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Pediatrics

Adherence to index-based dietary patterns in childhood and BMI trajectory during the transition to adolescence: the EPOCH study

International Journal of Obesity volume 45, pages 2439–2446 (2021)Cite this article

Subjects

Abstract

Background

In the United States, one in five adolescents are obese. Index-based dietary patterns are measures of the overall diet that have the potential to serve as valuable obesity risk stratification tools. However, little is known about the association between adherence to index-based dietary patterns in childhood and BMI during the transition from childhood to adolescence.

Objective

To prospectively examine the relationship between adherence to three index-based dietary patterns in childhood and BMI trajectory during the transition to adolescence.

Methods

The study included 581 children enrolled in a Colorado prospective cohort study conducted between 2006 and 2015. Dietary intake was assessed with the Block Kids Food Frequency Questionnaire at age 10 years. Scores were calculated for the Healthy Eating Index—2010 (HEI-2010), the alternate Mediterranean (aMED) diet, and the Dietary Approaches to Stop Hypertension (DASH) diet. Weight and height were assessed via anthropometry at two research visits (ages 10 and 16 years), with interim clinical measurements extracted from Kaiser Permanente medical records. Separate mixed models were used to assess the association between each diet index score and BMI over a 6-year period. Models were stratified by sex and adjusted for age, race/ethnicity, income, and exposure to gestational diabetes.

Results

Median (IQR) number of BMI assessments was 14 (10–18). Among girls, for every ten-unit increase in HEI-2010 score, there was an average 0.64 kg/m2 decrease (p = 0.007) in BMI over time, after adjustment for covariates. Among girls, there was no association between BMI and aMED (β = −0.19, p = 0.24) or DASH (β = 0.28, p = 0.38). Among boys, there was no statistically significant association between BMI and HEI-2010 (0.06, p = 0.83), aMED (0.07, p = 0.70), or DASH (0.42, p = 0.06).

Conclusions

Efforts to prevent adolescent obesity could benefit from considering the degree of adherence to federal dietary guidance, as assessed by the HEI, in the period preceding adolescence, especially among girls.

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Funding

T32 DK007658, R01DK068001, R01DK068001, R01GM121081.

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Authors and Affiliations

  1. Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, CO, USA

    Traci A. Bekelman, Brandy M. Ringham, Katherine A. Sauder, Kylie H. Harrall, Deborah H. Glueck & Dana Dabelea

  2. Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA

    Traci A. Bekelman, Katherine A. Sauder & Dana Dabelea

  3. Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Katherine A. Sauder, Susan L. Johnson, Deborah H. Glueck & Dana Dabelea

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  1. Traci A. Bekelman
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Contributions

TAB, SLJ, DHG, KAS, and DD conceptualized the project; TAB, BMR, KHH, and DHG analyzed the data; TAB drafted the manuscript. All authors played an important role in interpreting the results, provided substantive feedback on the manuscript, and approved the final version.

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Correspondence to Traci A. Bekelman.

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Bekelman, T.A., Ringham, B.M., Sauder, K.A. et al. Adherence to index-based dietary patterns in childhood and BMI trajectory during the transition to adolescence: the EPOCH study. Int J Obes 45, 2439–2446 (2021). https://doi.org/10.1038/s41366-021-00917-z

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