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Accepted manuscript

Role of dietary intake and physical activity in reducing weight social inequalities among adolescents: an application of G-formula to PRALIMAP-INÈS trial

Published online by Cambridge University Press:  27 May 2024

Mohamed Dakin*
Affiliation:
Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
Florian Manneville
Affiliation:
Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France Inserm, CHRU Nancy, Université de Lorraine, CIC-Clinical Epidemiology, Nancy, F-54000, France
Johanne Langlois
Affiliation:
Conservatoire National des Arts et Métiers – Institut scientifique et technique de la nutrition et de l’alimentation (Cnam-ISTNA), Nancy, France
Serge Briançon
Affiliation:
Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
Edith Lecomte
Affiliation:
Conservatoire National des Arts et Métiers – Institut scientifique et technique de la nutrition et de l’alimentation (Cnam-ISTNA), Nancy, France
Elisabeth Spitz
Affiliation:
Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
Karine Legrand
Affiliation:
Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France Inserm, CHRU Nancy, Université de Lorraine, CIC-Clinical Epidemiology, Nancy, F-54000, France
Philip Böhme
Affiliation:
Service d’endocrinologie, diabétologie et nutrition, CHRU Nancy, Nancy, F-54000, France
Francis Guillemin
Affiliation:
Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France Inserm, CHRU Nancy, Université de Lorraine, CIC-Clinical Epidemiology, Nancy, F-54000, France
Abdou Omorou
Affiliation:
Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France Inserm, CHRU Nancy, Université de Lorraine, CIC-Clinical Epidemiology, Nancy, F-54000, France
*
Corresponding author: Mohamed Dakin, Inserm, UMR 1319 INSPIIRE, Université de Lorraine, 9 avenue de la Forêt de Haye, 54505 Vandoeuvre-lès-Nancy, France, Tel. +33(0)7 45 35 61 10, Email: mohamed.dakin@univ-lorraine.fr
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Abstract

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Interventions aiming to reduce social inequalities of weight status in adolescents usually focus on lifestyle behaviours, but their effectiveness is limited. This study analysed the effect of achieving levels of dietary intake (DI) and/or physical activity (PA) guidelines on reducing social inequalities in weight status among adolescents. We included adolescents from the PRomotion de l’ALIMentation et de l’Activité Physique – INÉgalité de Santé (PRALIMAP-INÈS) trial with weight status data available at baseline and 1-year follow-up (n=1130). PA and DI were measured using the International Physical Activity Questionnaire and a validated food frequency questionnaire, respectively. We estimated the likelihood of a 1-year reduction in body mass index z-score (BMIz) and population risk difference (PRD) under hypothetical DI and PA levels and socioeconomic status using the parametric G-formula. When advantaged and less advantaged adolescents maintained their baseline DI and PA, we found social inequalities in weight status, with a PRD of a 1-year reduction in BMIz of -1.6% (-3.0%; -0.5%). These inequalities were not observed when less advantaged adolescents increased their proportion of achieving DI guidelines by 30% (PRD=2.2% [-0.5%; 5.0%]) unlike the same increase in PA (PRD= -3.9% [-6.8%; -1.3%]). Finally, social inequalities of weight status were not observed when levels of achievement of both PA and DI guidelines increased by 30% (PRD= 2.2% [-0.5%; 4.0%]). Enhancing DI rather than PA could be effective in reducing social inequalities in weight status among adolescents. Future interventions aiming to reduce these inequalities should mostly target DI to be effective.

Type
Research Article
Copyright
© The Authors 2024