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Food intake patterns and body mass index in observational studies

International Journal of Obesity volume 25, pages 1741–1751 (2001)Cite this article

Abstract

OBJECTIVE: To review studies of patterns of food intake, as assessed by diet index, factor analysis or cluster analysis, and their associations with body mass index or obesity (BMI/Ob).

DESIGN: Systematic literature review MEDLINE search with crosscheck of references.

STUDIES: Thirty observational studies relating food intake patterns to anthropometric information were identified and reviewed. Food intake patterns were defined using a diet index, factor or cluster analysis in 12, nine and nine studies, respectively. Measures of body mass were made concurrently with the diet assessment in all studies, and only in a few cases were the primary outcomes related to BMI/Ob.

RESULTS: The food intake patterns identified could, in most factor or cluster analysis studies, be categorised as: (a) meat, fatty, sweet or energy dense foods; (b) vegetables, fruit, whole grain and low-fat foods; or (c) by high alcohol consumption. The diet indexes were designed to capture a high diversity and/or food combinations matching the recommendations.

The relationships with BMI/Ob were inconsistent—ten studies found that intake patterns, which we categorised as fatty, sweet or energy dense were positively associated with BMI/Ob, while similar patterns in four other studies were negatively associated with BMI. The significant associations between diet index score and BMI/Ob were consistently negative, while the associations between factor scores or cluster membership and BMI/Ob were less clear in terms of food intake pattern. Men and women had similar food intake patterns, but food intake patterns were less often positively associated with BMI/Ob in women. In 11 studies, there were no significant associations between food intake pattern and BMI/Ob.

CONCLUSION: This review showed that no consistent associations could be identified between BMI or Ob and food intake patterns, derived from diet index, factor analysis or cluster analysis. However, the heterogeneity of food intake patterns identified by such analyses and the lack of gold standards for the application of these techniques hampers consistent analysis of a relation between food intake patterns and health.

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References

  1. WHO . Obesity: preventing and managing the global epidemic WHO/NUT/NCD/98 1, WHO: Geneva 1998

    Google Scholar 

  2. Lissner L, Heitmann BL . Dietary fat and obesity: evidence from epidemiology Eur J Clin Nutr 1995 49: 79–90.

    CAS  PubMed  Google Scholar 

  3. Jørgensen LM, Sørensen TI, Schroll M, Larsen S . Influence of dietary factors on weight change assessed by multivariate graphical models Int J Obes Relat Metab Disord 1995 19: 909–915.

    PubMed  Google Scholar 

  4. Willett WC . Is dietary fat a major determinant of body fat? Am J Clin Nutr 1998 67: 556S–562S.

    Article  CAS  PubMed  Google Scholar 

  5. Heini AF, Weinsier RL . Divergent trends in obesity and fat intake patterns: the American paradox Am J Med 1997 102: 259–264.

    Article  CAS  PubMed  Google Scholar 

  6. Kant AK, Schatzkin A, Graubard BI, Schairer C . A prospective study of diet quality and mortality in women JAMA 2000 283: 2109–2115.

    Article  CAS  PubMed  Google Scholar 

  7. Kant AK . Indexes of overall diet quality: a review J Am Diet Assoc 1996 96: 785–791.

    Article  CAS  PubMed  Google Scholar 

  8. Aldenderfer MS, Blashfield RK . Cluster analysis Sage: Beverly Hills, CA 1984

    Book  Google Scholar 

  9. Kline P . An easy guide to factor analysis Routledge: NY 1994

    Google Scholar 

  10. Loehlin JC . Latent variable models: an introduction to factor, path, and structural analysis 3rd edn Lawrence Erlbaum: Mahwah NJ 1998

    Google Scholar 

  11. Kennedy ET, Ohls J, Carlson S, Fleming K . The Healthy Eating Index: design and applications J Am Diet Assoc 1995 95: 1103–1108.

    Article  CAS  PubMed  Google Scholar 

  12. Kant AK, Block G, Schatzkin A, Ziegler RG, Nestle M . Dietary diversity in the US population, NHANES II, 1976–1980 J Am Diet Assoc 1991 91: 1526–1531.

    CAS  PubMed  Google Scholar 

  13. Howell MA . Factor analysis of international cancer mortality data and per capita food consumption Br J Cancer 1974 29: 328–336.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Kleinbaum DG, Kupper LL, Muller KE, Nizam A . Variable reduction and factor analysis In: Applied regression analysis and other multivariable methods PWS-Kent Publishing Co: US 1988 595–641.

    Google Scholar 

  15. Gates JC, Huenemann RL, Brand RJ . Food choices of obese and non-obese persons J Am Diet Assoc 1975 67: 339–343.

    CAS  PubMed  Google Scholar 

  16. Kant AK . Consumption of energy-dense, nutrient-poor foods by adult Americans: nutritional and health implications. The third National Health and Nutrition Examination Survey, 1988–1994 Am J Clin Nutr 2000 72: 929–936.

