Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Pediatric Highlight
  • Published:

Pattern of long-term fat intake and BMI during childhood and adolescence—results of the DONALD Study

International Journal of Obesity volume 28, pages 1203–1209 (2004)Cite this article

Abstract

OBJECTIVE: Adverse dietary habits have been discussed as being conducive to the increased prevalence of obesity in children and adolescents. No single dietary factor has been clearly identified so far. We analyzed long-term fat intake patterns during childhood and adolescence and their influence on body fatness.

METHODS: Four clusters with different patterns of percent energy from fat were found in 228 individuals from the age of 2–18 y participating in the DONALD Study (Dortmund Nutritional Anthropometric Longitudinally Designed Study) with at least 10 yearly weighed dietary records between 1985 and 2002. Clusters were evaluated with regard to macronutrient and food group intakes and body mass index (BMI).

RESULTS: The mean energy density and the ratio of energy intake to estimated basal metabolic rate per subject differed significantly between clusters. All calculated macronutrients (per energy intake) with the exception of dietary fiber differed significantly as well as intakes of Meat/Fish/Eggs, Fats/Oils and Fruit/Vegetables. Although these differences in dietary characteristics persisted during the study period, no differences of BMI (calculated as standard deviation score) were found either at the first or last examination per subject. The mean BMI during the study period differed significantly, with the highest BMI in the low fat intake cluster.

CONCLUSION: BMI could not be explained by different dietary patterns during childhood and adolescence in this long-term evaluation of dietary records. Underreporting especially in obese subjects, the problem of detecting minor overconsumption of energy intake that favors the development of obesity over long periods, and the small study sample may explain these conflicting results.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

References

  1. Kromeyer-Hauschild K, Zellner K, Jaeger U, Hoyer H . Prevalence of overweight and obesity among school children in Jena (Germany). Int J Obes Relat Metab Disord 1999; 23: 1143–1150.

    Article  CAS  PubMed  Google Scholar 

  2. Martinez JA . Obesity in young Europeans: genetic and environmental influences. Eur J Clin Nutr 2000; 54 (Suppl 1): S56–S60.

    Article  PubMed  Google Scholar 

  3. Freedman DS, Srinivasan SR, Valdez RA, Williamson DF, Berenson GS . Secular increases in relative weight and adiposity among children over two decades: the Bogalusa Heart Study. Pediatrics 1997; 99: 420–426.

    Article  CAS  PubMed  Google Scholar 

  4. Schrauwen P, Westerterp KR . The role of high-fat diets and physical activity in the regulation of body weight. Br J Nutr 2000; 84: 417–427.

    Article  CAS  PubMed  Google Scholar 

  5. Koletzko B, Girardet JP, Klish W, Tabacco O . Obesity in children and adolescents worldwide: current views and future directions—Working Group Report of the First World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr 2002; 35 (Suppl 2): S205–S212.

    Article  PubMed  Google Scholar 

  6. McGloin AF, Livingstone MB, Greene LC, Webb SE, Gibson JM, Jebb SA, Cole TJ, Coward WA, Wright A, Prentice AM . Energy and fat intake in obese and lean children at varying risk of obesity. Int J Obes Relat Metab Disord 2002; 26: 200–207.

    Article  CAS  PubMed  Google Scholar 

  7. Maffeis C, Pinelli L, Schutz Y . Fat intake and adiposity in 8 to 11-year-old obese children. Int J Obes Relat Metab Disord 1996; 20: 170–174.

    CAS  PubMed  Google Scholar 

  8. Guillaume M, Lapidus L, Lambert A . Obesity and nutrition in children. The Belgian Luxembourg Child Study IV. Eur J Clin Nutr 1998; 52: 323–328.

    Article  CAS  PubMed  Google Scholar 

  9. Garaulet M, Martinez A, Victoria F, Perez-Llamas F, Ortega RM, Zamora S . Difference in dietary intake and activity level between normal-weight and overweight or obese adolescents. J Pediatr Gastroenterol Nutr 2000; 30: 253–258.

    Article  CAS  PubMed  Google Scholar 

  10. Tucker LA, Seljaas GT, Hager RL . Body fat percentage of children varies according to their diet composition. J Am Diet Assoc 1997; 97: 981–986.

    Article  CAS  PubMed  Google Scholar 

  11. Atkin LM, Davies PS . Diet composition and body composition in preschool children. Am J Clin Nutr 2000; 72: 15–21.

    Article  CAS  PubMed  Google Scholar 

  12. Remer T, Dimitriou T, Kersting M . Does fat intake explain fatness in healthy children? Eur J Clin Nutr 2002; 56: 1046–1047.

