G. Early milk feeding influences taste acceptance and liking during infancy. Am J Clin Nutr. 2009;90:780–8.CrossRef Menella J, Forestell C, Morgan L, Beuchamp G. Early milk feeding influences taste acceptance and liking during infancy. Am J Clin Nutr. 2009;90:780–8.CrossRef
44.
go back to reference Canella D, Levy R, Martins A, Claro R, Moubarac J, Baraldi L, et al. Ultra-processed food products and obesity in Brazilian households (2008–2009). Plos One. 2014;9(3):e92752.CrossRefPubMedPubMedCentral Canella D, Levy R, Martins A, Claro R, Moubarac J, Baraldi L, et al. Ultra-processed food products and obesity in Brazilian households (2008–2009). Plos One. 2014;9(3):e92752.CrossRefPubMedPubMedCentral
45.
go back to reference Louzada M, Martins A, Canella D, Baraldi L, Levy R, Claro R, et al. Impact of ultra-processed foods on micronutrient content in the Brazilian diet. Rev Saude Publica. 2015;49:1–8.CrossRef Louzada M, Martins A, Canella D, Baraldi L, Levy R, Claro R, et al. Impact of ultra-processed foods on micronutrient content in the Brazilian diet. Rev Saude Publica. 2015;49:1–8.CrossRef
46.
go back to reference Bielemann R, Motta J, Minten G, Horta B, Gigante D. Consumption of ultra-processed foods and their impact on the diet of young adults. Rev Saude Publica. 2015;49:28.PubMedPubMedCentral Bielemann R, Motta J, Minten G, Horta B, Gigante D. Consumption of ultra-processed foods and their impact on the diet of young adults. Rev Saude Publica. 2015;49:28.PubMedPubMedCentral
47.
go back to reference Monteiro C, Levy R, Claro R, Castro I, Cannon G. A new classification of foods based on the extent and purpose of their processing. Cad Saude Publica. 2010;26(11):2039–49.CrossRefPubMed Monteiro C, Levy R, Claro R, Castro I, Cannon G. A new classification of foods based on the extent and purpose of their processing. Cad Saude Publica. 2010;26(11):2039–49.CrossRefPubMed
48.
Metadata
Title
Dietary intake patterns of children aged 6 years and their association with socioeconomic and demographic characteristics, early feeding practices and body mass index
Authors
Leonardo Pozza Santos
Maria Cecília Formoso Assunção
Alicia Matijasevich
Iná S. Santos
Aluísio J. D. Barros
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3725-2

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