title: Dietary intake patterns of children aged 6 years and their association with socioeconomic and demographic characteristics, early feeding practices and body mass index.
abstract: Dietary intake patterns of children from the 2004 Pelotas birth cohort study have been described at 12, 24 and 48 months of age, but there is no information about dietary patterns of these children at 6 years. Then, we aimed to identify and describe dietary intake patterns of children aged 6 years as well as to assess their association with socioeconomic and demographic characteristics, early feeding practices and BMI z-score at 6 years.
  
  
  
  We used principal components analysis to identify dietary intake patterns of 3,427 children from the 2004 Pelotas (Brazil) birth cohort study. We used multiple linear regression models to evaluate whether socioeconomic and demographic characteristics (socioeconomic position, mother's age at birth, and child's sex and skin colour), early feeding practices (exclusive breastfeeding duration and age of introduction of complementary foods), and BMI z-score at 6 years were associated with dietary intake patterns.
  
  
  
  We identified seven dietary components of children's dietary intake patterns, namely: fruits and vegetables, snacks and treats, coffee and bread, milk, cheese and processed meats, rice and beans and carbohydrates. Dietary patterns were socially patterned, since six dietary components were associated with socioeconomic position. Moreover, high intake of snacks and treats and less fruits and vegetables were associated with children born to teenage mothers, with those exclusively breastfed for less than one month, and with those who started on complementary feeding before 4 months. Finally, overweight and obese children at 6 years presented lower intake of four out of seven dietary components, but we need to be cautious in interpretation due to limitations on food consumption reporting and due to possible reverse causality.
  
  
  
  Dietary intake patterns in children are strongly influenced by socioeconomic characteristics. Other factors such as younger maternal age at birth, and both early weaning and early introduction of complementary feeding appear to be related with 'unhealthier' patterns. Overweight and obese children presented lower intake of four out of seven dietary components, but further studies would be interesting to understand the longitudinal effect of children's feeding practices on BMI and adiposity.
authors.affiliation: Postgraduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro Street, 3th floor, Pelotas, Zip Code 96020-220, Brazil. leonardo_pozza@yahoo.com.br.
authors.forename: Leonardo Pozza
authors.initials: LP
authors.lastname: Santos
authors.affiliation: Postgraduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro Street, 3th floor, Pelotas, Zip Code 96020-220, Brazil.
authors.forename: Maria Cecília Formoso
authors.initials: MCF
authors.lastname: Assunção
authors.affiliation: Postgraduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro Street, 3th floor, Pelotas, Zip Code 96020-220, Brazil.|Department of Preventive Medicine, University of São Paulo, 455 Dr Arnaldo avenue, 2nd floor, São Paulo, Zip Code 01246-903, Brazil.
authors.forename: Alicia
authors.initials: A
authors.lastname: Matijasevich
authors.affiliation: Postgraduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro Street, 3th floor, Pelotas, Zip Code 96020-220, Brazil.
authors.forename: Iná S
authors.initials: IS
authors.lastname: Santos
authors.affiliation: Postgraduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro Street, 3th floor, Pelotas, Zip Code 96020-220, Brazil.
authors.forename: Aluísio J D
authors.initials: AJD
authors.lastname: Barros
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D001938:Brazil; D001942:Breast Feeding; D002648:Child; D015331:Cohort Studies; D003710:Demography; D004032:Diet / Q000592:standards; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009035:Mothers; D009765:Obesity; D050177:Overweight; D011247:Pregnancy; D011253:Pregnancy in Adolescence; D025341:Principal Component Analysis; D062410:Snacks; D012923:Social Class; D011795:Surveys and Questionnaires; D014886:Weaning
keywords: Cohort studies; Dietary intake; Nutrition assessment; Principal component analysis