    Article  CAS  PubMed  Google Scholar 

  13. Rolland-Cachera MF, Deheeger M, Akrout M, Bellisle F . Influence of macronutrients on adiposity development: a follow up study of nutrition and growth from 10 months to 8 years of age. Int J Obes Relat Metab Disord 1995; 19: 573–578.

    CAS  PubMed  Google Scholar 

  14. Klesges RC, Klesges LM, Eck LH, Shelton ML . A longitudinal analysis of accelerated weight gain in preschool children. Pediatrics 1995; 95: 126–130.

    CAS  PubMed  Google Scholar 

  15. Maffeis C, Talamini G, Tato L . Influence of diet, physical activity and parents' obesity on children's adiposity: a four-year longitudinal study. Int J Obes Relat Metab Disord 1998; 22: 758–764.

    Article  CAS  PubMed  Google Scholar 

  16. Robertson SM, Cullen KW, Baranowski J, Baranowski T, Hu S, de Moor C . Factors related to adiposity among children aged 3 to 7 years. J Am Diet Assoc 1999; 99: 938–943.

    Article  CAS  PubMed  Google Scholar 

  17. Magarey AM, Daniels LA, Boulton TJ, Cockington RA . Does fat intake predict adiposity in healthy children and adolescents aged 2–15 y? A longitudinal analysis. Eur J Clin Nutr 2001; 55: 471–481.

    Article  CAS  PubMed  Google Scholar 

  18. Berkey CS, Rockett HR, Field AE, Gillman MW, Frazier AL, Camargo Jr CA, Colditz GA . Activity, dietary intake, and weight changes in a longitudinal study of preadolescent and adolescent boys and girls. Pediatrics 2000; 105: E56.

    Article  CAS  PubMed  Google Scholar 

  19. Cavadini C, Siega-Riz A, Popkin BM . US adolescent food intake trends from 1965 to 1996. Arch Dis Child 2000; 83: 18–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Troiano RP, Briefel RR, Carroll MD, Bialostosky K . Energy and fat intakes of children and adolescents in the United States: data from the national health and nutrition examination surveys. Am J Clin Nutr 2000; 72: 1343S–1353S.

    Article  CAS  PubMed  Google Scholar 

  21. Alexy U, Sichert-Hellert W, Kersting M . Fifteen-year time trends in energy and macronutrient intake in German children and adolescents: results of the DONALD study. Br J Nutr 2002; 87: 595–604.

    Article  CAS  PubMed  Google Scholar 

  22. Kersting M, Sichert-Hellert W, Alexy U, Manz F, Schoch G . Macronutrient intake of 1 to 18 year old German children and adolescents. Z Ernahrungswiss 1998; 37: 252–259.

    Article  CAS  PubMed  Google Scholar 

  23. Schultze-Pawlitschko V, Alexy U, Kersting M, Sichert-Hellert W . Cluster analysis for children with similar fat intake pattern during childhood and adolescence—results of the DONALD study. Nutr Res (under review).

  24. Goldberg GR, Black AE, Jebb SA, Cole TJ, Murgatroyd PR, Coward WA, Prentice AM . Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording. Eur J Clin Nutr 1991; 45: 569–581.

    CAS  PubMed  Google Scholar 

  25. Schofield WN . Predicting basal metabolic rate, new standards and review of previous work. Hum Nutr Clin Nutr 1985; 39 (Suppl 1): 5–41.

    PubMed  Google Scholar 

  26. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 1240–1243.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Kromeyer-Hauschild K, Wabitsch M, Kunze D, Geller F, Geiß H, Hesse V, Hippel von A, Jaeger U, Johnson D, Korte W, Menner K, Müller G, Müller J, Neimann-Pilatus A, Remer T, Schaefer F, Wittchen H, Zabransky S . Perzentile für den Body-mass-Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschr Kinderheilkd 2001; 149: 807–818.

    Article  Google Scholar 

  28. Arbeitsgemeinschaft Adipositas im Kindes- und Jungendalter (AGA). Leitlinien. Leipzig, September 2002. Available at http://www.a-g-a.de/modules/Leitlinie/Leitlinie.pdf Accessed June 15, 2003.

  29. Sichert-Hellert W, Kersting M, Schoch G . Underreporting of energy intake in 1 to 18 year old German children and adolescents. Z Ernahrungswiss 1998; 37: 242–251.

    Article  CAS  PubMed  Google Scholar 

  30. Hermanussen M, Grasedyck L, Kromeyer-Hauschild K, Prokopec M, Chrzastek-Spruch H . Growth tracks in pre-pubertal children. Ann Hum Biol 2002; 29: 667–676.

