Identification of dietary patterns by principal component analysis in schoolchildren in the South of Brazil and associated factors

Bratkowski, Gabriela Rodrigues; Backes, Vanessa; Olinto, Maria Teresa; Henn, Ruth Liane

doi:10.1590/1806-93042020000300005

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Revista Brasileira de Saúde Materno Infantil

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ORIGINAL ARTICLES • Rev. Bras. Saude Mater. Infant. 20 (3) • Jul-Sep 2020 • https://doi.org/10.1590/1806-93042020000300005 copy

Identification of dietary patterns by principal component analysis in schoolchildren in the South of Brazil and associated factors

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives:

to identify dietary patterns (DP) and associated factors in first grade school-children in elementary schools in the South of Brazil.

Methods:

school-based cross-sectional study, with a non-probabilistic sample of 782 schoolchildren aged 6 to 8. Food intake was assessed by a food frequency questionnaire. DP were identified using the principal component analysis and the prevalence ratios were obtained by Poisson regression with a robust variance.

Results:

four DP were identified and accounted for 25.3% of the total variance: "fruit, vegetables and fish" (8.5%), "sweets and salty snacks" (7.0%), "dairy, ham and biscuits" (5.0%) and "common Brazilian food" (4.8%). After the adjustment, breakfast habit and lower frequency of meals in front of a screen increased the probability of adherence to a high consumption of DP of "fruit, vegetables and fish". The maternal schooling level was linearly and inversely associated with DP of "sweets and salty snacks" and "common Brazilian food", and positively related to the DP of "dairy, ham and biscuits". Schoolchildren with food inse-curity and sufficiently active had higher probability of adherence to DP of "common Brazilian food".

Conclusions:

four DP were identified and associated with food insecurity, maternal socioeconomic characteristics and schoolchildren’s behavioral characteristics.

Key words:
Feeding behavior; Child; Principal components analysis

Food included in FFQ
Rice	Beet	Margarine
Corn	Fruit	Butter
Cassava	Fruit salad	Fried food
Potato	Milk	Sweet biscuits
Pasta	Cheese	Cookies with filling
Bread	Yogurt	Crackers
Beans	Meat	Salty snack
Lettuce	Chicken	Candy
Cabbage	Fish	Chocolate
Tomato	Egg	Gum
Cucumber	Sausage	Lollipop
Kale	Baloney / Mortadella	Block of raw brown sugar
Pumpkin	Frankfurters	Soda
Chayote	Ham	Artificial juice
Carrot	Salami

Characteristics	N	%
Gender
Male	414	52.9
Female	368	47.1
Mothers' Age (years)
20 - 29	288	36.8
30 - 39	316	40.4
≥ 40	178	22.8
Economical level^* * Two missing data for this variable (n=780);
B and C	136	17.4
D	463	59.4
E	181	23.2
Mothers' schooling (years)
≤ 5	271	34.7
6 - 10	311	39.7
≥ 11	200	25.6
Food insecurity (FI)
Without FI	429	54.9
With FI	353	45.1
Breakfast habit
Yes	635	81.2
No	147	18.8
Having meals in front of the screen^ One missing data for this variable (N=781).
Often	233	29.8
Sometimes	216	27.7
Never	332	42.5
Physical activity level
Sufficient	320	40.9
Insufficient	462	59.1
Sedentary behavior (hour)
> 2	650	83.1
≤ 2	132	16.9

