A study of dietary patterns and their association with insulin resistance in obese and overweight children in Bronx, New York
Objective: To identify prominent dietary patterns in overweight and obese children using Principle Component Analysis (PCA) and evaluate their potential associations with insulin resistance.^ Design: We performed a cross sectional analysis on baseline data from obese/overweight children (n=360, BMI ≥ 85, 7–12 years old) who received primary care in Jacobi Medical Center, Bronx, New York) and enrolled in the Family Weight Management Study (FWMS, registered at www.clinicaltrials.gov, NCT00851201). Enrollment occurred from January 2009 to December 2011.^ Dietary patterns were identified using PCA and the Block Food Frequency Questionnaire information from the FWMS. To determine the number of factors, we used the criterion of an eigenvalue > 1, factor loadings > 0.30, Cronbach’s alpha > 0.70, and face validity. Insulin resistance was defined as HOMA-IR ≥ 2.6. The association between insulin resistance and dietary patterns was assessed using logistic regression analysis.^ Results: We identified two major dietary patterns. Dietary pattern 1: ‘pizza and pasta’ was characterized by high loadings of pizza, pasta, red meat, chicken, fries, sweets, processed meat, and sweet breads. Dietary pattern 2: ‘snacks and dessert’ was characterized by high loadings of snacks, desserts, soft drinks, bread and refined grains. Results of multivariate logistic regression showed that there was a significant association between parents’ place of birth and both dietary pattern scores. Children with higher intake of the ‘pizza and pasta’ dietary pattern were more likely to have parents born in the United States (OR = 3.79, 95 % CI: 1.66–8.26). Children in the higher intake category of the ‘snacks and dessert’ were more likely to have a parent born in the United States (OR = 2.16, 95 % CI: 1.02 –4.55). Children whose mothers had high school or post-secondary education were more likely to consume foods from the ‘pizza and pasta’ dietary pattern compared to children whose mothers had less than a high school education (OR = 1.81, 95% CI: 1.03–2.03; OR = 2.39, 95% CI= 1.08–2.29, respectively).^ Results of multivariable analysis showed that child age (adjusted OR = 1.90, 95% CI; 1.46-2.42, p< 0.0001), gender (adjusted OR females = 2.34, 95% CI; 1.60-4.73, p < 0.01), child BMI (adjusted OR= 2.01, 95% CI; (0.91-4.84), 0.08) mother education (adjusted OR high school diploma = 2.81, 95% CI; 1.29-6.10, p < 0.009), parent place of birth [(adjusted OR Puerto Rico = 0.18, 95% CI; 0.36-0.91, 0.04) (adjusted OR Jamaica 0.21, 95% CI; 0.36-0.05-0.88, 0.03)] had a significant effect on insulin resistance. However, no significant relationships between this dietary pattern and insulin resistance were observed, partly due to the fact that there was a low variability in food intake among study population. Principal component analysis did not identify any major dietary patterns with which characterized with by high intake of healthy foods such as fruits, vegetables, low-fat dairy products, meats, and nuts.^
Assassi, Parisa, "A study of dietary patterns and their association with insulin resistance in obese and overweight children in Bronx, New York" (2016). Texas Medical Center Dissertations (via ProQuest). AAI10251882.