(P22-016-24) Associations Between BMI and Child Diet in the Galápagos: A Comparison of a-priori and a-posteriori Dietary Pattern Approaches

Objectives: The Galápagos Islands are characterized by the highest rates of obesity among children under 5 in Ecuador. We used two methods to approximate child dietary patterns (DPs) in the Galápagos and tested whether these measures were associated with child body mass index (BMI).

Methods: Data come from 75 children, ages 2-5 years who participated in The Healthy Families Study (2018-2019). Anthropometric data and 24-hour dietary recalls (24H-DRs) were collected by trained research staff. All 24H-DR items were mapped to the Global Diet Quality Project's Diet Quality Questionnaire (DQQ) food groups to generate index-based scores (0-9 possible points) for “Noncommunicable Disease (NCD) Protect” and “NCD Risk” (a priori method). Principal components analysis (PCA) was used to assess how DQQ groups patterned together based on sample data (a posteriori method). Orthogonal rotation enhanced interpretability of DPs. Separate multivariable linear regression models were used to test associations between BMI and DPs. All models were adjusted for child age and gender.

Results: Children were 3.4±1.1 years, 42.7% were female, and mean BMI was 16.4±1.6. Scores for NCD Protect and NCD Risk were 2.5±1.1 and 1.2±1.2, respectively. PCA produced three DPs: 1) High cheese and soft drinks, 2) High fried foods; and, 3) Low dark-green vegetables, high dessert foods. NCD Risk score was associated with BMI in the model adjusted for child age and gender (B=0.33, 95% Confidence Interval [CI]: 0.05, 0.62), and remained significant in the model containing the NCD Protect score (B=0.32, 95% CI: 0.04, 0.61). There was no association between child BMI and the NCD Protect score or any of the DPs produced through PCA.

Conclusions: The a-priori index based method developed by the Global Diet Quality Project, specifically the NCD Risk index score, performed better than PCA for predicting BMI. The items contained in this score include foods to limit or avoid such as deep fried food, processed meat, fast food, and soft drinks. Focusing on these items can have implications for future intervention development, and further research is needed to advance our understanding of factors influencing child diet patterns in Galápagos.

Funding Sources: Fogarty International Center; Eunice Kennedy Shriver National Institute of Child Health and Human Development.