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The present study aimed to identify food patterns among 2–9-year-olds and investigate sociodemographic, anthropometric and behavioural predictors of less healthy dietary patterns.
Cross-sectional study. Parents of 2–9-year-olds completed an FFQ and factor analysis was applied to identify dietary patterns. Parents also completed questionnaires assessing sociodemographic, anthropometric and behavioural characteristics of parents and children, including parental feeding practices.
Participants were recruited from private schools of Campinas and São Paulo, SP, Brazil, between April and June 2014.
Parents of 2–9-year-olds (n 929).
Two dietary patterns emerged: ‘traditional food’ and ‘ultra-processed food’. Lower maternal education (OR=2·05, P=0·010) and higher maternal weight status (OR=1·43, P=0·044) were associated with a greater likelihood of the ultra-processed food pattern. Lower perceived parental responsibility for adequacy of food group intake (OR=2·41, P=0·020), and lower scores on the parental feeding practices of ‘Healthy Eating Guidance’ (OR=1·83, P<0·001) and ‘Monitoring’ (OR=2·52, P<0·001), were also associated with the presence of this pattern, as was higher child’s screen use during mealtimes (OR=1·61, P=0·004).
The present study is the first to evaluate associations between less healthy dietary patterns of Brazilian 2–9-year-olds and parental feeding practices. Our findings highlight sociodemographic, anthropometric and behavioural factors within families that could be used to target tailored policies to at-risk populations.
To study risk factors for overweight among Brazilian adolescents of low-income families.
Case–control study of obese and non-obese adolescents.
Anthropometric survey including 1420 students (aged 14–19 years) attending a public high school in São Paulo, Brazil.
Selection of 83 overweight (body mass index (BMI) >85th percentile) and 89 non-overweight (BMI >5th percentile and <85th percentile) subjects, frequency-matched by age, gender, pubertal development and socio-economic status. Among the nutritional, familial and behavioural data available, five covariates (parents' obesity, adolescents' past obesity, to have a best friend, dietary restriction and habit of napping) were included in the fitted hierarchical conditional logistic regression models.
Parents or guardians and adolescents were weighed, measured and answered a pre-tested questionnaire applied by trained nutritionists and paediatricians.
The prevalence of overweight was 15.2%. As previous risks, obese parents and obesity during infancy presented odds ratios (OR) and 95% confidence intervals (CI) of 2.23 (1.15–4.35) and 3.60 (1.47–8.80), respectively. As concurrent factors, the habit of napping, to have a best friend and reported dietary restriction presented OR (95% CI) of 3.43 (1.32–8.92), 5.15 (1.76–15.07) and 7.26 (2.95–17.88), respectively. Dietary patterns, frequency of obesogenic foods and other physical activity indicators presented no statistical significance.
In case–control studies, OR may overestimate the true risks. Parents' obesity and previous childhood obesity were identified as risk factors; therefore these factors should be the target for preventive programmes and policies in order to prevent the burden of obesity in the near future.
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