Skip to main content
Intended for healthcare professionals
Restricted access
Review article
First published online June 8, 2021

Examining the associations between a posteriori dietary patterns and obesity indexes: Systematic review of observational studies

Abstract

Background:

Few reports on the association of population-derived dietary patterns with excess body weight, using the approach of a systematic review currently exist.

Aim:

The aim of the present systematic review was to identify dietary patterns associated with body mass index (BMI), body weight (BW)/BMI change, weight status and weight loss maintenance status.

Methods:

Using MEDLINE (via PubMed) and EBSCO Host databases, we systematically reviewed studies from 1980 to 2020, which included men and women, aged ≥18 years. Primary outcome was BMI or the longitudinal change of individuals’ BW or BMI, or weight status (normal weight/overweight/obesity) or weight loss maintenance status. We included observational studies, with or without a prospective design. Studies which met the inclusion criteria were evaluated based on the Newcastle–Ottawa Scale; only a posteriori dietary patterns were evaluated.

Results:

Twenty-six studies were eligible for inclusion in the current analysis. The results indicate a relationship between adherence to a lacto-vegetarian dietary pattern, characterized by high intake of fruits, vegetables, whole grains, unprocessed cereals, dairy and low intake of high-fat foods and sweets, and longitudinal change of individuals’ BW or BMI, or the risk of overweight/obesity.

Conclusions:

Promotion of this healthy dietary pattern, as an alternative to focusing on specific nutrients or foods, may be a promising approach to be included in future long-term weight maintenance interventions.

Get full access to this article

View all access and purchase options for this article.

Data availability statement

Data and materials are available upon request.

