Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Association of dietary patterns with blood pressure and body adiposity in adolescents: a systematic review

European Journal of Clinical Nutrition volume 75, pages 1440–1453 (2021)Cite this article

Subjects

Abstract

This paper aimed to systematically review the results of observational studies that investigated the association of dietary patterns with blood pressure and body adiposity markers in adolescents. Articles were searched in July 2020 in PubMed, Scopus, Web of Science, and Scientific Electronic Library Online (SciELO). Of the 3408 studies found, 24 fulfilled the inclusion criteria and were considered in this review. Almost all studies (n = 23) identified at least one unhealthy pattern, predominantly characterized as consumption of confectionery, refined grains, sweets, sweetened drinks, red meats, and processed meats. Fourteen of the twenty-four studies found a significant association between any dietary pattern and blood pressure and/or body adiposity markers. There was a positive association of dietary patterns - characterized by the consumption of foods rich in sodium, animal fat, refined carbohydrates, and low in fiber - with increased blood pressure and body adiposity. Our findings highlight the importance of studies with this scope, whose results can support the surveillance of adolescent’s health. However, considering the limited number of studies that found a significant association and their limitations, the present results should be interpreted carefully. More prospective studies are needed to determine how adherence to dietary patterns could influence blood pressure and body adiposity markers in the long term.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: PRISMA flow diagram.

Similar content being viewed by others

References

  1. World Health Organization (WHO). Noncommunicable diseases country profiles 2018. Geneva: WGO; 2018. https://www.who.int/nmh/publications/ncd-profiles-2018/en/.

  2. Moreno LA, Gottrand F, Huybrechts I, Ruiz JR, González-Gross M, DeHenauw S, HELENA Study Group. Nutrition and lifestyle in european adolescents: the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Adv Nutr. 2014;5:615S–623S.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. United States Department of Agriculture. A series of systematic reviews on the relationship between dietary patterns and health outcomes. 2014. https://nesr.usda.gov/are-prevailing-patterns-diet-behavior-population-assessed-using-factor-or-cluster-analysis-0. Accessed June 2020.

  4. Schneider BC, Dumith SC, Orlandi SP, Assunção MCF. Diet and body fat in adolescence and early adulthood: a systematic review of longitudinal studies. Ciênc saúde coletiva. 2017;22:1539–52.

    Article  Google Scholar 

  5. Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipido. 2002;13:3–9.

    Article  CAS  Google Scholar 

  6. Michels KB, Schulze MB. Can dietary patterns help us detect diet-disease associations? Nutr Res Rev. 2005;18:241–8.

    Article  PubMed  Google Scholar 

  7. Ocké MC. Evaluation of methodologies for assessing the overall diet: dietary quality scores and dietary pattern analysis. Proc Nutr Soc. 2013;72:191–9.

    Article  PubMed  Google Scholar 

  8. Borges CA, Rinaldi AE, Conde WL, Mainardi GM, Behar D, Slater B. Dietary patterns: a literature review of the methodological characteristics of the main step of the multivariate analyzes. Rev Bras Epidemiol. 2015;18:837–57.

    Article  PubMed  Google Scholar 

  9. Silva DFO, Lyra CO, Lima SCVC. Dietary habits of adolescents and associated cardiovascular risk factors: a systematic review. Ciênc saúde coletiva. 2016;21:1181–96.

    Article  Google Scholar 

  10. McNaughton SA, Ball K, Mishra GD, Crawford DA. Dietary patterns of adolescents and risk of obesity and hypertension. J Nutr. 2008;138:364–70.

    Article  CAS  PubMed  Google Scholar 

  11. Alizadeh M, Didarloo A, Esmaillzadeh A. Dietary patterns of young females and their association with waist circumference as a health Index in Northwest of Iran, 2007. Iran Red Crescent Med J. 2015;17:e17594

    PubMed  PubMed Central  Google Scholar 

  12. Hojhabrimanesh A, Akhlaghi M, Rahmani E, Sasan A, Masoumeh A, Maryam N, et al. A Western dietary pattern is associated with higher blood pressure in Iranian adolescents. Eur J Nutr. 2017;56:399–408.

