Association of dietary patterns and body phenotypes in Brazilian adolescents

this school-based cross-sectional study involved 1,022 adolescents aged ten to 19 years. Dietary patterns and body phenotypes were defined using a principal component analysis. Body phenotype was defined using anthropometry, body composition, biochemistry, sexual maturation, and dietary patterns from 19 food groups, using a food frequency questionnaire. The association between the dietary patterns and body phenotypes was assessed using a linear regression model.

Results:

five body phenotypes (BP1_adiposity, BP2_puberty, BP3_biochemical, BP4_muscular, BP5_{lipids_biochemical}) and five dietary patterns (DP1_{ultraprocessed_foods}, DP2_{fresh_foods}, DP3_{bread_rice_beans}, DP4_{culinary_preparations}, DP5_{cakes_rice_beans}) were identified. There were higher BP_{_adiposity} scores for obese adolescents, but energy expenditure was similar for obese and non-obese adolescents. Physical activity was positively associated with BMI, BP_{_adiposity}, and BP_{_puberty}. We observed a negative association between DP_{_ultraprocessed_foods} and BMI, and a positive association between DP_{_fresh_food. DP_fresh_foods} was positively associated with BP_{_adiposity}; DP_{_ultraprocessed_foods} and DP_{_culinary_preparations} were negatively associated with this phenotype. BP_{_biochemical} was negatively associated with DP_{_fresh_foods}.

Conclusion:

we identified a negative association between a dietary pattern composed mainly of ultra-processed foods, fresh foods, and BP_{_adiposity}. These associations need to be better explored, especially in adolescents, as both dietary patterns and phenotypes were defined using multivariate analysis.

Key words
Body phenotype; Dietary pattern; Adolescent; Obesity

Food groups	Original foods
Fruits	Apple; mango/papaya; orange/tangerine; strawberry/pineapple; banana; fruit juices
Vegetables	Tomato; pumpkin/carrot; broccoli; lettuce; beet; chayote
Meat/poultry/fish/eggs	Fried meat, pork, chicken and fish; grilled meat, pork, chicken and fish; fried eggs/scrambled eggs/omelet
Processed meat/sausage	Sausages
Snacks	Snacks
Fast foods	Hot dog; burguer, sandwichs
Breads	White bread; loaf bread
Fried tubers	French fries/fried manioc
Dairy foods	Yoghurts; cheese; whole milk; creamy cheese
Fatty foods	Margarine; butter; olive oil/oil
Sugary drinks	Soft drinks; carbonated drinks; nectar juices
Sugar/pastries	Sugar; chocolate poder; goodies; jam/fruits in syrup
Ice-cream	Ice-cream; popsicle
Cookies	Filled cookies; non-filled cookies
Bakery foods	Baked, pizza,
Cakes	Cakes; cake mixes
Side dishes	Potate salad with mayonnaise; pasta with tomato sauce; pasta with tomato sauce and meat; risoto with chicken or fish
Rice/beans	Rice and beans (Brazilian dish)
Potatoes/corn	Boiled potatoes; boiled corn

Variables	Eigenvalues
Variables	BP_adiposity	BP_puberty	BP_biochemical	BP_muscular	BP_lipids_biochemical
Weight (kg)	0.4313
Height (cm)		0.3840
Triciptal skinfold (mm)	0.4897
Subscapular skinfold (mm)	0.5165
Waist circunference (cm)	0.5017
Phase angle (°)				0.2538	-0.3623
Pubic hair (sexual maturation)		0.5099
Gonads and breast (sexual maturation)		0.5126
Hemoglobin (mg/dL)				0.9204
Triglycerides (mg/dL)			0.2360		0.2932
Glucose (mg/dL)			0.9270
Total cholesterol/LDL-chol					0.8664
Age (years)		0.5079
KMO	0.8096