    Article  CAS  PubMed  Google Scholar 

  17. McCullough ML, Feskanich D, Stampfer MJ, Rosner BA, Hu FB, Hunter DJ, Variyam JN, Colditz GA, Willett WC . Adherence to the dietary guidelines for Americans and risk of major chronic disease in women Am J Clin Nutr 2000 72: 1214–1222.

    Article  CAS  PubMed  Google Scholar 

  18. McCullough ML, Feskanich D, Rimm EB, Giovannucci EL, Ascherio A, Variyam JN, Spiegelman D, Stampfer MJ, Willett WC . Adherence to the dietary guidelines for Americans and risk of major chronic disease in men Am J Clin Nutr 2000 72: 1223–1231.

    Article  CAS  PubMed  Google Scholar 

  19. Kant AK, Schatzkin A, Block G, Ziegler RG, Nestle M . Food group intake patterns and associated nutrient profiles of the US population J Am Diet Assoc 1991 91: 1532–1537.

    CAS  PubMed  Google Scholar 

  20. Kant AK, Schatzkin A, Harris TB, Ziegler RG, Block G . Dietary diversity and subsequent mortality in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study Am J Clin Nutr 1993 57: 434–440.

    Article  CAS  PubMed  Google Scholar 

  21. Slattery ML, Berry TD, Potter J, Caan B . Diet diversity, diet composition, and risk of colon cancer (United States) Cancer Causes Control 1997 8: 872–882.

    Article  CAS  PubMed  Google Scholar 

  22. McCrory MA, Fuss PJ, McCallum JE, Yao M, Vinken AG, Hays NP, Roberts SB . Dietary variety within food groups: association with energy intake and body fatness in men and women. [See comments.] Am J Clin Nutr 1999 69: 440–447.

    Article  CAS  PubMed  Google Scholar 

  23. Gibson SA . Are high-fat, high-sugar foods and diets conducive to obesity? Int J Food Sci Nutr 1996 47: 405–415.

    Article  CAS  PubMed  Google Scholar 

  24. Kayrooz K, Moy TF, Yanek LR, Becker DM . Dietary fat patterns in urban African American women J Community Health 1998 23: 453–469.

    Article  CAS  PubMed  Google Scholar 

  25. Farchi G, Mariotti S, Menotti A, Seccareccia F, Torsello S, Fidanza F . Diet and 20-y mortality in two rural population groups of middle-aged men in Italy Am J Clin Nutr 1989 50: 1095–1103.

    Article  CAS  PubMed  Google Scholar 

  26. Huijbregts PP, Feskens EJ, Kromhout D . Dietary patterns and cardiovascular risk factors in elderly men: the Zutphen Elderly Study Int J Epidemiol 1995 24: 313–320.

    Article  CAS  PubMed  Google Scholar 

  27. Hulshof KF, Wedel M, Lowik MR, Kok FJ, Kistemaker C, Hermus RJ, ten-Hoor F, Ockhuizen T . Clustering of dietary variables and other lifestyle factors (Dutch Nutritional Surveillance System) J Epidemiol Community Health 1992 46: 417–424.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Fraser GE, Welch A, Luben R, Bingham SA, Day NE . The effect of age, sex, and education on food consumption of a middle-aged English cohort-EPIC in East Anglia Prev Med 2000 30: 26–34.

    Article  CAS  PubMed  Google Scholar 

  29. Pryer JA, Nichols R, Elliott P, Thakrar B, Brunner E, Marmot M . Dietary patterns among a national random sample of British adults J Epidemiol Community Health 2001 55: 29–37.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Greenwood DC, Cade JE, Draper A, Barrett JH, Calvert C, Greenhalgh A . Seven unique food consumption patterns identified among women in the UK Women's Cohort Study Eur J Clin Nutr 2000 54: 314–320.

    Article  CAS  PubMed  Google Scholar 

  31. Tucker KL, Dallal GE, Rush D . Dietary patterns of elderly Boston-area residents defined by cluster analysis J Am Diet Assoc 1992 92: 1487–1491.

    CAS  PubMed  Google Scholar 

  32. Wirfalt AK, Jeffery RW . Using cluster analysis to examine dietary patterns: nutrient intakes, gender, and weight status differ across food pattern clusters J Am Diet Assoc 1997 97: 272–279.

    Article  CAS  PubMed  Google Scholar 

  33. Schroll K, Carbajal A, Decarli B, Martins I, Grunenberger F, Blauw YH, de-Groot CP . Food patterns of elderly Europeans. SENECA Investigators Eur J Clin Nutr 1996 50 (Suppl 2): S86–100.

    PubMed  Google Scholar 

  34. Gex-Fabry M, Raymond L, Jeanneret O . Multivariate analysis of dietary patterns in 939 Swiss adults: sociodemographic parameters and alcohol consumption profiles Int J Epidemiol 1988 17: 548–555.

    Article  CAS  PubMed  Google Scholar 

  35. Barker ME, McClean SI, Thompson KA, Reid NG . Dietary behaviours and sociocultural demographics in Northern Ireland Br J Nutr 1990 64: 319–329.

    Article  CAS  PubMed  Google Scholar 

  36. Wolff CB, Wolff HK . Maternal eating patterns and birth weight of Mexican American infants Nutr Health 1995 10: 121–134.

