Lack of An Association Between Dietary Patterns and Adiposity Among Primary School Children in Kilimanjaro Tanzania

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Abstract Introduction: Good dietary habits for children should be shaped while children are still growing so these behaviours benefit children in their later life. We examined dietary patterns and their association with adiposity among primary school children from northern Tanzania. Methods: We collected dietary data by 24-hour recall and food frequency questionnaire (FFQ) for 1170 primary school children aged 9 – 11 years from 20 primary schools in the Kilimanjaro region. We used factor analysis and FFQ data to identify dietary patterns. Children were categorised into terciles of their adherence to each dietary pattern. We used multilevel logistic regression to evaluate the association of dietary pattern terciles with adiposity indicators: body mass index z–scores (BMI z scores), body fat percentage by bioelectrical impedance, triceps and subscapular skinfold thicknesses, and waist circumference. Results: Fifteen percent of children had BMI Z> 1.0, indicating overweight or obesity. We identified two dietary patterns by factor analysis: a healthy pattern characterised by frequent consumption of fruits and vegetables and a mixed dietary pattern characterised by intake of fatty snacks, sweets and sugar snacks, sugary beverages, meat and alternatives, milk, and milk products. After adjusting for potential confounders, for both models: model 1 (age and sex) and model 2 (age, sex, school type, time spent walking to school, district (urban/ rural), availability of television and electronic gadgets at home and neighbourhood playground), we found no evidence of associations of adherence to either dietary pattern with adiposity measures. Conclusion: Dietary patterns were not associated with adiposity in Tanzanian primary school children, possibly because of limitations of the FFQ, which did not record information on portion sizes. Future research should focus on understanding the key foods / snacks consumed by school children, portion sizes and their long-term effects on adiposity in children.

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