Dietary patterns and childhood obesity

The interaction between nutrition and health has been reduced to a single nutrient strategy, showing a reductionist approach. Diet quality involves nutrients, other compounds such as phytochemicals and the combined effect of their biological activity. The use of dietary patterns (DPs) may better explain the risk of noncommunicable diseases than specific nutrients or foods. Also, the use of diet quality indices implies the quantification of the overall healthfulness of a dietary pattern (DP) based on its components. In children and adolescents, knowledge about the association between diet quality and several diseases is limited. Also, the use of multiple methods to obtain DP increases the complexity of identifying them. In this sense, a proposal of core food patterns could help and enhance the possibility of overspreading dietary guidelines over countries, taking into consideration each country's specific and cultural characteristics. The DP evolution seems to be divided into two separate periods, from toddlerhood to childhood, a transition period with changes at the diet level. However, after this period a more consistent DP seems to be established. In this sense, several clinical studies have been developed to link DP with several diseases, such as obesity. The principle of Mediterranean DP could be a useful strategy for the treatment of obesity in children because it seems to lead to promising reductions in body mass index and percentage of obesity. Also, those DPs characterized by highly processed and energy-dense foods seem to be linked directly with childhood obesity. DPs have important implications for childhood obesity and related cardiometabolic health. Moreover, for the establishment of a healthy and sustainable diet, the basis of a universal healthy reference diet should focus on foods of vegetal origin and also low to moderate amounts of animal food products, to have a low environmental impact and contribute to food and nutrition security and healthy life for present and future generations. Considering the impact of DPs on young population groups and their tracking into adulthood, a call to achieve an increased consumption of plant-based foods and reduce the consumption of animal-source foods combined the investment in public health information and sustainable education, and also coordination between departments of health, education and environment is necessary.