Food*	Dietary pattern
Food*	"fruit, vegetables and fish"	"sweets and salty snacks"	"dairy, ham and biscuits"	"common Brazilian food"
Kale	0.639	-0.002	0.054	0.004
Carrot	0.611	-0.115	0.143	0.042
Cabbage	0.575	0.180	-0.134	0.261
Beet	0.545	-0.003	0.042	0.034
Pumpkin	0.532	0.020	0.093	-0.036
Lettuce	0.497	-0.043	0.028	0.287
Tomato	0.452	0.004	0.059	0.302
Cassava	0.423	0.019	0.021	0.162
Potato	0.414	0.216	0.216	0.127
Chayote	0.408	-0.023	0.107	0.003
Fish	0.400	0.115	0.065	-0.049
Cucumber	0.390	0.168	0.009	-0.048
Fruit salad	0.375	0.140	0.094	0.031
Fruit	0.355	-0.049	0.268	0.296
Corn	0.304	0.041	0.133	-0.106
Lollipop	0.068	0.666	-0.143	0.030
Candy	0.065	0.658	-0.240	0.053
Salty snacks	-0.112	0.605	0.060	0.122
Gum	0.103	0.600	-0.181	0.111
Soda	-0.169	0.481	0.272	-0.073
Cookies with filling	-0.072	0.408	0.359	0.080
Block of raw brown sugar	0.106	0.387	0.052	-0.014
Chocolate	0.092	0.377	0.122	-0.301
Frankfurters	0.144	0.374	0.244	-0.056
Fried foods	0.081	0.310	0.199	-0.023
Cheese	0.140	-0.104	0.594	0.042
Yogurt	0.066	0.139	0.523	0.068
Ham	0.068	-0.048	0.484	-0.023
Crackers	0.289	-0.020	0.364	-0.034
Milk	0.163	-0.110	0.208	-0.035
Margarine	0.051	0.029	0.089	0.562
Bread	-0.022	-0.031	0.057	0.525
Beans	0.152	-0.028	-0.104	0.495
Rice	0.064	-0.057	-0.060	0.471
Baloney / Mortadella	-0.032	0.254	0.274	0.409
Artificial juice	-0.014	0.075	0.136	0.377
Chicken	0.080	0.083	0.042	0.330
Pasta	0.080	0.244	0.216	0.027
Butter	0.280	0.070	0.115	0.078
Meat	0.053	0.055	0.243	0.081
Egg	0.129	0.294	0.201	0.099
Salami	0.149	0.106	0.249	-0.011
Sausage	0.040	0.225	0.279	0.219
Variance explained (%)	8.5	7.0	5.0	4.8

Variables	"Fruit, vegetables and fish"		"Sweets/ salty snacks"
Variables	Crude PR (CI95%)	Adjusted PR (CI95%)	Crude PR (CI95%)	Adjusted PR (CI95%)
Level I
Gender	0.058^* * Wald test for heterogeneity;	0.068^* * Wald test for heterogeneity;	0.544^* * Wald test for heterogeneity;	-
Male	1	1	0.92 (0.69-1.21)
Female	1.31 (0.99-1.74)	1.30 (0.98-1.72)	1
Mothers' age (years)	0.819^ Wald test for linear trend.	-	0.666^ Wald test for linear trend.	-
20 - 29	1		1.05 (0.73-1.51)
30 - 39	1.00 (0.73-1.38)		0.87 (0.60-1.26)
≥ 40	1.05 (0.72-1.52)		1
Economical level	0.040^ Wald test for linear trend.	0.109^ Wald test for linear trend.	0.018^ Wald test for linear trend.	0.229^ Wald test for linear trend.
E	1	1	1.77 (1.1 1-2.83)	1.36 (0.81-2.28)
D	1.38 (0.94-2.02)	1.38 (0.92-2.05)	1.30 (0.85-2.01)	1.13 (0.72-1.77)
B and C	1.60 (1.02-2.53)	1.51 (0.91-2.50)	1	1
Mothers' schooling (years)	0.145^ Wald test for linear trend.	0.630^ Wald test for linear trend.	0.002^ Wald test for linear trend.	0.020^ Wald test for linear trend.
≤ 5	1	1	1.88 (1.26-2.81)	1.68 (1.08-2.62)
6 - 10	1.12 (0.80-1.57)	1.02 (0.72-1.44)	1.52 (1.01-2.28)	1.43 (0.93-2.18)
≥ 11	1.05 (0.91-1.88)	1.10 (0.74-1.65)	1	1
Level II
FI	0.771^* * Wald test for heterogeneity;	-	0.010^* * Wald test for heterogeneity;	0.057^* * Wald test for heterogeneity;
With FI	1		1.45 (1.09-1.92)	1.32 (0.99-1.77)
Without FI	1.04 (0.79-1.38)		1	1
Breakfast	0.052^* * Wald test for heterogeneity;	0.038^* * Wald test for heterogeneity;	0.179^* * Wald test for heterogeneity;	0.064^* * Wald test for heterogeneity;
No	1	1	1.26 (0.90-1.76)	1.38 (0.98-1.93)
Yes	1.50 (1.00-2.27)	1.55 (1.02-2.34)	1	1
Meals in front of the screen	0.013^ Wald test for linear trend.	0.015^ Wald test for linear trend.	0.011^ Wald test for linear trend.	0.015^ Wald test for linear trend.
Often	1	1	1.61 (1.17-2.22)	1.57 (1.14-2.17)
Sometimes	1.46 (0.98-2.18)	1.38 (0.92-2.05)	0.99 (0.68-1.44)	1.00 (0.69-1.46)
Never	1.60 (1.12-2.31)	1.57 (1.09-2.26)	1	1
PA level	0.181^* * Wald test for heterogeneity;	0.181^* * Wald test for heterogeneity;	<0.001^* * Wald test for heterogeneity;	<0.001^* * Wald test for heterogeneity;
Insufficient	1	1	0.59 (0.45-0.79)	0.59 (0.44-0.78)
Sufficient	1.21 (0.91-1.61)	1.21 (0.91-1.61)	1	1
Sedentary behavior (hour)	0.557^* * Wald test for heterogeneity;		0.455^* * Wald test for heterogeneity;
> 2	1	-	1.16 (0.78-1.72)	-
≤ 2	0.90 (0.61-1.32)		1

