Eating habits among adolescents and their mothers : Stockholm Weight Development Study (SWEDES)

Abstract

The aims of this thesis were threefold. Firstly, to explore the possibility to improve the quality of dietary data and to identify under- and overreporters of energy intake. Secondly, to investigate the eating habits of adolescents and the association with overweight. Thirdly, to study the associations between maternal and child eating habits.

SWEDES is a cross-sectional study from Stockholm of 481 children and their mothers. Their diet was assessed by an extensive dietary questionnaire from the SOS (Swedish Obese Subjects) study. Questionnaires regarding meal patterns and eating behaviours (TFEQ) were also used. Energy expenditure was assessed by adding estimated PA from validated questionnaires to calculated BMR. Body measurements included both BMI and fat mass measured by BodPod. Salivary cariogenic bacteria counts were used as an objective estimate for sugar intake.

To improve dietary data an energy quotient was used (EI:EE) as a variable controlling for energy misreporting. In doing that, we found associations for body fatness with total energy intake, as well as to a high relative intake of sugar (when measured as bacteria counts) and a low relative intake of milk. The adolescents had in general reasonably aacceptable eating habits compared to nutritional recommendations, even though there was a relatively high intake of low-nutritious foods (25 E%). Subjects with poor breakfast habits and/or high soft drink consumption had a less healthy eating pattern than other subjects. High fruit juice, as well as soft drink, consumption was associated with a lower intake of nutritious foods such as milk and cooked meals. Relationships between mother and child were found in eating habits, in BMI and in the tendency to underreport. Overall, the eating pattern of daughters had a stronger relationship with the mothers than the sons had. Foods which strongly and positively correlated to the intake of the mothers were cakes/cookies/buns, fruit juice and salty snacks in both girls and boys. Milk and soft drinks had no relationship at all between the generations. To overreport the total energy intake was as common among the adolescents as to underreport the energy intake. The overreporters had specific characteristics, somewhat inverted of those of underreporters, with for example lower family income and a lower BMI.

As expected, a high total energy intake seems to be the most important dietary predictor for overweight. However, more specifically our results suggest that attempts to reduce the consumption of sweet beverages and to encourage eating breakfast could be useful prevention strategies against weight gain in adolescents. When aiming at decreasing the intake of for example cakes/cookies/buns and salty snacks in adolescents, the mothers could be targeted, whereas other ways have to be used when aiming at reducing soft drink intake. The quality of dietary surveys will be improved if misreporters are identified and adjusted for in the statistical analyses. However by excluding under- and/or overreporters important information from different sub-groups are lost.