    Article  CAS  PubMed  Google Scholar 

  31. Livingstone MB, Black AE . Markers of the validity of reported energy intake. J Nutr 2003; 133 (Suppl 3): 895S–920S.

    Article  CAS  PubMed  Google Scholar 

  32. Ludwig DS . Dietary glycemic index and obesity. J Nutr 2000; 130: 280S–283S.

    Article  CAS  PubMed  Google Scholar 

  33. Ludwig DS . The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA 2002; 287: 2414–2423.

    Article  CAS  PubMed  Google Scholar 

  34. Brand-Miller JC, Holt SH, Pawlak DB, McMillan J . Glycemic index and obesity. Am J Clin Nutr 2002; 76: 281S–285S.

    Article  CAS  PubMed  Google Scholar 

  35. Alexy U, Kersting M . Was Kinder essen - und was sie essen sollten. Hans Marseille Verlag: München; 1999.

    Google Scholar 

  36. Alexy U, Sichert-Hellert W, Kersting M . Associations between intake of added sugars and intakes of nutrients and food groups in the diets of German children and adolescents. Br J Nutr 2003; 90: 441–447.

    Article  CAS  PubMed  Google Scholar 

  37. Ludwig DS, Peterson KE, Gortmaker SL . Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet 2001; 357: 505–508.

    Article  CAS  PubMed  Google Scholar 

  38. Togo P, Osler M, Sorensen TI, Heitmann BL . Food intake patterns and body mass index in observational studies. Int J Obes Relat Metab Disord 2001; 25: 1741–1751.

    Article  CAS  PubMed  Google Scholar 

  39. Ballew C, Kuester S, Serdula M, Bowman B, Dietz W . Nutrient intakes and dietary patterns of young children by dietary fat intakes. J Pediatr 2000; 136: 181–187.

    Article  CAS  PubMed  Google Scholar 

  40. Rogers I, Emmett P . Fat content of the diet among pre-school children in Britain; relationship with food and nutrient intakes. Eur J Clin Nutr 2002; 56: 252–263.

    Article  CAS  PubMed  Google Scholar 

  41. Hampl JS, Betts NM . Comparisons of dietary intake and sources of fat in low- and high-fat diets of 18- to 24-year-olds. J Am Diet Assoc 1995; 95: 893–897.

    Article  CAS  PubMed  Google Scholar 

  42. Jequier E . Pathways to obesity. Int J Obes Relat Metab Disord 2002; 26 (Suppl 2): S12–S17.

    Article  CAS  PubMed  Google Scholar 

  43. Kersting M, Sichert-Hellert W, Lausen B, Alexy U, Manz F, Schoch G . Energy intake of 1 to 18 year old German children and adolescents. Z Ernahrungswiss 1998; 37: 47–55.

    Article  CAS  PubMed  Google Scholar 

  44. Alexy U, Kersting M, Sichert-Hellert W, Manz F, Schoch G . Energy intake and growth of 3- to 36-month-old German infants and children. Ann Nutr Metab 1998; 42: 68–74.

    Article  CAS  PubMed  Google Scholar 

  45. Kroke A, Manz F, Kersting M, Remer T, Sichert-Hellert W, Alexy U, Lentze M . The DONALD Study: history, current status and future perspectives. Eur J Nutr 2004; 43: 45–54.

    Article  PubMed  Google Scholar 

  46. Ikeda JP, Mitchell RA . Dietary approaches to the treatment of the overweight pediatric patient. Pediatr Clin N Am 2001; 48: 955–968 ix.

    Article  CAS  Google Scholar 

  47. World Health Organization (WHO). Diet, nutrition and the prevention of chronic diseases. Technical report series 916, Geneva, 2003.

Download references

Acknowledgements

The Ministry of Education, Science and Research North-Rhine-Westphalia, Germany, and the German Federal Ministry of Consumer Protection, Food and Agriculture supported this work. We are grateful to Christa Chahda and Ruth Schäfer for collecting and coding the dietary records in the DONALD-Study and to Diane Pavlitzek for proof reading.

Author information

Authors and Affiliations

  1. Research Institute of Child Nutrition (FKE), Heinstueck 11, Dortmund, D-44225, Germany

    U Alexy, W Sichert-Hellert, M Kersting & V Schultze-Pawlitschko

Authors
  1. U Alexy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W Sichert-Hellert
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M Kersting
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. V Schultze-Pawlitschko
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to U Alexy.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Alexy, U., Sichert-Hellert, W., Kersting, M. et al. Pattern of long-term fat intake and BMI during childhood and adolescence—results of the DONALD Study. Int J Obes 28, 1203–1209 (2004). https://doi.org/10.1038/sj.ijo.0802708

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802708

Keywords

This article is cited by

Search

Advanced search

Quick links