Abstract 1 International Journal of Obesity (2001) 25: 1741
– 1751
REVIEW: Food intake
patterns and body mass index in observational studies
P Togo(1), M Osler(2), TIA Sørensen(3) and BL Heitmann(1)
1) Centre for Preventive Medicine, Research Unit for Dietary
Studies, Glostrup University Hospital, Glostrup, Denmark;
2) Institute of Public Health, University of Copenhagen, Copenhagen, Denmark;
and
3) Danish Epidemiology Science Centre at the Institute of Preventive Medicine,
Copenhagen University Hospital, Copenhagen, Denmark
OBJECTIVE: To review studies of patterns of food intake, as
assessed by diet index, factor analysis or cluster analysis, and their associations with body mass index or obesity (BMI=Ob).
DESIGN: Systematic literature review MEDLINE search with crosscheck of references.
STUDIES: Thirty observational studies relating food intake patterns to
anthropometric information were identified and reviewed. Food intake patterns were defined using a diet index, factor or cluster analysis
in 12, nine and nine studies, respectively. Measures of body mass were made concurrently with the diet assessment in all
studies, and only in a few cases were the primary outcomes related to BMI=Ob.
RESULTS: The food intake patterns identified could, in most factor or cluster
analysis studies, be categorised as: (a) meat, fatty, sweet or energy dense foods; (b) vegetables, fruit, whole grain and low-fat
foods; or (c) by high alcohol consumption. The diet indexes were designed to capture a high diversity and=or food combinations
matching the recommendations.
The relationships with BMI=Ob were inconsistent—ten studies found that intake
patterns, which we categorised as fatty, sweet or energy dense were positively associated with BMI=Ob, while similar patterns
in four other studies were negatively associated with BMI. The significant associations between diet index score and BMI=Ob were
consistently negative, while the associations between factor scores or cluster membership and BMI=Ob were less clear in terms
of food intake pattern. Men and women had similar food intake patterns, but food intake patterns were less often
positively associated with BMI=Ob in women. In 11 studies, there were no significant associations between food intake pattern and BMI=Ob.
CONCLUSION: This review showed that no consistent associations could be
identified between BMI or Ob and food intake
patterns, derived from diet index, factor analysis or cluster analysis. However,
the heterogeneity of food intake patterns identified by such analyses and the lack of gold standards for the application of these
techniques hampers consistent analysis of a relation between food intake patterns and health.