References

Albuquerque RCR, Baltar VT, Marchioni DML (2014) Breast cancer and dietary patterns: A systematic review. Nutrition reviews 72(1): 1–17.
Arabshahi S, Ibiebele TI, Hughes MCB, et al. (2016) Dietary patterns and weight change: 15-year longitudinal study in Australian adults. European Journal of Nutrition 56(4): 1455–1465.
Asghari G, Mirmiran P, Yuzbashian E, et al. (2017) A systematic review of diet quality indices in relation to obesity. British Journal of Nutrition 117(8): 1055–1065.
Bertoia ML, Mukamal KJ, Cahill LE, et al. (2015) Changes in intake of fruits and vegetables and weight change in United States men and women followed for up to 24 years: Analysis from three prospective cohort studies. PLOS Medicine 13(1): e1001956.
Boggs DA, Palmer JR, Spiegelman D, et al. (2011) Dietary patterns and 14-y weight gain in African American women. American Journal of Clinical Nutrition 94(1): 86–94.
Buckland G, Bach A, Serra-Majem L (2008) Obesity and the Mediterranean diet: A systematic review of observational and intervention studies. Obesity Reviews 9(6): 582–593.
Chaltiel D, Julia C, Adjibade M, et al. (2019) Adherence to the 2017 French dietary guidelines and adult weight gain: A cohort study. PLOS Medicine 16(12): e1003007.
Cho YA, Shin A, Kim J (2011) Dietary patterns are associated with body mass index in a Korean population. Journal of the American Dietetic Association 111(8): 1182–1186.
Cunha DB, De Almeida RMVR, Sichieri R, et al. (2010) Association of dietary patterns with BMI and waist circumference in a low-income neighbourhood in Brazil. British Journal of Nutrition 104(6): 908–913.
Denova-Gutiérrez E, Castañón S, Talavera JO, et al. (2011) Dietary patterns are associated with different indexes of adiposity and obesity in an urban Mexican population. The Journal of Nutrition 141(5): 921–927.
Flores M, Macias N, Rivera M, et al. (2010) Dietary patterns in Mexican adults are associated with risk of being overweight or obese. The Journal of Nutrition 140(10): 1869–1873.
Freeland-Graves JH, Nitzke S (2013) Position of the Academy of Nutrition and Dietetics: Total diet approach to healthy eating. Journal of the Academy of Nutrition and Dietetics 113(2): 307–317.
Gadgil MD, Anderson CA, Kandula NR, et al. (2015) Dietary patterns are associated with metabolic risk factors in South Asians living in the United States. The Journal of Nutrition 145(6): 1211–1217.
Hosseini-Esfahani F, Djazaieri S-A, Mirmiran P, et al. (2012) Which food patterns are predictors of obesity in Tehranian adults? Journal of Nutrition Education and Behavior 44(6): 564–573.
Hu FB (2002) Dietary pattern analysis: A new direction in nutritional epidemiology. Current Opinion in Lipidology 13(1): 3–9.
Jastreboff AM, Kotz CM, Kahan S, et al. (2019) Obesity as a disease: The Obesity Society 2018 position statement. Obesity 27(1): 7–9.
Jessri M, Lou WY, L’Abbé MR (2016) The 2015 Dietary Guidelines for Americans is associated with a more nutrient-dense diet and a lower risk of obesity. American Journal of Clinical Nutrition 104(5): 1378–1392.
Kant AK (2004) Dietary patterns and health outcomes. Journal of the American Dietetic Association 104(4): 615–635.
Karfopoulou E, Brikou D, Mamalaki E, et al. (2017) Dietary patterns in weight loss maintenance: Results from the MedWeight study. European Journal of Nutrition 56(3): 991–1002.
Karl JP, Roberts SB (2014) Energy density, energy intake, and body weight regulation in adults. Advances in Nutrition 5(6): 835–850.
Kim D-YY, Ahn A, Lee H, et al. (2019) Dietary patterns independent of fast food are associated with obesity among Korean adults: Korea National Health and Nutrition Examination Survey 2010–2014. Nutrients 11(11): 2740.
Kim J, Jo I, Joung H (2012) A rice-based traditional dietary pattern is associated with obesity in Korean adults. Journal of the Academy of Nutrition and Dietetics 112(2): 246–253.
Livingstone KM, McNaughton SA (2017) Dietary patterns by reduced rank regression are associated with obesity and hypertension in Australian adults. British Journal of Nutrition 117(2): 248–259.
Livingstone KM, McNaughton SA (2018) Association between diet quality, dietary patterns and cardiometabolic health in Australian adults: A cross-sectional study. Nutrition Journal 17(1): 19.
Machado Arruda SP, da Silva AAM, Kac G, et al. (2016) Dietary patterns are associated with excess weight and abdominal obesity in a cohort of young Brazilian adults. European Journal of Nutrition 55(6): 2081–2091.
Maki KC, Palacios OM, Koecher K, et al. (2019) The relationship between whole grain intake and body weight: Results of meta-analyses of observational studies and randomized controlled trials. Nutrients 11(6): 1245.
