DESIGN: We analysed data of children who participated in the Health Survey for England from 1997 to 2016 (n=34 235). This repeated cross-sectional survey reported weight loss attempts and sociodemographic characteristics. Body weight and height were measured by trained interviewers, and body mass index for age z-score was calculated. Multivariable logistic regression was used to investigate the sociodemographic determinants.
SETTING: England.
PARTICIPANTS: Children (8-17 years).
MAIN OUTCOME MEASURES: Weight loss attempts by year, age group, gender, BMI for age z-score, ethnicity and household income.
RESULTS: The prevalence of reported weight loss attempts increased significantly from 21.4% (1997-1998) to 26.5% (2015-2016). The increase was significant for boys, older children, Asian children, children from lower income households and in all categories of BMI for age z-score. Significant predictors of weight loss attempts included having overweight (8-12 years old, OR 4.01 (%CI 3.47 to 4.64); 13-17 years old, OR 1.96 (%CI 1.58 to 2.42)) or obesity (8-12 years old, OR 13.57 (%CI 11.94 to 15.43); 13-17 years old, OR 4.72 (%CI 3.94 to 5.66)) as well as being older, girls, from ethnic minority groups or low household income.
CONCLUSION: The prevalence of reported weight loss attempts among children is increasing at a faster rate than the rise in excess weight and includes an increasing proportion of children with a 'healthy' weight. The increase in the prevalence of reported weight loss attempts among children is greatest among subgroups with lower baseline prevalence.
METHODS: We examined determinants and tracking of a dietary pattern (DP) associated with metabolic risk and its key food groups among 860 adolescents in the Western Australian Pregnancy (Raine) Cohort study. Food intake was reported using a food frequency questionnaire (FFQ) at 14 and 17 years. Z-scores for an 'energy-dense, high-fat, low-fibre' DP were estimated by applying reduced rank regression at both ages. Tracking was based on the predictive value (PV) of remaining in the DPZ-score or food intake quartile at 14 and 17 years. Early-life exposures included: maternal age; maternal pre-pregnancy body mass index; parent smoking status during pregnancy; and parent socio-economic position (SEP) at 14 and 17 years. Associations between the DPZ-scores, early-life factors and SEP were analysed using regression analysis.
RESULTS: Dietary tracking was strongest among boys with high DPZ-scores, high intakes of processed meat, low-fibre bread, crisps and savoury snacks (PV > 1) and the lowest intakes of vegetables, fruit and legumes. Lower maternal education (β = 0.09, P = 0.002 at 14 years; β = 0.14, P
METHODS AND RESULTS: Data was sourced from participants in the Western Australian Pregnancy (Raine) Cohort Study. At 14 and 17 y, dietary intake, anthropometric and biochemical data were measured and z-scores for an 'energy dense, high fat and low fibre' DP were estimated using reduced rank regression (RRR). Associations between DP z-scores and cardiometabolic risk factors were examined using regression models. Tracking of DP z-scores was assessed using Pearson's correlation coefficient. A 1 SD unit increase in DP z-score between 14 and 17 y was associated with a 20% greater odds of high metabolic risk (95% CI: 1.01, 1.41) and a 0.04 mmol/L higher fasting glucose in boys (95% CI: 0.01, 0.08); a 28% greater odds of a high-waist circumference (95% CI: 1.00, 1.63) in girls. An increase of 3% and 4% was observed for insulin and HOMA (95% CI: 1%, 7%), respectively, in boys and girls, for every 1 SD increase in DP z-score and independently of BMI. The DP showed moderate tracking between 14 and 17 y of age (r = 0.51 for boys, r = 0.45 for girls).
CONCLUSION: An 'energy dense, high fat, low fibre' DP is positively associated with cardiometabolic risk factors and tends to persist throughout adolescence.