Diet quality moderates link between excess weight, psychosocial issues for children

The quality of a child’s diet is a moderating factor between excess weight and psychosocial health, according to results of a study published in JAMA Network Open.

“Children and adolescents with obesity are considered to be at increased risk for developing conditions associated with psychosocial health, such as depression, anxiety, low self-esteem, lower quality of life and behavioral disorders,” Jose Francisco Lopez-Gil, PhD, of the health and social research center at the University of Castilla-La Mancha in Spain, and colleagues wrote.

Researchers sought to examine whether healthy eating habits in children moderates the association between weight issues and psychosocial problems.

Lopez-Gil and colleagues conducted a population-based, cross-sectional study in which they collected data from the Spanish National Health Survey in 2017. A total of 3,772 children (50.6% male), aged 4 to 14 years, whose eligibility was determined by completing a minor’s questionnaire after a parent in the same household completed an adult questionnaire were included. Statistical analysis was undertaken from Sept. 21, to Oct. 27, 2021.

BMI z scores were computed following the sex and age criteria of the International Obesity Task Force and were used to determine excess weight. Diet quality was assessed using the Spanish Healthy Eating Index (S-HEI), where a higher score denotes greater adherence to Spanish Society of Community Nutrition guidelines and, therefore, a higher diet quality. Psychosocial problems were gauged by the Strengths and Difficulties Questionnaire completed by parents or guardians. All analyses were adjusted for major confounders.

Results showed the prevalence of excess weight among participants was 38.4% (n=1,448), and diet quality moderated the association between excess weight and psychosocial problems (95% CI, –0.09 to –0.02).

Moderation analysis revealed two different areas of significance regarding S-HEI score — the association between excess weight and psychosocial problems was greater for children with an S-HEI score lower than 67.5; and conversely, lower for children with an S-HEI score higher than 84.9.

Data also revealed a neutral ground, where association between excess weight and psychosocial problems neither increased nor decreased in those with an S-HEI score between 67.5 and 84.9.

“These finding are clinically relevant because psychosocial problems are a major concern for young people with excess weight,” Lopez-Gil and colleagues wrote.