Higher scores in a Refined high in sugar, salt, and fat dietary pattern are associated with excess adiposity among 54-month-olds: Growing Up in New Zealand cohort

Abstract Healthy dietary patterns (DP) in early life constitute an internationally recommended platform for preventing childhood obesity. New Zealand (NZ) ranks high globally for the prevalence of child obesity. Yet, national data on overall diet quality and its relationship with healthy weight remain limited. Data from 54-month-olds ( n 6048) in the Growing Up in New Zealand cohort were used to examine associations between indicators of adiposity and scores on two previously identified DP. Excess adiposity was defined by body-mass ondex/age (BMI/A) >+2 z -score (WHO Growth Standards) and a waist-to-height ratio (WtHR) >90th percentile within the cohort. Adjusted associations were examined using multiple Poisson regressions with robust variance. Prevalence ratios (PR) and 95 % confidence intervals (CI) were reported. Compared with females in the lowest tertile of adherence to a DP characterised by high intake of refined foods and those high in sugar, salt and unhealthy fats, those in the middle (PR: 1·56; 95 % CI 1·07–2·28; p = 0·021) and third tertile (PR: 2·14; 95 % CI 1·48–3·10; p < 0·001) had a higher prevalence of overweight/obesity (BMI/A). Scores in this DP were not associated with BMI/A > +2 z in males nor with WtHR > 90 th percentile in either sex. There were no associations between the tertiles of a DP characterised by high intake of fruit, vegetables and protein foods, and the two adiposity indicators examined for both sexes. Overall, poorer diet quality was linked to obesity at 54 months, with sex-specific effects, supporting national early childhood obesity prevention strategies targeting foods high in sugar, salt and unhealthy fats.