    Article  CAS  PubMed  Google Scholar 

  13. Cunha DB, Bezerra IN, Pereira RA, Sichieri R. At-home and away-from-home dietary patterns and BMI z-scores in Brazilian adolescents. Appetite. 2018;120:374–80.

    Article  PubMed  Google Scholar 

  14. Oparil S, Acelajado MC, Bakris GL, Berlowitz DR, Cífková R, Dominiczak AF, et al. Hypertension. Nat Rev Dis Prim. 2018;4:18014.

    Article  PubMed  Google Scholar 

  15. Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR. et al. The global syndemic of obesity, undernutrition, and climate change: the Lancet Commission report. Lancet. 2019;393:791–846. https://doi.org/10.1016/S0140-6736(18)32822-8. Epub 2019 Jan 27. Erratum in: Lancet. 2019.393:746.

    Article  PubMed  Google Scholar 

  16. World Health Organization. Global action plan for the prevention and control of NCDs 2013-20. Geneva: World Health Organization; 2013. http://www.who.int/nmh/events/ncd_action_plan/en/. Accessed June 2020.

  17. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Brasil. Ministério da Saúde. Methodological Guidelines. Preparation of systematic review and meta-analysis of comparative observational studies on risk factors and prognosis. Brasília: Ministério da Saúde; 2014. http://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_metodologicas_fatores_risco_prognostico.pdf. Accessed June 2020.

  19. World Health Organization. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. Technical Report Series No. 854. Geneva: World Health Organization; 1995. https://www.who.int/childgrowth/publications/physical_status/en/. Accessed June 2020.

  20. Song Y, Park MJ, Paik H-Y, Joung H. Secular trends in dietary patterns and obesity-related risk factors in Korean adolescents aged 10 – 19 years. Int J Obes. 2009;34:48–56.

    Article  Google Scholar 

  21. Joung H, Hong S, Song Y, Ahn BC, Park MJ. Dietary patterns and metabolic syndrome risk factors among adolescents. Korean J Pediatr. 2012;55:128–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Chan R, Chan D, Rd WL, Lo D, Li L, Woo J. et al. A cross-sectional study to examine the association between dietary patterns and risk of overweight and obesity in Hong Kong Chinese adolescents aged 10–12 years. J Am Coll Nutr. 2014;33:450–8.

    Article  PubMed  Google Scholar 

  23. Garba JA, Rampal L, Hejar AR, Salmiah MS. Major dietary patterns and their associations with socio-demographic characteristics and obesity among adolescents in Petaling District, Malaysia. Malays J Med Heal Sci. 2015;10:13–21.

    Google Scholar 

  24. Yang Y, Hu XM, Chen TJ, Bai MJ. Rural-urban differences of dietary patterns, overweight, and bone mineral status in Chinese students. Nutrients. 2016;8:537.

    Article  PubMed Central  Google Scholar 

  25. Emi NA, Gan WY, Mohd Shariff Z, Zaini AA, Shamsuddin NH, Appukutty M, et al. Associations of an empirical dietary pattern with cardiometabolic risk factors in Malaysian adolescents. Nutr Metab. 2020;17:28.

    Article  CAS  Google Scholar 

  26. Appannah G, Pot GK, Huang RC, Oddy WH, Beilin LJ, Mori TA, et al. Identification of a dietary pattern associated with greater cardiometabolic risk in adolescence. Nutr Metab Cardiovasc Dis. 2015;25:643–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Ambrosini GL, Oddy WH, Robinson M, Therese A, Sullivan O, Hands BP, et al. Adolescent dietary patterns are associated with lifestyle and family psycho-social factors. Public Health Nutr. 2009;12:1807–15.

    Article  PubMed  Google Scholar 

  28. Ambrosini GL, Huang RC, Mori TA, Hands BP, O’Sullivan TA, Klerk NH, et al. Dietary patterns and markers for the metabolic syndrome in Australian adolescents. Nutr Metab Cardiovasc Dis. 2010;20:274–83.

