Determinants of a dietary pattern linked with greater
metabolic risk and its tracking during adolescence
G. K. Pot,
W. H. Oddy,
S. A. Jebb
& G. L. Ambrosini
Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Malaysia
Medical Research Council Human Nutrition Research, Cambridge, UK
Diabetes and Nutritional Sciences Division, School of Medicine, King’s College London, London, UK
Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
Telethon Kids Institute, Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
Nufﬁeld Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK
School of Population Health, University of Western Australia, Perth, WA, Australia
adolescents, dietary patterns, food groups, Raine
Study, social determinants, tracking.
G. L. Ambrosini, School of Population Health
M431, University of Western Australia, 35 Stirling
Highway, Crawley 6009, Perth, WA, Australia.
Tel.: +61 0 8 6488 7375
Fax: +61 0 8 6488 1188
How to cite this article
Appannah G., Pot G.K., Oddy W.H., Jebb S.A. &
Ambrosini G.L. (2018) Determinants of a dietary
pattern linked with greater metabolic risk and its
tracking during adolescence. J Hum Nutr Diet.
Background: Although growing evidence suggests that dietary patterns asso-
ciated with noncommunicable diseases in adulthood may develop early in
life, when these are established, as well as their determinants, remains
Methods: We examined determinants and tracking of a dietary pattern
(DP) associated with metabolic risk and its key food groups among 860
adolescents in the Western Australian Pregnancy (Raine) Cohort study.
Food intake was reported using a food frequency questionnaire (FFQ) at 14
and 17 years. Z-scores for an ‘energy-dense, high-fat, low-ﬁbre’ DP were
estimated by applying reduced rank regression at both ages. Tracking was
based on the predictive value (PV) of remaining in the DP Z-score or food
intake quartile at 14 and 17 years. Early-life exposures included: maternal
age; maternal pre-pregnancy body mass index; parent smoking status during
pregnancy; and parent socio-economic position (SEP) at 14 and 17 years.
Associations between the DP Z-scores, early-life factors and SEP were anal-
ysed using regression analysis.
Results: Dietary tracking was strongest among boys with high DP Z-scores,
high intakes of processed meat, low-ﬁbre bread, crisps and savoury snacks
(PV > 1) and the lowest intakes of vegetables, fruit and legumes. Lower
maternal education (b = 0.09, P = 0.002 at 14 years; b = 0.14, P < 0.001 at
17 years) and lower maternal age at birth (b = 0.09, P = 0.003 at 14 years;
b = 0.11, P = 0.004 at 17 years) were positively associated with higher DP
Conclusions: An energy-dense, high-fat, low-ﬁbre dietary pattern tracks
more strongly among adolescent boys who have high scores for this pattern
at 14 years of age. These ﬁndings highlight target foods and population sub-
groups for early interventions aiming to improve dietary behaviours.
ª 2017 The British Dietetic Association Ltd.
Journal of Human Nutrition and Dietetics