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Childhood obesity increases with low fiber,
energy-dense, high-fat dietary patterns while
high fiber patterns may reduce fat absorption Winter 2009, Vol 5, Issue 14 
The authors of this featured study sought to identify a dietary pattern of multiple
factors that contribute to obesity, rather than analyzing data for isolated risk factors.
Noting the complexity of dietary patterns with multiple nutrients and food features,
Johnson et al presumed that "a dietary pattern based on the energy density and
fiber and fat contents of the diet may be more informative of obesity risk." The
investigators note that while the World Health Organization has identified energy
density and fiber as key determinants, little research is available which thoroughly
analyzed prospective studies for associations of these factors in children. Instead of
using a traditional "hypothesis driven" approach or "exploratory" method,
Johnson et al applied a unique research methodology in their analysis called
"reduced rank regression (RRR)." This approach uses existing evidence of dietary
effects on disease together with exploratory statistics as a means of identifying
dietary patterns related to specific diseases, such as obesity.
This study extended previous research commenced in 1991 in the Avon
Longitudinal Study of Parents and Children (ALSPAC), a prospective cohort
study tracking growth and development from pregnancy into childhood. Diets were
assessed among 521 children at 5 and 9 y of age, and 682 children at 7 and 9 y.
Using dietary energy density (DED), fiber density (FD) and fat intake as intermediate
variables, a dietary pattern was established with the RRR. Using the RRR
dietary pattern, scores were established in relation to diet, child fatness and potential
confounders. Several forms of statistical analysis were applied, all with the use
of the data program "SPSS version 11.0 (SPSS Inc, Chicago, IL)."
Johnson et al identified a dietary pattern for children at ages 5 and 7 years that was
associated with low fiber, high DED and high-fat intake. Increases in fat mass and
risk of excessive fat storage at age 9 were prospectively associated with an overall
increase in dietary pattern score. The dietary patterns were analyzed in five quintiles
by body size. Researchers observed that "children in quintile 5 of dietary pattern
score were >4 times more likely to have excess adiposity than children in quintile 1."
This pattern of obesity was much greater for the dietary pattern of three variables
than any one alone. Johnson et al note their analysis also suggests a possible correlation
of increased fiber intake and decreased absorption of fats, though further
research is warranted. Their findings observed increased fatness 2 and 4 y after
dietary patterns of high DED, low fiber and high-fat intake in children, indicating
the value of earlier dietary interventions.
Study: Johnson, L., et al, Am J Clin Nutr, 87: 846-54. (2008) RETURN from dietary fiber and childhood obesity |
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