Food groups	Eigenvalues
Food groups	DP_ultraprocessed	DP_fresh_foods	DP_bread_ rice_beans	DP_culinary_ preparation	DP_cake_rice_beans
Fruits	0.2026	0.3858		-0.2922
Vegetables		0.5671
Meat/poultry/fish/eggs	0.2695			-0.3262
Processed meat/sausage	0.2631			-0.3946
Snacks		-0.3213
Fast foods	0.2363	-0.2564
Breads			0.4429
Fried tubers	0.2249
Dairy foods	0.2381			0.2745	-0.5600
Fatty foods	0.2176		0.3655
Sugary drinks	0.2383			-0.4395
Sugar/pastries	0.2016	-0.2837	0.2908		-0.4547
Ice-cream	0.2303		-0.2580
Cookies	0.2419
Bakery foods	0.2801		-0.2149
Cakes				0.3711	0.2785
Side dishes	0.3443	0.2220
Rice and beans			0.4314	0.2335	0.4669
Boiled potato and corn	0.2590	0.3157	-0.2532	0.3137
KMO	0.8579

Variables		Outcomes (scores)
Variables	BMI (score)	BP_adiposity	BP_puberty	BP_biochemical	BP_muscular	BP_lipids_biochemical
DP_{_ultraprocessed}	-0.08 (-0.11;-0.05)	-0.08 (-0.13;-0.03)	-0.01 (-0.02;0.04)	0.02 (-0.01;0.04)	0.01 (-0.02;0.04)	0.02 (-0.01;0.05)
DP_{_fresh_foods}	0.09 (0.04;0.14)	0.09 (0.003;0.17)	0.009 (-0.045;0.062)	-0.05 (-0.10;-0.004)	0.01 (-0.04;0.06)	-0.04 (-0.09;0.01)
DP_{_bread_rice_beans}	-0.06 (-0.13;-0.00)	-0.06 (-0.16;0.03)	0.078 (0.017;0.139)	0.04 (-0.02;0.09)	0.02 (-0.03;0.07)	-0.01 (-0.07;0.04)
DP_{_culinary_preparation}	-0.06 (-0.13;0.01)	-0.15 (-0.24;-0.04)	-0.04 (-0.11;0.03)	-0.03 (-0.09;0.03)	-0.02 (-0.08;0.04)	-0.002 (-0.06;0.06)
DP_{_cake_rice_beans}	-0.02 (-0.08;0.05)	0.01 (-0.10;0.12)	0.02 (-0.05;0.08)	0.03 (-0.04;0.09)	0.01 (-0.06;0.07)	-0.03 (-0.09;0.04)
Physical activity	0.24 (0.16;0.32)	0.29 (0.16;0.41)	0.11 (0.03;0.19)	0.03 (-0.04;0.10)	0.03 (-0.05;0.10)	-0.06 (-0.14;0.01)
Age (years)
10 -14	0.00 (Ref)	0.00 (Ref)	0.00 (Ref)	0.00 (Ref)	0.00 (Ref)	0.00 (Ref)
15-19	-0.20 (-0.34;-0.05)	0.66 (0.43;0.89)	2.72 (2.57;2.86)	-0.17 (-0.30;-0.04)	0.08 (-0.05;0.21)	-0.07 (-0.14;0.12)
Sex
Male	0.00 (Ref)	0.00 (Ref)	0.00 (Ref)	0.00 (Ref)	0.00 (Ref)	0.00 (Ref)
Female	0.09 (-0.06;0.24)	0.41 (0.18;0.63)	-0.29 (-0.43;-0.14)	-0.46 (-0.59;-0.33)	-0.50 (-0.63;-0.37)	0.37 (0.24;0.50)
Wealth (score)	-0.01 (-0.05;0.03)	0.02 (-0.04;0.08)	0.003 (-0.04;0.04)	-0.05 (-0.08;-0.01)	0.05 (0.01;0.08)	0.02 (-0.01;0.06)

Instituto de Medicina Integral Prof. Fernando Figueira Rua dos Coelhos, 300. Boa Vista, 50070-550 Recife PE Brasil, Tel./Fax: +55 81 2122-4141 - Recife - PR - Brazil
E-mail: revista@imip.org.br

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[1] Associated Editor: Pricila Mullachery