Using reduced rank regression methods to identify dietary patterns associated with obesity: a cross-country study among European and Australian adolescents.
This study aims to examine repeatability of reduced rank regression (RRR) methods in calculating dietary patterns (DP) and cross-sectional associations with overweight (OW)/obesity across European and Australian samples of adolescents. Data from two cross-sectional surveys in Europe (2006/2007 Healthy Lifestyle in Europe by Nutrition in Adolescence study, including 1954 adolescents, 12-17 years) and Australia (2007 National Children's Nutrition and Physical Activity Survey, including 1498 adolescents, 12-16 years) were used. Dietary intake was measured using two non-consecutive, 24-h recalls. RRR was used to identify DP using dietary energy density, fibre density and percentage of energy intake from fat as the intermediate variables. Associations between DP scores and body mass/fat were examined using multivariable linear and logistic regression as appropriate, stratified by sex. The first DP extracted (labelled 'energy dense, high fat, low fibre') explained 47 and 31 % of the response variation in Australian and European adolescents, respectively. It was similar for European and Australian adolescents and characterised by higher consumption of biscuits/cakes, chocolate/confectionery, crisps/savoury snacks, sugar-sweetened beverages, and lower consumption of yogurt, high-fibre bread, vegetables and fresh fruit. DP scores were inversely associated with BMI z-scores in Australian adolescent boys and borderline inverse in European adolescent boys (so as with %BF). Similarly, a lower likelihood for OW in boys was observed with higher DP scores in both surveys. No such relationships were observed in adolescent girls. In conclusion, the DP identified in this cross-country study was comparable for European and Australian adolescents, demonstrating robustness of the RRR method in calculating DP among populations. However, longitudinal designs are more relevant when studying diet-obesity associations, to prevent reverse causality.
1International Agency for Research on Cancer,Nutrition and Metabolism Section, 69372 Lyon CEDEX 08,France.
Inge
I
Huybrechts
2Centre for Physical Activity and Nutrition Research,School of Exercise and Nutrition Sciences,Deakin University,Melbourne,VIC 3125,Australia.
Sandrine
S
Lioret
5Growth, Exercise, Nutrition and Development (GENUD) Research Group,School of Health Science (EUCS),University of Zaragoza,C/ Domingo Miral s/n,50009 Zaragoza,Spain.
Theodora
T
Mouratidou
1International Agency for Research on Cancer,Nutrition and Metabolism Section, 69372 Lyon CEDEX 08,France.
Marc J
MJ
Gunter
6Department of Nutrition and Dietetics,School of Health Science and Education,Harokopio University,Athens 17671,Greece.
Yannis
Y
Manios
7Research Institute of Child Nutrition,Rheinische Friedrich-Wilhelms-University Bonn,44225 Dortmund,Germany.
Mathilde
M
Kersting
8UMR995, Faculty of Medicine,University of Lille,CHRU,59045 Lille,France.
Frederic
F
Gottrand
9Preventive Medicine and Nutrition Unit,School of Medicine,University of Crete,PO Box 2208 GR-71003,Heraklion,Crete,Greece.
Anthony
A
Kafatos
10Department of Public Health, Faculty of Medicine and Health Sciences,Ghent University,Ghent 9000,Belgium.
Stefaan
S
De Henauw
11Department of Medical Physiology,School of Medicine,University of Granada,18014 Granada,Spain.
Magdalena
M
Cuenca-García
12Department of Pediatrics,Private Medical University,5020 Salzburg,Austria.
Kurt
K
Widhalm
13ImFINE Research Group,Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences (INEF),Technical University of Madrid,Madrid E-28040,Spain.
Marcela
M
Gonzales-Gross
16Department of Paediatrics, Medical Faculty,H-7624 Pécs,Hungary.
Denes
D
Molnar
5Growth, Exercise, Nutrition and Development (GENUD) Research Group,School of Health Science (EUCS),University of Zaragoza,C/ Domingo Miral s/n,50009 Zaragoza,Spain.
Luis A
LA
Moreno
4Paris-Descartes University,Paris, F-75014,France.
Sarah A
SA
McNaughton
D000273:Adipose Tissue; D000293:Adolescent; D001315:Australia; D015992:Body Mass Index; D002648:Child; D004032:Diet / Q000208:ethnology; D004034:Diet Surveys / Q000379:methods* / Q000706:statistics & numerical data; D005060:Europe; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000209:etiology / Q000517:prevention & control; D050177:Overweight; D015203:Reproducibility of Results
 %BF body fat percentage;  ALSPAC Avon Longitudinal Study of Parents and Children;  DED dietary energy density;  DP dietary pattern;  FD fibre density;  HELENA Healthy Lifestyle in Europe by Nutrition in Adolescence study;  MVPA moderate to vigorous physical activity;  NCNPAS National Children’s Nutrition and Physical Activity Survey;  OW overweight;  PA physical activity;  RRR reduced rank regression;  SB sedentary behaviour;  SES socio-economic status; Adolescents; Australian National Children’s Nutrition and Physical Activity Survey; Dietary patterns; Healthy Lifestyle in Europe by Nutrition in Adolescence study; Reduced rank regression analysis