Identification of a dietary pattern associated with greater cardiometabolic risk in adolescence

G. Appannah ^a^,^b,
G.K. Pot ^c,
R.C. Huang ^d,
W.H. Oddy ^d,
L.J. Beilin ^e,
T.A. Mori ^e,
S.A. Jebb ^f,
G.L. Ambrosini ^b^,^d^,^g^,^, (Associate Professor)

doi:10.1016/j.numecd.2015.04.007

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Abstract

Background and aims

Energy dense, high fat, low fibre diets may contribute to obesity in young people, however their relationships with other cardiometabolic risk factors are unclear. We examined associations between an ‘energy-dense, high-fat and low-fibre’ dietary pattern (DP) and cardiometabolic risk factors, and the tracking of this DP in adolescence.

Methods and Results

Data was sourced from participants in the Western Australian Pregnancy (Raine) Cohort Study. At 14 and 17 y, dietary intake, anthropometric and biochemical data were measured and z-scores for an ‘energy dense, high fat and low fibre’ DP were estimated using reduced rank regression (RRR). Associations between DP z-scores and cardiometabolic risk factors were examined using regression models. Tracking of DP z-scores was assessed using Pearson’s correlation coefficient.

A 1 SD unit increase in DP z-score between 14 and 17 y was associated with a 20% greater odds of high metabolic risk (95%CI: 1.01, 1.41) and a 0.04 mmol/L higher fasting glucose in boys (95%CI: 0.01, 0.08); a 28% greater odds of a high-waist circumference (95%CI: 1.00, 1.63) in girls. An increase of 3% and 4% was observed for insulin and HOMA (95%CI: 1%, 7%), respectively, in boys and girls, for every 1 SD increase in DP z-score and independently of BMI. The DP showed moderate tracking between 14 and 17 y of age (r = 0.51 for boys, r = 0.45 for girls).

Conclusion

An ‘energy dense, high fat, low fibre’ DP is positively associated with cardiometabolic risk factors and tends to persist throughout adolescence.

Keywords

Dietary patterns;
energy density;
fibre;
fat;
cardiometabolic risk factors;
adolescents;
Raine study

Abbreviations

CVD, cardiovascular diseases;
RRR, reduced rank regression;
DP, dietary pattern;
Raine, Western Australian Pregnancy (Raine) Cohort;
FFQ, food frequency questionnaire;
BMI, body mass index;
WC, waist circumference;
HOMA, insulin resistance;
y, years;
CSIRO, Commonwealth Scientific and Industrial Research Organisation;
CDC, Center for Disease Control;
IOTF, International Obesity Task Force;
HDL-C, high density lipoprotein cholesterol;
LDL-C, low density lipoprotein cholesterol;
PWC-170, Physical Working Capacity 170;
PCA, principal component analysis

: Corresponding author. School of Population Health M431, University of Western Australia, 35 Stirling Highway, Crawley 6009, Perth, Western Australia. Tel.: +61 (0) 8 6488 7375; fax: +61 (0) 8 6488 1188.

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Monday, 4 May 2015