title: Dietary patterns associated with overweight and obesity among Brazilian schoolchildren: an approach based on the time-of-day of eating events.
abstract: Several studies reported that the timing of eating events has critical implications in the prevention of obesity, but dietary patterns regarding the time-of-day have not been explored in children. The aim of this study was to derive latent food patterns of daily eating events and to examine their associations with overweight/obesity among schoolchildren. A population-based cross-sectional study was conducted with 7-10-year-old Brazilian schoolchildren (n 1232) who completed the Previous Day Food Questionnaire, illustrated with twenty-one foods/beverages in six daily eating events. Latent class analysis was used to derive dietary patterns whose association with child weight status was evaluated by multivariate multinomial regression. Four mutually exclusive latent classes of dietary patterns were identified and labelled according to the time-of-day of eating events and food intake probability (FIP): (A) higher FIP only at lunch; (B) lower FIP at all eating events; (C) higher FIP at lunch, afternoon and evening snacks; (D) lower FIP at breakfast and at evening snack, higher FIP at other meals/snacks. The percentages of children within these classes were 32·3, 48·6, 15·1 and 4·0 %, respectively. After controlling for potential confounders, the mean probabilities of obesity for these classes were 6 % (95 % CI 3·0, 9·0), 13 % (95 % CI 9·0, 17·0), 12 % (95 % CI 6·0, 19) and 11 % (95 % CI 5·0, 17·0), in the same order. In conclusion, the children eating traditional lunch with rice and beans as the main meal of the day (class A) had the lowest obesity risk, thus reinforcing the importance of both the food type and the time-of-day of its intake for weight status.
authors.affiliation: 1Department of Public Health,Center of Health Science,Federal University of Santa Catarina,Campus Universitário - Trindade,Florianópolis 88040-900,Brazil.
authors.forename: Emil
authors.initials: E
authors.lastname: Kupek
authors.affiliation: 2Center of Health Science,Federal University of Santa Catarina,Campus Universitário - Trindade,Florianópolis 88040-900,Brazil.
authors.forename: Adriana S
authors.initials: AS
authors.lastname: Lobo
authors.affiliation: 2Center of Health Science,Federal University of Santa Catarina,Campus Universitário - Trindade,Florianópolis 88040-900,Brazil.
authors.forename: Danielle B
authors.initials: DB
authors.lastname: Leal
authors.affiliation: 3Equipe de Recherche en Epidémiologie Nutritionnelle,Centre de Recherche en Epidémiologie et Statistiques,Université Paris 13,Inserm (U1153),Inra (U1125),Cnam,COMUE Sorbonne Paris Cité,Bobigny 93017,France.
authors.forename: France
authors.initials: F
authors.lastname: Bellisle
authors.affiliation: 2Center of Health Science,Federal University of Santa Catarina,Campus Universitário - Trindade,Florianópolis 88040-900,Brazil.
authors.forename: Maria Alice A
authors.initials: MA
authors.lastname: de Assis
mesh_terms: D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002652:Child Behavior / Q000208:ethnology; D002664:Child Nutritional Physiological Phenomena / Q000208:ethnology; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects* / Q000145:classification / Q000208:ethnology; D005247:Feeding Behavior / Q000208:ethnology; D005260:Female; D006801:Humans; D008297:Male; D062407:Meals / Q000208:ethnology; D009749:Nutrition Surveys; D050177:Overweight / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D063766:Pediatric Obesity / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D015995:Prevalence; D012306:Risk; D012574:Schools; D062410:Snacks / Q000208:ethnology; D013223:Statistics as Topic; D013997:Time Factors; D014504:Urban Health / Q000208:ethnology
keywords:  DP dietary patterns;  FIP food intake probability;  LCA latent class analysis;  PDFQ-3 third version of the Previous Day Food Questionnaire; Childhood obesity; Children’s dietary patterns; Eating events; Latent class analysis; Time-of-day