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Associations of dietary intake with cardiometabolic risk in a multi-ethnic cohort: a longitudinal analysis of the Determinants of Adolescence, now young Adults, Social well-being and Health (DASH) study

  • Louise M. Goff (a1) (a2), Peiyuan Huang (a1), Maria J. Silva (a1), Claire Bordoli (a1), Elli Z. Enayat (a1), Oarabile R. Molaodi (a3), Aidan Cassidy (a1), Maria Maynard (a4) and Seeromanie Harding (a1)...


Unfavourable dietary habits, such as skipping breakfast, are common among ethnic minority children and may contribute to inequalities in cardiometabolic disease. We conducted a longitudinal follow-up of a subsample of the UK multi-ethnic Determinants of Adolescent Social well-being and Health cohort, which represents the main UK ethnic groups and is now aged 21–23 years. We aimed to describe longitudinal patterns of dietary intake and investigate their impact on cardiometabolic risk in young adulthood. Participants completed a dietary behaviour questionnaire and a 24 h dietary intake recall; anthropometry, blood pressure, total cholesterol and HDL-cholesterol and HbA1c were measured. The cohort consisted of 107 White British, 102 Black Caribbean, 132 Black African, 98 Indian, 111 Bangladeshi/Pakistani and 115 other/mixed ethnicity. Unhealthful dietary behaviours such as skipping breakfast and low intake of fruits and vegetables were common (56, 57 and 63 %, respectively). Rates of skipping breakfast and low fruit and vegetable consumption were highest among Black African and Black Caribbean participants. BMI and cholesterol levels at 21–23 years were higher among those who regularly skipped breakfast at 11–13 years (BMI 1·41 (95 % CI 0·57, 2·26), P=0·001; cholesterol 0·15 (95 % CI –0·01, 0·31), P=0·063) and at 21–23 years (BMI 1·05 (95 % CI 0·22, 1·89), P=0·014; cholesterol 0·22 (95 % CI 0·06, 0·37), P=0·007). Childhood breakfast skipping is more common in certain ethnic groups and is associated with cardiometabolic risk factors in young adulthood. Our findings highlight the importance of targeting interventions to improve dietary behaviours such as breakfast consumption at specific population groups.


