Skip to main content Accessibility help

Childhood dietary patterns and body composition at age 6 years: the Children of Screening for Pregnancy Endpoints (SCOPE) study

  • Angela C. Flynn (a1), John M. D. Thompson (a2) (a3), Kathryn V. Dalrymple (a1), Clare Wall (a4), Shahina Begum (a1), Jaijus Pallippadan Johny (a3), Wayne S. Cutfield (a5) (a6), Robyn North (a5) (a6), Lesley M. E. McCowan (a3), Keith M. Godfrey (a7), Edwin A. Mitchell (a2) and Lucilla Poston (a1)...


Dietary patterns describe the combination of foods and beverages in a diet and the frequency of habitual consumption. Better understanding of childhood dietary patterns and antenatal influences could inform intervention strategies to prevent childhood obesity. We derived empirical dietary patterns in 1142 children (average age 6·0 (sd 0·2) years) in New Zealand, whose mothers had participated in the Screening for Pregnancy Endpoints (SCOPE) cohort study and explored associations with measures of body composition. Participants (Children of SCOPE) had their diet assessed by FFQ, and dietary patterns were extracted using factor analysis. Three distinct dietary patterns were identified: ‘Healthy’, ‘Traditional’ and ‘Junk’. Associations between dietary patterns and measures of childhood body composition (waist, hip, arm circumferences, BMI, bioelectrical impedance analysis-derived body fat % and sum of skinfold thicknesses (SST)) were assessed by linear regression, with adjustment for maternal influences. Children who had higher ‘Junk’ dietary pattern scores had 0·24 (sd 0·08; 95 % CI 0·04, 0·13) cm greater arm and 0·44 (sd 0·05; 95 % CI 0·01, 0·10) cm greater hip circumferences and 1·13 (sd 0·07; 95 % CI 0·03, 0·12) cm greater SST and were more likely to be obese (OR 1·74; 95 % CI 1·07, 2·82); those with higher ‘Healthy’ pattern scores were less likely to be obese (OR 0·62; 95 % CI 0·39, 1·00). In a large mother–child cohort, a dietary pattern characterised by high-sugar and -fat foods was associated with greater adiposity and obesity risk in children aged 6 years, while a ‘Healthy’ dietary pattern offered some protection against obesity. Targeting unhealthy dietary patterns could inform public health strategies to reduce the prevalence of childhood obesity.


