To identify predictors of obesity in adults and investigate to what extent these predictors are independent of other major confounding factors.


Data collected at baseline from 1441 participants from the Food4Me study conducted in seven European countries were included in this study. A food frequency questionnaire was used to measure dietary intake. Accelerometers were used to assess physical activity levels (PA), whereas participants self-reported their body weight, height and waist circumference via the internet.


The main factors associated (p < 0.05) with higher BMI per 1-SD increase in the exposure were age (β:1.11 kg/m2), intakes of processed meat (β:1.04 kg/m2), red meat (β:1.02 kg/m2), saturated fat (β:0.84 kg/m2), monounsaturated fat (β:0.80 kg/m2), protein (β:0.74 kg/m2), total energy intake (β:0.50 kg/m2), olive oil (β:0.36 kg/m2), sugar sweetened carbonated drinks (β:0.33 kg/m2) and sedentary time (β:0.73 kg/m2). In contrast, the main factors associated with lower BMI per 1-SD increase in the exposure were PA (β:−1.36 kg/m2), intakes of wholegrains (β:−1.05 kg/m2), fibre (β:−1.02 kg/m2), fruits and vegetables (β:−0.52 kg/m2), nuts (β:−0.52 kg/m2), polyunsaturated fat (β:−0.50 kg/m2), Healthy Eating Index (β:−0.42 kg/m2), Mediterranean diet score (β:−0.40 kg/m2), oily fish (β:−0.31 kg/m2), dairy (β:−0.31 kg/m2) and fruit juice (β:−0.25 kg/m2).


These findings are important for public health and suggest that promotion of increased PA, reducing sedentary behaviours and improving the overall quality of dietary patterns are important strategies for addressing the existing obesity epidemic and associated disease burden.

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Additional information

Carlos Celis-Morales and Katherine M. Livingstone contributed equally to this work


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The Food4me randomised controlled trial was funded by the European Commission under the Food, Agriculture, Fisheries and Biotechnology Theme of the 7th Framework Programme for Research and Technological Development [265494].

Author contributions

Author responsibilities were as follows: CCM, KML, AA, JCM performed the statistical analysis and wrote the manuscript. YM, IT, CAD, ERG, LB, JAL, JAM, WHS, HD, MG and JCM contributed to the research design. JCM was the Food4Me Proof of Principle study leader. CCM, CFMM, HF, CBO, CW, ALM, RF, SNC, RSC, CPL, MG, MCW, ERG, LB and JCM contributed to the developing of the Standardised Operating Procedures for the study. CCM, SNC, RSC, CW, CBO, HF, CFMM, AM, RF, CPL, MG, IT, MCW and JCM conducted the intervention. CCM, CFMM and WHS contributed to physical activity measurements.

Author information

Author notes


    1. Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK

      • Carlos Celis-Morales
      • , Katherine M. Livingstone
      •  & John C. Mathers
    2. BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK

      • Carlos Celis-Morales
      •  & Alexander Affleck
    3. Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain

      • Santiago Navas-Carretero
      • , Rodrigo San-Cristobal
      •  & J Alfredo Martinez
    4. Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands

      • Cyril F. M. Marsaux
      •  & Wim H. M. Saris
    5. UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland

      • Clare B O’Donovan
      • , Hannah Forster
      • , Clara Woolhead
      • , Eileen R. Gibney
      • , Marianne C. Walsh
      • , Lorraine Brennan
      •  & Mike Gibney
    6. Department of Nutrition and Dietetics, Harokopio University, Athens, Greece

      • George Moschonis
      • , Christina-Paulina Lambrinou
      • , Christina Mavrogianni
      •  & Yannis Manios
    7. Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK

      • Anna L. Macready
      • , Rosalind Fallaize
      •  & Julie A. Lovegrove
    8. ZIEL Research Center of Nutrition and Food Sciences, Biochemistry Unit, Technische Universität München, Munchen, Germany

      • Silvia Kolossa
      •  & Hannelore Daniel
    9. Human Nutrition Department, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland

      • Iwona Traczyk
    10. Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway

      • Christian A Drevon


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