    Article  CAS  PubMed  Google Scholar 

  29. Howe AS, Black KE, Wong JE, Parnell WR, Skidmore PML. Dieting status influences associations between dietary patterns and body composition in adolescents: a cross-sectional study. Nutr J. 2013;12:1–10.

    Article  Google Scholar 

  30. Huybrechts I, Lioret S, Mouratidou T, Gunter MJ, Manios Y, Kersting M. et al. Using reduced rank regression methods to identify dietary patterns associated with obesity: a cross-country study among European and Australian adolescents. Br J Nutr. 2017;117:295–305.

    Article  CAS  PubMed  Google Scholar 

  31. Ambrosini GL, Emmett PM, Northstone K, Howe LD, Tilling K, Jebb SA. Identification of a dietary pattern prospectively associated with increased adiposity during childhood and adolescence. Int J Obes. 2012;36:1299–305.

    Article  CAS  Google Scholar 

  32. Bull CJ, Northstone K. Childhood dietary patterns and cardiovascular risk factors in adolescence: results from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort [published correction appears in Public Health Nutr. 2019 Nov;22(16):3101-3105]. Public Health Nutr. 2016;19:3369–77.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Richter A, Heidemann C, Schulze MB, Roosen J, Thiele S, Mensink GBM. Dietary patterns of adolescents in Germany - Associations with nutrient intake and other health related lifestyle characteristics. BMC Pediatr. 2012;12:1–14.

    Article  CAS  Google Scholar 

  34. Bodega P, Fernández-Alvira JM, Santos-Beneit G, de Cos-Gandoy A, Fernández-Jiménez R, Moreno LA, et al. Dietary patterns and cardiovascular risk factors in Spanish adolescents: a cross-sectional analysis of the SI! Program for Health Promotion in Secondary Schools. Nutrients. 2019;11:2297.

    Article  CAS  PubMed Central  Google Scholar 

  35. Ochoa-Avilés A, Verstraeten R, Lachat C, Andrade S, Van Camp J, Donoso S, et al. Dietary intake practices associated with cardiovascular risk in urban and rural Ecuadorian adolescents: a cross-sectional study. BMC Public Health. 2014;14:939.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  36. Borges CA, Marchioni DML, Levy RB, Slater B. Dietary patterns associated with overweight among Brazilian adolescents. Appetite. 2018;123:402–9.

    Article  PubMed  Google Scholar 

  37. Alves MA, Retondario A, Bricarello LP, Fernandes R, Souza AM, Zeni LAZR. et al. Association between dietary patterns and overweight/obesity: a Brazilian national school-based research (ERICA 2013-2014). J Public Health. 2019;28:163–71.

    Article  Google Scholar 

  38. Gutiérrez-pliego LE, Camarillo-Romero ES, Montenegro-Morales LP, Garduño-García JJ. Dietary patterns associated with body mass index (BMI) and lifestyle in Mexican adolescents. BMC Public Health. 2016;16:1–7.

    Article  Google Scholar 

  39. Aounallah-Skhiri H, Traissac P, El Ati J, Eymard-Duvernay S, Landais E, Achour N, et al. Nutrition transition among adolescents of a south-Mediterranean country: dietary patterns, association with socio-economic factors, overweight and blood pressure. A cross-sectional study in Tunisia. Nutr J. 2011;10:38.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. World Health Organization. Fact sheet N°394, Healthy diet. 2015. https://www.who.int/publications/m/item/healthy-diet-factsheet394. Accessed June 2020.

  41. Ozemek C, Laddu DR, Arena R, Lavie CJ. The role of diet for prevention and management of hypertension. Curr Opin Cardiol. 2018;33:388–93.

    Article  PubMed  Google Scholar 

  42. Falkner B. Hypertension in children and adolescents: epidemiology and natural history. Pediatr Nephrol. 2010;25:1219–24.