Corresponding author

*Corresponding author: Dr Angela C. Flynn, email


Hide All
1.Reilly, JJ & Kelly, J (2011) Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. Int J Obes 35, 891898.
2.World Health Organization (2016) Report of the Commission on Ending Childhood Obesity. (accessed March 2019).
3.Lobstein, T, Baur, L & Uauy, R (2004) Obesity in children and young people: a crisis in public health. Obes Rev 5, 485.
4.Northstone, K & Emmett, PM (2008) Are dietary patterns stable throughout early and mid-childhood? A birth cohort study. Br J Nutr 100, 10691076.
5.Mikkilä, V, Räsänen, L, Raitakari, OT, et al. (2005) Consistent dietary patterns identified from childhood to adulthood: the cardiovascular risk in Young Finns Study. Br J Nutr 93, 923931.
6.Hu, FB (2002) Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13, 39.
7.Newby, PK & Tucker, KL (2004) Empirically derived eating patterns using factor or cluster analysis: a review. Nutr Rev 62, 177203.
8.Rezagholizadeh, F, Djafarian, K, Khosravi, S, et al. (2017) A posteriori healthy dietary patterns may decrease the risk of central obesity: findings from a systematic review and meta-analysis. Nutr Res 41, 113.
9.Ambrosini, GL (2014) Childhood dietary patterns and later obesity: a review of the evidence. Proc Nutr Soc 73, 137146.
10.Rocha, NP, Milagres, LC, Longo, GZ, et al. (2017) Association between dietary pattern and cardiometabolic risk in children and adolescents: a systematic review. J Pediatr 93, 214222.
11.Logan, KM, Gale, C, Hyde, MJ, et al. (2017) Diabetes in pregnancy and infant adiposity: systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed 102, F65F72.
12.Fisk, CM, Crozier, SR, Inskip, HM, et al. (2011) Influences on the quality of young children’s diets: the importance of maternal food choices. Br J Nutr 105, 287296.
13.Kenny, LC, Black, MA, Poston, L, et al. (2014) Early pregnancy prediction of preeclampsia in nulliparous women, combining clinical risk and biomarkers: the Screening for Pregnancy Endpoints (SCOPE) international cohort study. Hypertension 64, 644652.
14.Dalrymple, KV, Begum, S, Thompson, JMDet al. (2019) Relationships of maternal body mass index and plasma biomarkers with childhood body mass index and adiposity at 6 years: the Children of SCOPE study. Paediatr Obes 14, e12537.
15.Metcalf, PA, Scragg, RKR, Sharpe, S, et al. (2003) Short-term repeatability of a food frequency questionnaire in New Zealand children aged 1–14 y. Eur J Clin Nutr 57, 14981503.
16.World Health Organization (2008) Training Course on Child Growth Assessment: WHO Child Growth Standards. Geneva: WHO.
17.Schaefer, F, Georgi, M, Zieger, A, et al. (1994) Usefulness of bioelectric impedance and skinfold measurements in predicting fat-free mass derived from total body potassium in children. Pediatr Res 35, 617624.
18.Northstone, K & Emmett, P (2005) Multivariate analysis of diet in children at four and seven years of age and associations with socio-demographic characteristics. Eur J Clin Nutr 59, 751760.
19.Power, ML & Schulkin, J (2008) Sex differences in fat storage, fat metabolism, and the health risks from obesity: possible evolutionary origins. Br J Nutr 99, 931940.
20.Taveras, EM, Gillman, MW, Kleinman, K, et al. (2010) Racial/ethnic differences in early-life risk factors for childhood obesity. Pediatrics 125, 686995.
21.Falconer, CL, Park, MH, Croker, H, et al. (2014) Can the relationship between ethnicity and obesity-related behaviours among school-aged children be explained by deprivation? A cross-sectional study. BMJ Open 4, e003949.
22.Szeto, IMY, Das, PJ, Aziz, A, et al. (2009) Multivitamin supplementation of Wistar rats during pregnancy accelerates the development of obesity in offspring fed an obesogenic diet. Int J Obes 33, 364372.
23.Patel, N, Dalrymple, KV, Briley, AL, et al. (2018) Mode of infant feeding, eating behaviour and anthropometry in infants at 6-months of age born to obese women – a secondary analysis of the UPBEAT trial. BMC Pregnancy Childbirth 18, 355.
24.Lampard, AM, Franckle, RL & Davison, KK (2014) Maternal depression and childhood obesity: a systematic review. Prev Med 59, 6067.
25.Mizutani, T, Suzuki, K, Kondo, N, et al. (2007) Association of maternal lifestyles including smoking during pregnancy with childhood obesity. Obesity 15, 31333139.
26.Leng, J, Li, W, Zhang, S, et al. (2015) GDM women’s pre-pregnancy overweight/obesity and gestational weight gain on offspring overweight status. PLOS ONE 10, e0129536.
27.Zheng, JS, Liu, H, Ong, KK, et al. (2017) Maternal blood pressure rise during pregnancy and offspring obesity risk at 4 to 7 years old: the Jiaxing Birth Cohort. J Clin Endocrinol Metab 102, 43154322.
28.Strauss, RS (1997) Effects of the intrauterine environment on childhood growth. Br Med Bull 53, 8195.
29.Pervanidou, P, Chouliaras, G, Akalestos, A, et al. (2014) Increased placental growth factor (PlGF) concentrations in children and adolescents with obesity and the metabolic syndrome. Hormones 13, 369374.
30.Wall, CR, Thompson, JMD, Robinson, E, et al. (2013) Dietary patterns of children at 3.5 and 7 years of age: a New Zealand birth cohort study. Acta Paediatr 102, 137142.
31.Johnson, L, Mander, AP, Jones, LR, et al. (2008) Energy-dense, low-fiber, high-fat dietary pattern is associated with increased fatness in childhood. Am J Clin Nutr 87, 846854.
32.Ambrosini, GL, Emmett, PM, Northstone, K, et al. (2012) Identification of a dietary pattern prospectively associated with increased adiposity during childhood and adolescence. Int J Obes 36, 12991305.
33.Murrin, CM, Heinen, MM & Kelleher, CC (2015) Are dietary patterns of mothers during pregnancy related to children’s weight status? Evidence from the lifeways cross-generational Cohort Study. AIMS Public Health 2, 274296.
34.Okubo, H, Crozier, SR, Harvey, NC, et al. (2015) Diet quality across early childhood and adiposity at 6 years: the Southampton Women’s Survey. Int J Obes 39, 14561462.
35.Heslehurst, N, Vieira, R, Akhter, Z, et al. (2019) The association between maternal body mass index and child obesity: a systematic review and meta-analysis. PLoS Med 16, e1002817.
36.Catalano, PM, Farrell, K, Thomas, A, et al. (2009) Perinatal risk factors for childhood obesity and metabolic dysregulation. Am J Clin Nutr 90, 13031313.
37.Nelson, SM, Matthews, P & Poston, L (2009) Maternal metabolism and obesity: modifiable determinants of pregnancy outcome. Hum Reprod Update 16, 255275.
38.Serdula, MK, Alexander, MP, Scanlon, KS, et al. (2002) What are preschool children eating? A review of dietary assessment. Annu Rev Nutr 21, 475498.
39.Martínez, ME, Marshall, JR & Sechrest, L (1998) Invited commentary: factor analysis and the search for objectivity. Am J Epidemiol 148, 1719.
40.World Health Organization (2015) Interim report of the commission on ending childhood obesity. Geneva: WHO. (accessed December 2019).
41.Jimenez-Pavon, D & Kelly, JRJ (2010) Associations between objectively measured habitual physical activity and adiposity in children and adolescents: systematic review. Int J Pediatr Obes 5, 318.
42.Ekelund, U, Hildebrand, M & Collings, PJ (2014) Physical activity, sedentary time and adiposity during the first two decades of life. Proc Nutr Soc 73, 319329.


Type Description Title
Supplementary materials

Flynn et al. supplementary material
Table S1

 Word (25 KB)
25 KB

Childhood dietary patterns and body composition at age 6 years: the Children of Screening for Pregnancy Endpoints (SCOPE) study

  • Angela C. Flynn (a1), John M. D. Thompson (a2) (a3), Kathryn V. Dalrymple (a1), Clare Wall (a4), Shahina Begum (a1), Jaijus Pallippadan Johny (a3), Wayne S. Cutfield (a5) (a6), Robyn North (a5) (a6), Lesley M. E. McCowan (a3), Keith M. Godfrey (a7), Edwin A. Mitchell (a2) and Lucilla Poston (a1)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.