Corresponding author

*Corresponding author: Dr L. M. Goff, email


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1. Becker, E, Boreham, R, Chaudhury, M, et al. (2006) Health Survey for England 2004. The Health of Minority Ethnic Groups. London: Joint Health Surveys Unit, National Centre for Social Research, Department of Epidemiology and Public Health at the Royal Free and University College Medical School.
2. Donin, AS, Nightingale, CM, Owen, CG, et al. (2010) Ethnic differences in blood lipids and dietary intake between UK children of black African, black Caribbean, South Asian, and white European origin: the Child Heart and Health Study in England (CHASE). Am J Clin Nutr 92, 776783.
3. Ogden, CL, Flegal, KM, Carroll, MD, et al. (2002) Prevalence and trends in overweight among US children and adolescents, 1999–2000. JAMA 288, 17281732.
4. Nelson, TF, Gortmaker, SL, Subramanian, SV, et al. (2007) Disparities in overweight and obesity among US college students. Am J Health Behav 31, 363373.
5. Zhang, Q, Wang, Y & Huang, ES (2009) Changes in racial/ethnic disparities in the prevalence of type 2 diabetes by obesity level among US adults. Ethn Health 14, 439457.
6. Donin, AS, Nightingale, CM, Owen, CG, et al. (2010) Nutritional composition of the diets of South Asian, black African-Caribbean and white European children in the United Kingdom: the Child Heart and Health Study in England (CHASE). Br J Nutr 104, 276285.
7. Harding, S, Teyhan, A, Maynard, MJ, et al. (2008) Ethnic differences in overweight and obesity in early adolescence in the MRC DASH study: the role of adolescent and parental lifestyle. Int J Epidemiol 37, 162172.
8. Nicklas, TA, Myers, L, Reger, C, et al. (1998) Impact of breakfast consumption on nutritional adequacy of the diets of young adults in Bogalusa, Louisiana: ethnic and gender contrasts. J Am Diet Assoc 98, 14321438.
9. Ritterman Weintraub, ML, Fernald, LC, Adler, N, et al. (2015) Perceptions of social mobility: development of a new psychosocial indicator associated with adolescent risk behaviors. Front Public Health 3, 62.
10. Donin, AS, Nightingale, CM, Owen, CG, et al. (2014) Regular breakfast consumption and type 2 diabetes risk markers in 9- to 10-year-old children in the child heart and health study in England (CHASE): a cross-sectional analysis. PLoS Med 11, e1001703.
11. Smith, KJ, Gall, SL, McNaughton, SA, et al. (2010) Skipping breakfast: longitudinal associations with cardiometabolic risk factors in the Childhood Determinants of Adult Health Study. Am J Clin Nutr 92, 13161325.
12. Berkey, CS, Rockett, HR, Gillman, MW, et al. (2003) Longitudinal study of skipping breakfast and weight change in adolescents. Int J Obes Relat Metab Disord 27, 12581266.
13. Szajewska, H & Ruszczynski, M (2010) Systematic review demonstrating that breakfast consumption influences body weight outcomes in children and adolescents in Europe. Crit Rev Food Sci Nutr 50, 113119.
14. Merten, MJ, Williams, AL & Shriver, LH (2009) Breakfast consumption in adolescence and young adulthood: parental presence, community context, and obesity. J Am Diet Assoc 109, 13841391.
15. Watts, AW, Mason, SM, Loth, K, et al. (2016) Socioeconomic differences in overweight and weight-related behaviors across adolescence and young adulthood: 10-year longitudinal findings from project EAT. Prev Med 87, 194199.
16. Harding, S, Whitrow, M, Maynard, MJ, et al. (2007) Cohort profile: the DASH (Determinants of Adolescent Social well-being and Health) study, an ethnically diverse cohort. Int J Epidemiol 36, 512517.
17. Nelson, M, Holmes, B, Roberts, C, et al. (2013) Dietary assessment – recalls. Diet and physical activity measurement toolkit. (accessed October 2018).
18. Nelson, Atkinson & Meyer, J (1997) A Photographic Atlas of Food Portion Sizes. London: MAFF Publications.
19. Goff, LM, Timbers, L, Style, H, et al. (2014) Dietary intake in Black British adults: an observational assessment of nutritional composition and the role of traditional foods in UK Caribbean and West African diets. Public Health Nutr 18, 21912201.
20. Stadlmayr, B, Charrondiere, RVE, Bayli, R, et al. (2012) West African Food Composition Table. Rome: Food and Agriculture Organization of the United Nations.
21. Department of Health (2011) National Diet and Nutrition Survey: Headline Results from Years 1 and 2 (Combined) of the Rolling Programme 2008-9-2009-10. England: Department of Health.
22. Henry, CJ (2005) Basal metabolic rate studies in humans: measurement and development of new equations. Public Health Nutr 8, 11331152.
23. Rennie, KL, Coward, A & Jebb, SA (2007) Estimating under-reporting of energy intake in dietary surveys using an individualised method. Br J Nutr 97, 11691176.
24. Dowd, KP, Harrington, DM & Donnelly, AE (2012) Criterion and concurrent validity of the activPAL professional physical activity monitor in adolescent females. PLOS ONE 7, e47633.
25. Gower, BA, Nagy, TR & Goran, MI (1999) Visceral fat, insulin sensitivity, and lipids in prepubertal children. Diabetes 48, 15151521.
26. Ramachandran, A, Snehalatha, C, Viswanathan, V, et al. (1997) Risk of noninsulin dependent diabetes mellitus conferred by obesity and central adiposity in different ethnic groups: a comparative analysis between Asian Indians, Mexican Americans and Whites. Diabetes Res Clin Pract 36, 121125.
27. Herman, WH, Ma, Y, Uwaifo, G, et al. (2007) Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the Diabetes Prevention Program. Diabetes Care 30, 24532457.
28. Ziemer, DC, Kolm, P, Weintraub, WS, et al. (2010) Glucose-independent, black-white differences in hemoglobin A1c levels: a cross-sectional analysis of 2 studies. Ann Intern Med 152, 770777.
29. Vyas, A, Greenhalgh, A, Cade, J, et al. (2003) Nutrient intakes of an adult Pakistani, European and African-Caribbean community in inner city Britain. J Hum Nutr Diet 16, 327337.
30. Goff, LM, Griffin, BA, Lovegrove, JA, et al. (2013) Ethnic differences in beta-cell function, dietary intake and expression of the metabolic syndrome among UK adults of South Asian, black African-Caribbean and white-European origin at high risk of metabolic syndrome. Diab Vasc Dis Res 10, 315323.
31. Miller, GJ, Kotecha, S, Wilkinson, WH, et al. (1988) Dietary and other characteristics relevant for coronary heart disease in men of Indian, West Indian and European descent in London. Atherosclerosis 70, 6372.
32. McKeigue, PM, Marmot, MG, Adelstein, AM, et al. (1985) Diet and risk factors for coronary heart disease in Asians in northwest London. Lancet 2, 10861090.
33. Knight, TM, Smith, Z, Whittles, A, et al. (1992) Insulin resistance, diabetes, and risk markers for ischaemic heart disease in Asian men and non-Asian in Bradford. Br Heart J 67, 343350.
34. Sevak, L, McKeigue, PM & Marmot, MG (1994) Relationship of hyperinsulinemia to dietary intake in south Asian and European men. Am J Clin Nutr 59, 10691074.
35. Deshmukh-Taskar, P, Nicklas, TA, Radcliffe, JD, et al. (2013) The relationship of breakfast skipping and type of breakfast consumed with overweight/obesity, abdominal obesity, other cardiometabolic risk factors and the metabolic syndrome in young adults. The National Health and Nutrition Examination Survey (NHANES): 1999–2006. Public Health Nutr 16, 20732082.
36. Poslusna, K, Ruprich, J, de Vries, JH, et al. (2009) Misreporting of energy and micronutrient intake estimated by food records and 24 hour recalls, control and adjustment methods in practice. Br J Nutr 101, Suppl. 2, S73S85.



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