    Article  CAS  PubMed  Google Scholar 

  37. Slattery ML, Boucher KM, Caan BJ, Potter JD, Ma KN . Eating patterns and risk of colon cancer Am J Epidemiol 1998 148: 4–16.

    Article  CAS  PubMed  Google Scholar 

  38. Randall DE, Marshall JR, Brasure J, Graham S . Patterns in food use and compliance with NCI dietary guidelines Nutr Cancer 1991 15: 141–158.

    Article  CAS  PubMed  Google Scholar 

  39. Kant AK, Schatzkin A, Ziegler RG . Dietary diversity and subsequent cause-specific mortality in the NHANES I epidemiologic follow–up study J Am Coll Nutr 1995 14: 233–238.

    Article  CAS  PubMed  Google Scholar 

  40. Hu FB, Rimm EB, Stampfer MJ, Ascherio A, Spiegelman D, Willett WC . Prospective study of major dietary patterns and risk of coronary heart disease in men Am J Clin Nutr 2000 72: 912–921.

    Article  CAS  PubMed  Google Scholar 

  41. Fung TT, Rimm EB, Spiegelman D, Rifai N, Tofler GH, Willett WC, Hu FB . Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk Am J Clin Nutr 2001 73: 61–67.

    Article  CAS  PubMed  Google Scholar 

  42. Gittelsohn J, Wolever TM, Harris SB, Harris GR, Hanley AJ, Zinman B . Specific patterns of food consumption and preparation are associated with diabetes and obesity in a Native Canadian community J Nutr 1998 128: 541–547.

    Article  CAS  PubMed  Google Scholar 

  43. Beaudry M, Galibois I, Chaumette P . Dietary patterns of adults in Quebec and their nutritional adequacy Can J Public Health 1998 89: 347–351.

    CAS  PubMed  PubMed Central  Google Scholar 

  44. Rose G . The strategy of preventive medicine Oxford University Press: New York 1992

    Google Scholar 

  45. Slattery ML, Edwards SL, Boucher KM, Anderson K, Caan BJ . Lifestyle and colon cancer: an assessment of factors associated with risk Am J Epidemiol 1999 150: 869–877.

    Article  CAS  PubMed  Google Scholar 

  46. Heitmann BL, Lissner L . Dietary underreporting by obese individuals—is it specific or non-specific? Br Med J 1995 311: 986–989.

    Article  CAS  Google Scholar 

  47. Pomerleau J, Ostbye T, Bright-See E . Potential underreporting of energy intake in the Ontario Health Survey and its relationship with nutrient and food intakes Eur J Epidemiol 1999 15: 553–557.

    Article  CAS  PubMed  Google Scholar 

  48. Hu FB, Rimm E, Smith WS, Feskanich D, Stampfer MJ, Ascherio A, Sampson L, Willett WC . Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire Am J Clin Nutr 1999 69: 243–249.

    Article  CAS  PubMed  Google Scholar 

  49. Lissner L, Heitmann BL, Bengtsson C . Population studies of diet and obesity Br J Nutr 2000 83 (Suppl 1): S21–S24.

    CAS  PubMed  Google Scholar 

  50. Heitmann BL, Lissner L, Sørensen TI, Bengtsson C . Dietary fat intake and weight gain in women genetically predisposed for obesity Am J Clin Nutr 1995 61: 1213–1217.

    Article  CAS  PubMed  Google Scholar 

  51. Baecke JA, Burema J, Frijters JE, Hautvast JG, Wiel-Wetzels WA . Obesity in young Dutch adults: II, daily life-style and body mass index Int J Obes 1983 7: 13–24.

    CAS  PubMed  Google Scholar 

  52. Heitmann BL, Erikson H, Ellsinger BM, Mikkelsen KL, Larsson B . Mortality associated with body fat, fat-free mass and body mass index among 60-year-old Swedish men-a 22-year follow-up. The study of men born in 1913 Int J Obes Relat Metab Disord 2000 24: 33–37.

    Article  CAS  PubMed  Google Scholar 

  53. Randall E, Marshall JR, Brasure J, Graham S . Dietary patterns and colon cancer in western New York Nutr Cancer 1992 18: 265–276.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

This study was supported by a grant from the University of Copenhagen, DK (no. 301-116-5/99). The establishment of the Research Unit for Dietary Studies was financed by the FREJA programme from the Danish Medical Research Council (no. 9801037).

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Authors and Affiliations

  1. Centre for Preventive Medicine, Research Unit for Dietary Studies, Glostrup University Hospital, Glostrup, Denmark

    P Togo & BL Heitmann

  2. Institute of Public Health, University of Copenhagen, Copenhagen, Denmark

    M Osler

  3. Danish Epidemiology Science Centre at the Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, Denmark

    TIA Sørensen

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  1. P Togo
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Correspondence to P Togo.

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Togo, P., Osler, M., Sørensen, T. et al. Food intake patterns and body mass index in observational studies. Int J Obes 25, 1741–1751 (2001). https://doi.org/10.1038/sj.ijo.0801819

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