Liberali Rafaela, Kupek Emil, Assis Maria Alice Altenburg de
Post-Graduation Program in Medical Sciences, Federal University of Santa Catarina, Florianopolis, SC, Brazil.
Department of Public Health, Federal University of Santa Catarina, Florianopolis, SC, Brazil.
Child Obes. 2020 Mar;16(2):70-85. doi: 10.1089/chi.2019.0059. Epub 2019 Nov 19.
Childhood overweight and obesity are recognized as predictors of the risk of obesity in adulthood. The aim of this systematic literature review was to determine the association between dietary pattern and obesity risk among children. Articles were selected from databases (Cochrane Library, Lilacs, Eric, Livivo, and PubMed/Medline), without limitations regarding language or date. Database-specific search terms included the key words "obesity," "diet," "dietary pattern," "childhood," "children," "adolescents," and relevant synonyms. The review included studies that reported the assessment of the dietary pattern in childhood and that correlated eating patterns with the obesity risk through cluster analysis (CA) and/or factor analysis and/or principal component analysis and presented odds ratios (ORs). The methodology of the selected studies was evaluated using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Owing to the heterogeneity among the assessments of the association of dietary patterns and obesity, the results are described narratively. Using a selection process in two phases, 16 articles were included. Fifteen studies used a cross-sectional design, and one case-control study. The included studies showed variation in sample size (range = 232 to 10,187 children/adolescents) and age (range = 1-19 years old). The studies reported between two and five dietary patterns each. The OR for the relationship between the dietary pattern and the risk of childhood obesity ranged from OR = 1.02; confidence interval (95% CI) (0.91-1.15) to OR = 3.55; 95% CI (1.80-7.03). In this study, the dietary patterns identified by the studies were given different names. The food intake patterns identified could, in most factor or CA studies, be categorized as (1) potentially obesogenic foods that increased risk of becoming overweight (including fatty cheeses, sugary drinks, processed foods, fast food, candies, snacks, cakes, animal products, whole milk, and refined grains) or (2) food classified as healthy with the weakest association with the risk of becoming overweight or obese (including low levels of sugar and fat and high levels of fruits, vegetables, whole grains, fish, nuts, legumes, and yogurt). Overall, the results indicated from most studies that a diet with a lower percentage of obesogenic foods should be effective in reducing the risk of developing obesity.
儿童超重和肥胖被认为是成年期肥胖风险的预测因素。本系统文献综述的目的是确定儿童饮食模式与肥胖风险之间的关联。文章从数据库(Cochrane图书馆、Lilacs、Eric、Livivo和PubMed/Medline)中选取,不限语言或日期。特定数据库的搜索词包括关键词“肥胖”“饮食”“饮食模式”“童年”“儿童”“青少年”以及相关同义词。该综述纳入了报告儿童期饮食模式评估且通过聚类分析(CA)和/或因子分析和/或主成分分析将饮食模式与肥胖风险相关联并呈现比值比(OR)的研究。使用JBI分析性横断面研究关键评估清单对所选研究的方法进行评估。由于饮食模式与肥胖关联评估之间存在异质性,结果采用叙述方式描述。通过两阶段的筛选过程,纳入了16篇文章。15项研究采用横断面设计,1项为病例对照研究。纳入研究的样本量(范围 = 232至10187名儿童/青少年)和年龄(范围 = 1至19岁)各不相同。各项研究报告的饮食模式均为2至5种。饮食模式与儿童肥胖风险之间关系的OR范围为OR = 1.02;置信区间(95%CI)(0.91 - 1.15)至OR = 3.55;95%CI(1.80 - 7.03)。在本研究中,各项研究确定的饮食模式有不同名称。在大多数因子分析或CA研究中确定的食物摄入模式可分为两类:(1)可能导致肥胖的食物,会增加超重风险(包括高脂奶酪、含糖饮料、加工食品、快餐、糖果、零食、蛋糕、动物制品、全脂牛奶和精制谷物);(2)与超重或肥胖风险关联最弱的健康食物(包括低糖低脂且富含水果、蔬菜、全谷物、鱼类、坚果、豆类和酸奶)。总体而言,大多数研究结果表明,致肥胖食物比例较低的饮食应能有效降低肥胖发生风险。