Diet Quality Scores, Obesity and Metabolic Syndrome in Children and Adolescents: A Systematic Review and Meta-Analysis.

Alicia Larruy-García, Lubna Mahmood, María L Miguel-Berges, Guiomar Masip, Miguel Seral-Cortés, Pilar De Miguel-Etayo, Luis A Moreno

Journal: Current obesity reports 2024;13(4):755-788

PMID: 39331350

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Plain Language Summary

Literature shows that obesity among children and adolescents tends to persist into later life, thus increasing the risk of obesity during adulthood. Obesity is considered as a risk factor in the development of Metabolic Syndrome (MetS). This study aimed to analyse various diet quality scores and their association with obesity and MetS in children and adolescents. This study was a systematic review and meta-analysis of seventy-three articles. The studies were evaluated as cross sectional (n= 53, 72%), cohort (n=15, 22%), and clinical trials (n=4, 6%). Results showed that: - high adherence to the Mediterranean diet (MD) was associated with low obesity measures but only in adolescents. - greater adherence to the MD may have a protective effect against cardiovascular disease and the development of obesity. Authors concluded that high adherence to diet quality scores has a positive effect on obesity measures and MetS in children and adolescents.

Abstract

PURPOSE OF REVIEW

We aimed to examine the relationship between various diet quality scores and obesity and Metabolic Syndrome (MetS) in children and adolescents.

RECENT FINDINGS

Obesity and MetS, which increase the risk of type 2 diabetes and cardiovascular disease from childhood through adolescence, have been associated with adherence to various diet quality scores. A systematic search was performed in PubMed/Medline, Scopus, SciELO, Embase, and Cochrane, covering the period until March 2024. Two researchers evaluated 3,519 studies according to the inclusion criteria. Finally, 73 articles that analysed the relationship between diet quality scores and obesity and MetS were included, and 6 of them were included in a meta-analysis. Children younger than 12 years old showed statistically significant differences indicating a higher Mediterranean diet (MD) score adherence compared to those with a low score adherence for BMI (MD = 0.33 kg/m, 95% CI: 0.01, 0.64) and WC values (MD = 1.21 cm, 95% CI: 0.50, 1.93). Additionally, in the meta-regression analysis, boys showed stronger associations for BMI, z-score BMI and WC (β = 19.82, 95% CI: 17.62, 22.03, β = 0.64, 95% CI: 0.33, 0.96 and β = 67.03, 95% CI: 57.29, 76.77, respectively). Studies in this review suggest an association between high adherence to different diet quality scores and low BMI. Meta-analysis assessing the association between adherence to the MD and BMI, and WC, showed a protective effect of the MD pattern against obesity outcomes. This systematic review and meta-analyses provided evidence on the effect of the diet quality on obesity and MetS in children and adolescents.

Address: Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Physiatry and Nursing Department, Faculty of Health Sciences, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Universidad de Zaragoza, Pedro Cerbuna Street, 50009, Zaragoza, Spain.; CIBER. Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.; Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Physiatry and Nursing Department, Faculty of Health Sciences, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Universidad de Zaragoza, Pedro Cerbuna Street, 50009, Zaragoza, Spain. [email protected].; CIBER. Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. [email protected].

DOI: 10.1007/s13679-024-00589-6