Higher dietary phytochemical index is associated with anthropometric indices in children and adolescents: The weight disorders survey of the CASPIAN-IV study
Abstract
Abstract.Objectives: The present study aimed to determine the association of total dietary phytochemical intake with generalized and abdominal obesity in children and adolescents. Material and methods: This nationwide cross-sectional study was conducted in 4296 students aged 6–18 years. Dietary phytochemical index (DPI) was calculated as a percentage of daily energy derived from phytochemical-rich foods divided by total daily energy intake. Results: The mean ± standard error of DPIs in the first, second, third and fourth quartiles were 12.70 ± 3.28, 20.36 ± 1.84, 27.52 ± 0.08 and 41.10 ± 0.26, respectively. Anthropometric measures including weight Z-score (−0.04 vs. 0.05, P = 0.023), body mass index (BMI) Z-score (−0.05 vs. 0.06, P = 0.013), waist circumference (WC) (65.80 cm vs. 66.95 cm P = 0.022), hip circumference (HC) (80.20 cm vs. 81.37 cm, P = 0.046), and neck circumference (NC) (30.06 cm vs. 30.45 cm, P = 0.031) were significantly lower among participants in the upper DPI quartile compared to those in the lower quartiles. In overweight and obese children, higher adjusted DPI scores had inverse correlation with BMI, WC, HC, wrist circumference, and NC (βs = −0.077, −0.10, −0.119, −0.01, and −0.032, respectively; P < 0.05). Comparison of the fourth quartile with the first quartile of DPI revealed beneficial effects of higher phytochemical intake on reducing the risk of obesity/overweight and abdominal obesity. However, these results were not statistically significant (P = 0.073). Conclusion: Higher DPI score was associated with lower risk of generalized and abdominal obesity in children and adolescents. However, the results were not statistically significant. Consuming phytochemical-rich foods can be encouraged to prevent childhood obesity.
References
1 . The prevalence and associated factors of non-communicable disease risk factors among civil servants in Ibadan, Nigeria. PLoS One. 2018;13:e0203587.
2 Prevalence of overweight and abdominal obesity in Greek children 6–12 years old: Results from the National Epidemiological Survey. Hippokratia. 2011;15:48–53.
3 Trends in abdominal obesity among U.S. children and adolescents. Pediatrics. 2014;134:e334–9.
4 . Increase in the prevalence of abdominal obesity in Brazilian school children (2000–2015). Int J Pediatr Adolesc Med. 2017;4:133–7.
5 . Trend in the prevalence of obesity and overweight among Iranian children and adolescents: A systematic review and meta-analysis. Nutrition. 2014;30:393–400.
6 A systematic review on the prevalence of overweight and obesity in Iranian children and adolescents. Iran J Pediatr. 2016;26:e2599.
7 Prevalence of general and abdominal obesity in a nationally representative sample of Iranian children and adolescents: The CASPIAN-IV study. Iran J Pediatr. 2015;25(3):e401.
8 . Vegetables containing phytochemicals with potential anti-obesity properties: A review. Food Res Int. 2013;52:323–33.
9 . A review on possible therapeutic targets to contain obesity: The role of phytochemicals. Obes Res Clin Pract. 2016;10:363–80.
10 . Relationship of the dietary phytochemical index to weight gain, oxidative stress and inflammation in overweight young adults. J Hum Nutr Diet. 2010;23:20–9.
11 . What can intervention studies tell us about the relationship between fruit and vegetable consumption and weight management? Nutr Rev. 2004;62:1–17.
12 . Food group intake and central obesity among children and adolescents in the Third National Health and Nutrition Examination Survey (NHANES III). Public Health Nutr. 2010;13:797–805.
13 . Lifestyle factors associated with overweight and obesity among Saudi adolescents. BMC public health. 2012;12:354.
14 Methodology and early findings of the assessment of determinants of weight disorders among Iranian children and adolescents: The childhood and adolescence surveillance and prevention of adult Noncommunicable Disease-IV study. Int J Prev Med. 2015;6:77–81.
15 . Body mass index in children and adolescents: Considerations for population-based application. Int J Obes (Lond). 2006;30:590–4.
16 . Utility of waist-to height ratio in assessing the status of central obesity and related cardiometabolic risk profile among normal weight and overweight/obese children: The Bogalusa Heart Study. BMC Pediatr. 2010;10:73.
17 Neck circumference percentiles of Iranian children and adolescents: The weight disorders survey of CASPIAN IV study. Int J Endocrinol Metab. 2017;15:e13569.
18 . 2000 CDC growth charts for the United States. Available from: https://www.cdc.gov/growthcharts. Hyattsville MD: National Center for Health Statistics; 2000.
19 . Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran Lipid and Glucose Study. J Epidemiol. 2010;20:150–8.
20 . Proposal for a dietary “phytochemical index”. Med Hypotheses. 2004;63:813–7.
21 . Risk of overweight and obesity among semivegetarian, lactovegetarian, and vegan women. Am J Clin Nutr. 2005;81(6):1267–74.
22 . A vegetarian dietary pattern as a nutrient-dense approach to weight management: An analysis of the national health and nutrition examination survey 1999–2004. J Am Diet Assoc. 2011;111:819–27.
23 . Vegetarian diets and weight status. Nutr Rev. 2006;64:175–88.
24 Low-calorie vegetarian versus Mediterranean diets for reducing body weight and improving cardiovascular risk profile: CARDIVEG Study (Cardiovascular Prevention With Vegetarian Diet). Circulation. 2018;137:1103–13.
25 . Effect of changing to a self-selected vegetarian diet on anthropometric measurements in UK adults. J Hum Nutr Diet. 2004;17:249–55.
26 . Vegetarian diets and weight reduction: A meta-analysis of randomized controlled trials. J Gen Intern Med. 2016;31:109–16.
27 . Vegetarian diets and childhood obesity prevention. Am J Clin Nutr. 2010;91:1525S–9S.
28 The relative impact of a vegetable-rich diet on key markers of health in a cohort of Australian adolescents. Asia Pac J Clin Nutr. 2008;17:107–15.
29 . Higher intake of phytochemical-rich foods is inversely related to prediabetes: A case-control study. Int J Prev Med. 2018;9:64–8.
30 . Association between dietary phytochemical index and 3-year changes in weight, waist circumference and body adiposity index in adults: Tehran Lipid and Glucose study. Nutr Metab. 2019;9:108–13.
31 . Association between high consumption of phytochemical-rich foods and anthropometric measures: A systematic review. Int J Food Sci Nutr. 2017;68:158–66.
32 . Phytonutrient intake and body composition: Considering colors. Func Foods Health Dis. 2019;9:108–22.
33 Consumption of extra-virgin olive oil rich in phenolic compounds improves metabolic control in patients with type 2 diabetes mellitus: A possible involvement of reduced levels of circulating visfatin. J Endocrinol Invest. 2016;39:1295–301.
34 Licorice flavonoid oil reduces total body fat and visceral fat in overweight subjects: A randomized, double-blind, placebo-controlled study. Obes Res Clin Pract. 2009;3:169–78.
35 . Relationship of the dietary phytochemical index to weight gain, oxidative stress and inflammation in overweight young adults. J Hum Nutr Diet. 2010;23:20–9.