Matta J, Nasreddine L, Jomaa L, et al. (2016) Metabolically healthy overweight and obesity is associated with higher adherence to a traditional dietary pattern: A cross-sectional study among adults in Lebanon. Nutrients 8(7): 432.
Medina-Remón A, Kirwan R, Lamuela-Raventós RM, et al. (2016) Dietary patterns and the risk of obesity, Type 2 diabetes mellitus, cardiovascular diseases, asthma, and mental health problems. Critical Reviews in Food Science and Nutrition 58(2): 262–296.
Moher D, Liberati A, Tetzlaff J, et al. (2009) Preferred reporting items for systematic reviews and meta-analyses: The PRISMA Statement. PLOS Medicine 6(7): e1000097.
Newby PK, Muller D, Hallfrisch J, et al. (2003) Dietary patterns and changes in body mass index and waist circumference in adults. The American Journal of Clinical Nutrition 77(6): 1417–251417.
Newby PK, Muller D, Hallfrisch J, et al. (2004) Food patterns measured by factor analysis and anthropometric changes in adults. The American Journal of Clinical Nutrition 80(2): 504–513.
Panagiotakos D (2008) α-priori versus α-posterior methods in dietary pattern analysis: A review in nutrition epidemiology. Nutrition Bulletin 33(4): 311–315.
Rahe C, Unrath M, Berger K (2014) Dietary patterns and the risk of depression in adults: A systematic review of observational studies. European Journal of Nutrition 53(4): 997–1013.
Rouhani MH, Salehi-Abargouei A, Surkan PJ, et al. (2014) Is there a relationship between red or processed meat intake and obesity? A systematic review and meta-analysis of observational studies. Obesity Reviews 15(9): 740–748.
Sahrai MS, Huybrechts I, Biessy C, et al. (2019) Association of a priori-defined dietary patterns with anthropometric measurements: A cross-sectional study in Mexican women. Nutrients 11(3): 603.
Santos I, Vieira PN, Silva MN, et al. (2017) Weight control behaviors of highly successful weight loss maintainers: The Portuguese Weight Control Registry. Journal of Behavioral Medicine 40(2): 366–371.
Satija A, Hu FB, Bowen L, et al. (2015) Dietary patterns in India and their association with obesity and central obesity. Public Health Nutrition 18(16): 3031–3041.
Schlesinger S, Neuenschwander M, Schwedhelm C, et al. (2019) Food groups and risk of overweight, obesity, and weight gain: A systematic review and dose–response meta-analysis of prospective studies. Advances in Nutrition 10(2): 205–218.
Schrijvers JK, McNaughton SA, Beck KL, et al. (2016) Exploring the dietary patterns of young New Zealand women and associations with BMI and body fat. Nutrients 8(8): 450.
Schulz M, Nöthlings U, Hoffmann K, et al. (2005) Identification of a food pattern characterized by high-fiber and low-fat food choices associated with low prospective weight change in the EPIC–Potsdam cohort. The Journal of Nutrition 135(5): 1183–1189.
Schulze MB, Fung TT, Manson JEAE, et al. (2006) Dietary patterns and changes in body weight in women. Obesity 14(8): 1444–1453.
Schwingshackl L, Hoffmann G, Schwedhelm C, et al. (2016) Consumption of dairy products in relation to changes in anthropometric variables in adult populations: A systematic review and meta-analysis of cohort studies. PLOS ONE 11(6): e0157461.
Shi Z, Hu X, Yuan B, et al. (2008) Vegetable-rich food pattern is related to obesity in China. International Journal of Obesity 32(6): 975–984.
Shi Z, Yuan B, Hu G, et al. (2011) Dietary pattern and weight change in a 5-year follow-up among Chinese adults: results from the Jiangsu Nutrition Study. The British Journal of Nutrition 105(7): 1047–1054.
Silveira BKS, De Novaes JF, Reis NDA, et al. (2018) ‘Traditional’ and ‘healthy’ dietary patterns are associated with low cardiometabolic risk in Brazilian subjects. Cardiology Research and Practice Article ID 4585412.
Swinburn BA, Caterson I, Seidell JC, et al. (2004) Diet, nutrition and the prevention of excess weight gain and obesity. Public health nutrition 7(1A): 123–146.
Togo P, Osler M, Sørensen TIAA, et al. (2004) A longitudinal study of food intake patterns and obesity in adult Danish men and women. International Journal of Obesity 28(4): 583–593.
Wells GA, Shea B, O’Connell D, et al. (2013) The Newcastle–Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. The Ottawa Hospital Research Institute (3): 1–4.
Whitton C, Rebello SA, Lee J, et al. (2018) A healthy Asian a posteriori dietary pattern correlates with a priori dietary patterns and is associated with cardiovascular disease risk factors in a multiethnic Asian population. The Journal of Nutrition 148(4): 616–623.
Yusof AS, Isa ZM, Shah SA (2012) Dietary patterns and risk of colorectal cancer: A systematic review of cohort studies (2000–2011). Asian Pacific Journal of Cancer Prevention 13(9): 4713–4717.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.