New food-based index predicts risk for overweight, obesity

Clara Gomez-Donoso

A new scoring system based on measures of dietary intake predicted long-term risk for overweight and obesity among adults in Spain, according to study findings presented at the European Congress on Obesity annual meeting.

“Prevention of obesity through anticipatory nutritional guidance is greatly preferable when possible, as it is extremely difficult to reverse weight gain,” Clara Gomez-Donoso, PharmD, a doctoral student in the department of preventive medicine and public health at the University of Navarra, Spain, told Endocrine Today. “Targeted, well-informed counseling on dietary habits by health care providers should start earlier, raising awareness of diet susceptibility to weight gain in the long term and encouraging patients to take action at the first few pounds of weight gain — not waiting until someone is overweight or obese and has developed the many resulting complications.”

In a prospective study, Gomez-Donoso and colleagues analyzed data from 11,349 middle-aged adults free of overweight or obesity at baseline participating in the ongoing SUN (Seguimiento Universidad de Navarra) project, a cohort of Spanish university graduates initiated in 1999. Researchers created a Dietary Obesity Prevention Score (DOPS) by analyzing 14 food groups, adjusting for total energy intake. DOPS positively weighted the consumption of vegetables, fruits, legumes, yogurt, nuts, fish and vegetable to animal protein ratio, whereas it negatively weighted the consumption of red meat, processed meats, saturated animal fat, refined grains, ultra-processed food, sugar-sweetened beverages and beer and spirits. Participants completed a semiquantitative 136-item food frequency questionnaire at baseline and again at 10 years. Energy-adjusted tertiles for each item were used to build DOPS, ranging from 14 to 42 points (lowest score defined as 20 and highest score defined as 35), according to researchers.

During a mean follow-up of 9.3 years, researchers observed 2,153 new cases of overweight or obesity.

Researchers found that a higher favorable DOPS was associated with a 51% lower risk for overweight or obesity after adjusting for potential confounders (adjusted HR for highest vs. lowest adherence = 0.49; 95% CI, 0.36-0.68). The risk for developing overweight or obesity was 13% lower for each four additional points in the DOPS index. Results were consistent after updating dietary intake with repeated measures (adjusted HR for highest vs. lowest adherence = 0.53; 95% CI, 0.38-0.74).

“Food-based dietary advice is simpler to implement, and it avoids confusion among the public, as it discriminates between quality choices,” Gomez-Donoso said. “This also prevents food corporations from strategically exploiting the reductive focus on nutrients to market unhealthy and highly processed foods using nutrient content claims.”

Gomez-Donoso said there is a need to analyze the effectiveness of using the dietary preventive score as a rapid educational tool in daily clinical practice.

“Nevertheless, it is also important to acknowledge the challenges of adopting healthier eating habits in an obesity-promoting environment, in which unhealthy food options are extremely cheap, ubiquitously available in large portions and heavily marketed through conventional and social media,” Gomez-Donoso said. “Thus, beyond health care providers delivering sound, actionable dietary advice and actively engaging patients to watch out for dietary risks and weight gain, identification and implementation of environmental changes that promote weight maintenance are essential for population-based efforts.” – by Regina Schaffer

For more information:

Clara Gomez-Donoso, PharmD, can be reached at the University of Navarra, Department of Preventive Medicine and Public Health, C/ Irunlarrea 1, 31008 Pamplona, Spain; email: cgomez.16@alumni.unav.es.

Reference:

Gomez-Donoso C, et al. Abstract T2P131. Presented at: European Congress on Obesity; May 23-26, 2018; Vienna.

Disclosure: Gomez-Donoso reports no relevant financial disclosures.