Childhood obesity is a burgeoning public health crisis, with significant implications for both physical and metabolic health. The relationship between diet and obesity is well-known, but the specifics of how different dietary patterns influence the risk of overweight and obesity (Ov/Ob) or metabolically unhealthy obesity (MUO) in children have not been fully elucidated. 

A recent systematic review and meta-analysis, conducted as part of the BIO-STREAMS project, was presented at the Nutrition Society Congress 2024 in Belfast, Northern Ireland from July 2-5, 2024, with the goal to address this gap.

Key Findings from the Systematic Review and Meta-Analysis

The research, conducted by A. Kyrkili and colleagues from the Harokopio University and the University of the Aegean in Greece, involved a comprehensive literature search following PRISMA guidelines. This review included studies published between January 2013 and June 2023, focusing on children and adolescents aged 2-19 years from Europe, the USA, Canada, and Oceania.

Out of 2603 references initially identified, 29 prospective studies met the inclusion criteria. These studies examined the relationship between dietary patterns and the risk of Ov/Ob or MUO. Dietary patterns were categorized as “healthy” (HDP) or “unhealthy” (UDP), although there were variations in how these patterns were defined across different studies.

Impact of Healthy Dietary Patterns (HDP)

The meta-analysis revealed that adherence to HDP, characterized by higher consumption of fruits, vegetables, and whole grains, was associated with a significant reduction in the odds of Ov/Ob. Specifically, the odds ratio (OR) was 0.85, indicating a 15% lower risk compared to non-adherence. Additionally, higher adherence to HDP was linked to lower BMI and a smaller increase in BMI over time.

“The meta-analysis revealed that adherence to HDP, characterized by higher consumption of fruits, vegetables, and whole grains, was associated with a significant reduction in the odds of Ov/Ob.”

Impact of Unhealthy Dietary Patterns (UDP)

Conversely, adherence to UDP, marked by higher intake of sweets, refined grains, fast foods, and processed meats, was associated with a 34% increase in the odds of Ov/Ob (OR: 1.34). There was also a marginally significant association between UDP adherence and higher z-BMI, suggesting that these unhealthy dietary choices contribute to increased body mass and potentially to metabolic complications.

Interpretation and Future Directions

“These findings underscore the preventive potential of healthy dietary patterns against childhood obesity,” says Dr. Meropi Kontogianni, a BIO-STREAMS project partner. “However, the heterogeneity in defining dietary patterns and exposures across studies necessitates careful interpretation of the results. Future research should aim to standardize definitions and methodologies to confirm these findings.”

Conclusion

This systematic review and meta-analysis highlight the critical role of diet in managing childhood obesity. Encouraging children and adolescents to adopt healthier dietary patterns could significantly reduce the risk of Ov/Ob and its associated metabolic complications. Policymakers and health practitioners should prioritize dietary interventions as a key strategy in combating childhood obesity. 

As the BIO-STREAMS project, funded by the European Union’s HORIZON 2022 research and innovation program, continues to explore these relationships, more refined and actionable insights are expected to emerge, paving the way for more effective public health strategies.

By understanding and promoting healthy dietary patterns, we can take a significant step towards mitigating the childhood obesity epidemic and ensuring a healthier future for the next generation.