    Article  PubMed  Google Scholar 

  43. Chen X, Wang Y. Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis. Circulation. 2008;117:3171–80.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Bibiloni MM, Martínez E, Llull R, Pons A, Tur JA. Western and Mediterranean dietary patterns among Balearic Islands’ adolescents: socio economic and lifestyle determinants. Public Health Nutr. 2012;15:683–92.

    Article  Google Scholar 

  45. Morinaka T, Wozniewicz M, Jeszka J, Bajerska J, Nowaczyk P, Sone Y. Westernization of dietary patterns among young Japanese and Polish females – a comparison study. Ann Agric Environ Med. 2013;20:122–30.

    PubMed  Google Scholar 

  46. Simmonds M, Llewellyn A, Owen CG, Woolacott N. Predicting adult obesity from childhood obesity: a systematic review and meta-analysis. Obes Rev. 2016;17:95–107.

    Article  CAS  PubMed  Google Scholar 

  47. Bloch KV, Klein CH, Szklo M, Kuschnir MCC, Abreu GA, Barufaldi LA, et al. ERICA: prevalences of hypertension and obesity in Brazilian adolescents. Rev Saúde Pública. 2016;50:9s.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Urbina EM, Khoury PR, Bazzano L, Burns TL, Daniels S, Dwyer T, et al. Relation of blood pressure in childhood to self-reported hypertension in adulthood. Hypertension. 2019;73:1224–30.

    Article  CAS  PubMed  Google Scholar 

  49. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N. Engl J Med. 2001;344:3–10.

    Article  CAS  PubMed  Google Scholar 

  50. Currie C, Zanotti C, Morgan A, Currie D, Looze M, Roberts C et al. Social determinants of health and well-being among young people. Health behaviour in school-aged children (HBSC) study: International report from the 2009/2010 survey. Health policy for children and adolescents. Copenhagen: WHO Regional Office for Europe; 2012. https://www.euro.who.int/en/publications/abstracts/social-determinants-of-health-and-well-being-among-young-people.-health-behaviour-in-school-aged-children-hbsc-study. Accessed June 2020.

Download references

Funding

This work was supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil, through a Master grant (MEAN; Finance Code 001). However, CAPES had no role in the design, analysis or writing of this manuscript.

Author information

Authors and Affiliations

  1. Faculdade de Nutrição, Universidade Federal de Mato Grosso, Cuiabá, Brazil

    Morgana Egle Alves Neves, Marielly Rodrigues de Souza, Bartira Mendes Gorgulho & Paulo Rogério Melo Rodrigues

  2. Avenida Fernando Corrêa da Costa, 2367. Bairro Boa Esperança, CEP 78060-900, Cuiabá, Mato Grosso, Brasil

    Morgana Egle Alves Neves, Marielly Rodrigues de Souza, Bartira Mendes Gorgulho, Ana Paula Muraro & Paulo Rogério Melo Rodrigues

  3. Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil

    Diana Barbosa Cunha

  4. Rua São Francisco Xavier, 524, Pavilhão João Lyra Filho, 7° andar, Rio de Janeiro, RJ, Brasil

    Diana Barbosa Cunha

  5. Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, Cuiabá, Brazil

    Ana Paula Muraro

Authors
  1. Morgana Egle Alves Neves
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marielly Rodrigues de Souza
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bartira Mendes Gorgulho
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Diana Barbosa Cunha
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ana Paula Muraro
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Paulo Rogério Melo Rodrigues
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

MEAN and PRMR designed the study. MEAN and APM developed syntax for searching databases and prepared the manuscript. MEAN and MRS contributed to the literature searches, data extraction, and independent reviewing. BMG, DBC and PRMR formulated the research question and prepared the manuscript. All authors contributed to the writing of the manuscript and approved it.

Corresponding author

Correspondence to Paulo Rogério Melo Rodrigues.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Neves, M.E.A., Souza, M.R.d., Gorgulho, B.M. et al. Association of dietary patterns with blood pressure and body adiposity in adolescents: a systematic review. Eur J Clin Nutr 75, 1440–1453 (2021). https://doi.org/10.1038/s41430-020-00850-w

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41430-020-00850-w

This article is cited by

Search

Advanced search

Quick links