Variables	"Dairy, ham and biscuits"		"Common Brazilian food"
Variables	Crude PR (CI95%)	Adjusted PR (CI95%)	Crude PR (CI95%)	Adjusted PR (CI95%)
Level I
Gender	0.209*	-	0.859*	-
Male	1.20 (0.90-1.59)		1
Female	1		1.03 (0.77-1.36)
Mothers' age (years)	0.027^ Wald test for linear trend.	0.057^ Wald test for linear trend.	0.201^ Wald test for linear trend.	-
20 - 29	1.55 (1.04-2.30)	1.42 (0.94-2.15)	1.25 (0.86-1.83)
30 - 39	1.26 (0.84-1.89)	1.19 (0.79-1.79)	1.04 (0.71-1.53)
≥ 40	1	1	1
Economical level	0.108^ Wald test for linear trend.	0.522^ Wald test for linear trend.	0.046^ Wald test for linear trend.	0.318^ Wald test for linear trend.
E	1	1	1.61 (1.03-2.50)	1.29 (0.79-2.1 1)
D	1.43 (0.98-2.08)	1.24 (0.83-1.85)	1.04 (0.69-1.58)	0.93 (0.60-1.43)
B and C	1.45 (0.91-2.31)	1.19 (0.71-1.99)	1	1
Mothers' schooling (years)	0.002^ Wald test for linear trend.	0.030^ Wald test for linear trend.	0.009^ Wald test for linear trend.	0.048^ Wald test for linear trend.
≤ 5	1	1	1.72 (1.17-2.54)	1.53 (0.99-2.37)
6 - 10	1.51 (1.06-2.15)	1.33 (0.91-1.94)	1.34 (0.90-1.99)	1.29 (0.85-1.95)
≥ 11	1.81 (1.24-2.63)	1.59 (1.05-2.43)	1	1
Level II
FI	0.044*	0.149*	0.002*	0.013*
With FI	1	1	1.57 (1.19-2.09)	1.44 (1.08-1.93)
Without FI	1.35 (1.01-1.80)	1.24 (0.92-1.67)	1	1
Breakfast	0.627*	-	0.162*	0.302*
No	1		1	1
Yes	1.10 (0.76-1.59)		1.33 (0.89-1.97)	1.23 (0.83-1.83)
Meals in front of the screen	0.913^ Wald test for linear trend.	-	0.296^ Wald test for linear trend.	-
Often	1		1
Sometimes	1.04 (0.72-1.51)		0.89 (0.60-1.31)
Never	1.02 (0.73-1.43)		1.17 (0.84-1.62)
PA level	0.449*	-	0.008*	0.010*
Insufficient	0.90 (0.68-1.19)		1	1
Sufficient	1		1.46 (1.10-1.93)	1.45 (1.09-1.92)
Sedentary behavior (hour)	0.060*	0.155*	0.556*	-
> 2	1.52 (0.98-2.35)	1.38 (0.89-2.13)	1
≤ 2	1	1	1.1 1 (0.78-1.60)

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[1] Authors’ contribuition

Bratkowski GR and Henn RL were responsible for the study design, data analysis and interpretation and writing of the manuscript. Backes V and Olinto MT contributed to the writing of the manuscript, analysis and interpretation of the data and revised the manuscript. All authors approved the final version of the manuscript.