Dietary patterns and adiposity over time - analysis of the ELSA-Brasil

Eur J Nutr. 2024 Feb 16. doi: 10.1007/s00394-024-03350-w. Online ahead of print.


Purpose: Combining different statistical methods to identify dietary patterns (DP) may provide new insights on how diet is associated with adiposity. This study investigated the association of DP derived from three data-driven methods and adiposity indicators over time.

Methods: This study used data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). DP were identified at baseline applying three statistical methods: Factor Analysis (FA), Treelet Transform (TT), and Reduced Rank Regression (RRR). The association between DP and adiposity indicators (weight, body mass index, waist circumference, body fat percentage and fat mass index) over the period of 8.2 years of follow-up was assessed by linear mixed-models.

Results: Convenience DP, marked by unhealthy food groups, was associated with higher adiposity over the follow-up period, regardless of the method applied. The DP identified by TT and marked by high consumption of rice and beans was associated with lower adiposity, whereas the similar DP identified by FA, but additionally characterised by consumption of poultry and red meat was associated with higher adiposity. Prudent DP, marked by plant-based food groups and fish, identified by FA was associated with lower adiposity across the median follow-up time.

Conclusion: Applying different methods to identify DP showed that a convenience DP was associated with higher adiposity independent of the method applied. We also identified the nuances within adherence to a Brazilian traditional dietary pattern characterised by the consumption of rice and beans, that only when combined with reduced consumption of animal protein and unhealthy foods was associated with lower adiposity over time.

Keywords: Adiposity; Body fat percentage; Dietary patterns; Fat mass index; Longitudinal study; Waist circumference.