Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Dr. Meurerlaan 8, Amsterdam, SM, 1067, The Netherlands.
Department Nutrition & Dietetics, Internal Medicine, Amsterdam University Medical Centers, location VUmc ZH4A12. De Boelelaan 1117, Amsterdam, HV, 1081, The Netherlands.
BMC Public Health. 2020 Apr 1;20(1):427. doi: 10.1186/s12889-020-08559-y.
Social inequalities in bodyweight start early in life and track into adulthood. Dietary patterns are an important determinant of weight development in children, towards both overweight and underweight. Therefore, we aimed to examine weight development between age 5 and 10 years by ethnicity, SES and thereafter by BMI category at age 5, to explore its association with dietary patterns at age 5.
Participants were 1765 children from the Amsterdam Born Children and their Development (ABCD) cohort that had valid data on BMI at age 5 and 10 and diet at age 5. Linear mixed model analysis was used to examine weight development between age 5 and 10 years and to assess if four previously identified dietary patterns at age 5 (snacking, full-fat, meat and healthy) were associated with weight development. Analyses were adjusted for relevant confounders, stratified by ethnicity and SES and thereafter stratified per BMI category at age 5.
Overall, weight decreased in Dutch and high SES children and increased in non-Dutch and low/middle SES children. Across the range of bodyweight categories at age 5, we observed a conversion to normal weight, which was stronger in Dutch and high SES children but less pronounced in non-Dutch and low/middle SES children. Overall, the observed associations between weight development and dietary patterns were mixed with some unexpected findings: a healthy dietary pattern was positively associated with weight development in most groups, regardless of ethnicity and SES (e.g. Dutch B 0.084, 95% CI 0.038;0.130 and high SES B 0.096, 95% CI 0.047;0.143) whereas the full-fat pattern was negatively associated with weight development (e.g. Dutch B -0.069, 95% CI -0.114;-0.024 and high SES B -0.072, 95% CI -0.119;-0.026).
We observed differential weight development per ethnic and SES group. Our results indicate that each ethnic and SES group follows its own path of weight development. Associations between dietary patterns and weight development showed some unexpected findings; follow-up research is needed to understand the association between dietary patterns and weight development.
体重的社会不平等在生命早期就开始出现,并一直持续到成年。饮食模式是儿童体重发展的一个重要决定因素,无论是超重还是体重不足。因此,我们旨在通过种族、社会经济地位(SES)以及之后在 5 岁时的 BMI 类别来研究 5 至 10 岁之间的体重发展情况,以探讨其与 5 岁时的饮食模式之间的关系。
本研究参与者为来自阿姆斯特丹出生儿童及其发展(ABCD)队列的 1765 名儿童,他们在 5 岁和 10 岁时的 BMI 数据以及 5 岁时的饮食数据有效。采用线性混合模型分析来研究 5 至 10 岁之间的体重发展情况,并评估在 5 岁时识别出的四种饮食模式(零食、全脂、肉类和健康)是否与体重发展有关。分析结果针对相关混杂因素进行了调整,按种族和 SES 进行了分层,之后按 5 岁时的 BMI 类别进行了分层。
总体而言,荷兰裔和高 SES 儿童的体重下降,而非荷兰裔和低/中 SES 儿童的体重增加。在 5 岁时的体重类别范围内,我们观察到体重向正常体重转变,这种转变在荷兰裔和高 SES 儿童中更为明显,但在非荷兰裔和低/中 SES 儿童中不太明显。总体而言,体重发展与饮食模式之间的关联是混杂的,有些结果出人意料:在大多数群体中,健康的饮食模式与体重发展呈正相关,无论种族和 SES 如何(例如,荷兰裔 B=0.084,95%CI 0.038;0.130 和高 SES B=0.096,95%CI 0.047;0.143),而全脂模式与体重发展呈负相关(例如,荷兰裔 B=-0.069,95%CI -0.114;-0.024 和高 SES B=-0.072,95%CI -0.119;-0.026)。
我们观察到不同种族和 SES 群体之间的体重发展存在差异。我们的研究结果表明,每个种族和 SES 群体都有自己的体重发展轨迹。饮食模式与体重发展之间的关联存在一些出人意料的结果;需要进一步的研究来了解饮食模式与体重发展之间的关系。