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Clustering of Dietary Patterns and Lifestyles Among Spanish Children in the EsNuPI Study †

  • Plaza-Díaz, Julio1, 2
  • Molina-Montes, Esther1, 2,
  • Soto-Méndez, María José3
  • Madrigal, Casandra3
  • Hernández-Ruiz, Ángela3
  • Valero, Teresa4
  • Lara Villoslada, Federico
  • Leis, Rosaura5, 6
  • Martínez de Victoria, Emilio1, 7
  • Moreno, José Manuel
  • Ortega, Rosa M.
  • Ruiz-López, María Dolores1, 3
  • Varela-Moreiras, Gregorio4, 8
  • Gil, Ángel1, 2, 3, 6
  • 1 (M.D.R.-L.)
  • 2 Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
  • 3 (Á.H.-R.)
  • 4 (G.V.-M.)
  • 5 Instituto de Investigación Sanitaria de Santiago, IDIS, Santiago de Compostela, University Clinical Hospital of Santiago, 15706 Santiago de Compostela, Spain
  • 6 CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
  • 7 Department of Physiology, University of Granada, 18071 Granada, Spain
  • 8 Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, 28668 Madrid, Spain
Published Article
Publication Date
Aug 21, 2020
DOI: 10.3390/nu12092536
PMID: 32825604
PMCID: PMC7551863
PubMed Central


Dietary patterns (DPs) are known to be tied to lifestyle behaviors. Understanding DPs and their relationships with lifestyle factors can help to prevent children from engaging in unhealthy dietary practices. We aimed to describe DPs in Spanish children aged 1 to <10 years and to examine their associations with sociodemographic and lifestyle variables. The consumption of toddler and young children milk formulas, enriched and fortified milk within the Spanish pediatric population is increasing, and there is a lack of evidence whether the consumption of this type of milk is causing an impact on nutrient intakes and if they are helping to reach the nutrient recommendations. Within the Nutritional Study in the Spanish Pediatric Population (EsNuPI), we considered two study cohorts and three different age groups in three year-intervals in each of them. The study cohort included 740 children in a representative sample of the urban non-vegan Spanish population and 772 children in a convenience cohort of adapted milk consumers (AMS) (including follow-on formula, toddler’s milk, growing up milk, and fortified and enriched milks) who provided information about sociodemographics, lifestyle, and dietary habits; a food frequency questionnaire was used for the latter. Principal component analysis was performed to identify DPs from 18 food groups. Food groups and sociodemographic/lifestyle variables were combined through a hierarchical cluster algorithm. Three DPs predominated in every age group and study sample: a palatable energy-dense food dietary pattern, and two Mediterranean-like DPs. However, children from the AMS showed a predominant dietary pattern markedly related to the Mediterranean diet, with high consumption of cereals, fruits and vegetables, as well as milk and dairy products. The age of children and certain lifestyle factors, namely level of physical activity, parental education, and household income, correlated closely with the dietary clusters. Thus, the findings provide insight into designing lifestyle interventions that could reverse the appearance of unhealthy DPs in the Spanish child population.

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