Huybrechts Inge, Lioret Sandrine, Mouratidou Theodora, Gunter Marc J, Manios Yannis, Kersting Mathilde, Gottrand Frederic, Kafatos Anthony, De Henauw Stefaan, Cuenca-García Magdalena, Widhalm Kurt, Gonzales-Gross Marcela, Molnar Denes, Moreno Luis A, McNaughton Sarah A
1International Agency for Research on Cancer,Nutrition and Metabolism Section, 69372 Lyon CEDEX 08,France.
2Centre for Physical Activity and Nutrition Research,School of Exercise and Nutrition Sciences,Deakin University,Melbourne,VIC 3125,Australia.
Br J Nutr. 2017 Jan;117(2):295-305. doi: 10.1017/S0007114516004669. Epub 2017 Feb 7.
This study aims to examine repeatability of reduced rank regression (RRR) methods in calculating dietary patterns (DP) and cross-sectional associations with overweight (OW)/obesity across European and Australian samples of adolescents. Data from two cross-sectional surveys in Europe (2006/2007 Healthy Lifestyle in Europe by Nutrition in Adolescence study, including 1954 adolescents, 12-17 years) and Australia (2007 National Children's Nutrition and Physical Activity Survey, including 1498 adolescents, 12-16 years) were used. Dietary intake was measured using two non-consecutive, 24-h recalls. RRR was used to identify DP using dietary energy density, fibre density and percentage of energy intake from fat as the intermediate variables. Associations between DP scores and body mass/fat were examined using multivariable linear and logistic regression as appropriate, stratified by sex. The first DP extracted (labelled 'energy dense, high fat, low fibre') explained 47 and 31 % of the response variation in Australian and European adolescents, respectively. It was similar for European and Australian adolescents and characterised by higher consumption of biscuits/cakes, chocolate/confectionery, crisps/savoury snacks, sugar-sweetened beverages, and lower consumption of yogurt, high-fibre bread, vegetables and fresh fruit. DP scores were inversely associated with BMI z-scores in Australian adolescent boys and borderline inverse in European adolescent boys (so as with %BF). Similarly, a lower likelihood for OW in boys was observed with higher DP scores in both surveys. No such relationships were observed in adolescent girls. In conclusion, the DP identified in this cross-country study was comparable for European and Australian adolescents, demonstrating robustness of the RRR method in calculating DP among populations. However, longitudinal designs are more relevant when studying diet-obesity associations, to prevent reverse causality.
本研究旨在检验降秩回归（RRR）方法在计算青少年饮食模式（DP）以及欧洲和澳大利亚青少年样本中超重（OW）/肥胖的横断面关联方面的可重复性。使用了来自欧洲两项横断面调查的数据（2006/2007年欧洲青少年营养健康生活方式研究，包括1954名12 - 17岁青少年）和澳大利亚的数据（2007年全国儿童营养与身体活动调查，包括1498名12 - 16岁青少年）。饮食摄入量通过两次非连续的24小时回忆法进行测量。RRR用于以饮食能量密度、纤维密度和脂肪能量摄入百分比作为中间变量来识别DP。使用多变量线性和逻辑回归，根据性别分层，检验DP得分与体重/脂肪之间的关联。提取的第一个DP（标记为“能量密集、高脂肪、低纤维”）分别解释了澳大利亚和欧洲青少年中47%和31%的反应变异。欧洲和澳大利亚青少年的情况相似，其特点是饼干/蛋糕、巧克力/糖果、薯片/咸味小吃、含糖饮料的消费量较高，而酸奶、高纤维面包、蔬菜和新鲜水果的消费量较低。在澳大利亚青少年男孩中，DP得分与BMI z评分呈负相关，在欧洲青少年男孩中呈临界负相关（与体脂百分比情况相同）。同样，在两项调查中，男孩中DP得分越高，OW的可能性越低。在青少年女孩中未观察到此类关系。总之，这项跨国研究中确定的DP在欧洲和澳大利亚青少年中具有可比性，表明RRR方法在计算不同人群的DP方面具有稳健性。然而，在研究饮食与肥胖的关联时，纵向设计更具相关性，以防止反向因果关系。
