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J Nutr. 2016 Mar 9. pii: jn224659. [Epub ahead of print]

Free Sugars and Total Fat Are Important Characteristics of a Dietary Pattern Associated with Adiposity across Childhood and Adolescence.

Author information

1
School of Population Health, The University of Western Australia, Perth, Australia; Medical Research Council Human Nutrition Research, Cambridge, United Kingdom; gina.ambrosini@uwa.edu.au.
2
Medical Research Council Human Nutrition Research, Cambridge, United Kingdom; Public Health Directorate, National Health Service Lincolnshire, Lincoln, United Kingdom;
3
School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom; and.
4
Medical Research Council Human Nutrition Research, Cambridge, United Kingdom; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.

Abstract

BACKGROUND:

The importance of dietary sugar compared with fat in the development of obesity is currently a topic of debate.

OBJECTIVE:

We aimed to identify dietary patterns (DPs) characterized by high sugar content, high fat content, or both and their longitudinal associations with adiposity during childhood and adolescence.

METHODS:

Participants were 6722 children from the ALSPAC (Avon Longitudinal Study of Parents and Children) who were born in 1991-1992. DPs were characterized by percentage of total energy intake (%E) from free sugars, %E from total fat, and dietary energy density (DED) and fiber density by using reduced rank regression at 7, 10, and 13 y of age. Total body fat mass was measured at 11, 13, and 15 y of age. Regression analyses were used to adjust for dietary misreporting, physical activity, and maternal social class.

RESULTS:

Two major DPs were identified: higher z scores for DP1 were associated with greater DED, greater %E from free sugars and total fat, and lower fiber density; higher z scores for DP2 were associated with greater %E from free sugars but lower %E from total fat and DED. A 1-SD increase in z score for DP1 was associated with a mean increase in the fat mass index z score of 0.04 SD units (95% CI: 0.01, 0.07; P = 0.017) and greater odds of excess adiposity (OR: 1.12; 95% CI: 1.0, 1.25; P = 0.038). DP2 was not associated with adiposity.

CONCLUSIONS:

An energy-dense DP high in %E from total fat and free sugars is associated with greater adiposity in childhood and adolescence. This appears to confirm the role of both fat and sugar and provides a basis for food-based dietary guidelines to prevent obesity in children.

KEYWORDS:

ALSPAC; adiposity; adolescents; children; diet; dietary patterns; energy density; fat; obesity; sugar

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