Dietary patterns in middle childhood and behavior problems in adolescence

Background/objectives Adherence to a “Western” style dietary pattern has been related to behavior problems in children in high-income countries; however, dietary patterns may differ in countries undergoing the nutrition transition. Associations of dietary patterns with behavior problems in a Latin American context have not been evaluated. Subjects/Methods Mothers of 385 children 5 to 12 y old completed a food frequency questionnaire (FFQ) on the children’s usual intake at enrollment into a cohort study. Four dietary patterns were identified through principal component analysis of the FFQ: animal protein, snacking, cheaper protein, and traditional/starch. After a median 6 y follow-up, adolescents reported behavior problems via the Youth Self Report, a standardized questionnaire. We compared the continuous distributions of externalizing and internalizing behavior problems and their subscales across quartiles of adherence to the four dietary patterns using multivariable linear regression. Results Boys in the highest quartile of adherence to the animal protein pattern in middle childhood had an adjusted 5.5 units lower (95% CI −9.5, −1.5) mean total externalizing problems score compared with boys in the lowest quartile ( P trend = 0.008). Adherence to the animal protein pattern was also inversely related to the aggressive behavior externalizing subscale in a dose–response manner among boys ( P trend = 0.009). There were no associations between adherence to other dietary patterns and externalizing problems in boys or girls. There were no associations with internalizing problems. Conclusion Adherence to an animal protein dietary pattern in middle childhood was associated with less externalizing behavior problems in adolescent boys.