A new study of over 1,700 US children reveals that higher fruit intake is linked to smaller waistlines, highlighting the role of fruit in fighting childhood obesity.
Study: Association between fruit intake and abdominal adiposity in 1,707 randomly selected U.S. children. Image credit: Oksana Kuzmina/Shutterstock.com
Professor Larry A. Tucker at Brigham Young University, United States, conducted a study on U.S. children to explore the relationship between fruit intake and abdominal adiposity. The study, which is published in Frontiers in Nutrition, highlighted the importance of consuming fruits in body weight management.
Background
Obesity and overweight are significant public health crises in the United States. Combined, they affect more than 40% of children in the US. The prevalence of these chronic metabolic conditions has increased almost fivefold among U.S. children and adolescents over the past 50 years.
Both obesity and overweight potentially increase the risk of other health conditions, including insulin resistance, high cholesterol, high blood pressure, type 2 diabetes, cardiovascular disease, depression, and anxiety.
Body mass index (BMI) is a valuable parameter for assessing obesity and overweight. However, it does not differentiate between fat and lean mass and does not consider body fat distribution. Given the importance of these factors in influencing disease risk, the Lancet Diabetes & Endocrinology Commission declared in their latest publication that alternative measures, such as waist circumference, might be more accurate for detecting excess body fat and obesity-related health risks. In this context, evidence indicates that abdominal adiposity and excessive fat accumulation in the abdomen are crucial predictors of cardiometabolic disease risk.
Consumption of high-energy foods contributes significantly to abdominal adiposity. A food's energy density depends on its water, fiber, and fat contents. Foods with higher amounts of fat and less water and fiber are considered high-energy. Excessive consumption of these foods can lead to being overweight and obesity. Low-energy foods, on the other hand, are good for health and weight management.
Given the increasing prevalence of childhood obesity and the importance of fruits as the lowest energy-dense food, this study was conducted on a nationally representative sample of U.S. children to assess the association between fruit intake and abdominal adiposity.
The study
The study involved more than 1500 children aged 8 to 11 who were randomly selected as part of the U.S. National Health and Nutrition Examination Survey (NHANES), which is conducted by the U.S. National Center for Health Statistics (NCHS) and the Centers for Disease Control and Prevention (CDC).
Participants' fruit intake was measured using two 24-hour dietary recalls and expressed as the percentage of total energy derived from fruit, excluding fruit juices. The waist circumference and sagittal abdominal diameter measurements were used to determine abdominal adiposity.
The association between fruit intake and abdominal adiposity was assessed after controlling for potential confounding factors, including age, sex, race, household size, year of assessment, recreational computer time, physical activity, total energy consumption, and carbohydrate, protein, fat, fiber, sugar, and saturated fat intake.
Study findings
The study was conducted on 1707 children, of whom about 27% reported no fruit intake, 36% reported low fruit intake, and 37% reported moderate-to-high fruit intake. The average daily fruit intake in the entire study population was 10% of the total energy intake.
The correlation analysis, controlling all confounding factors, revealed that higher fruit intake is significantly associated with lower waist circumference and sagittal abdominal diameter (abdominal height). These findings highlight the benefits of consuming fruit in reducing the risk of abdominal adiposity.
A statistically significant reduction in sagittal abdominal diameter was observed among children who consumed moderate-to-high amounts of fruits compared to those with no fruit intake. For waist circumference, the difference was marginally significant in the most fully adjusted model.
A subgroup analysis based on lifestyle behaviors revealed that the observed benefits of fruit intake remain significant for children who spent two hours or less per day in recreational computer use or performed at least one hour of physical activity four days per week or more.
However, the benefits were not significant among children who spent three hours or more per day using recreational computers or performed less than four days per week of physical activity.
Study significance
The study shows an association between moderate to high fruit consumption and significantly reduced abdominal adiposity in U.S. children aged 8 to 11. This association is stronger and more consistent in U.S. boys than girls.
According to the study findings, children with the highest fruit intake receive significantly higher amounts of dietary fiber, carbohydrates, and sugar and significantly lower amounts of saturated fat than those who avoid fruits entirely. The observed benefits may be explained by the low energy density of most fruits due to their high water, fiber, and low dietary fat content. A large body of studies has demonstrated that dietary patterns that primarily focus on consuming high amounts of low-energy-dense foods, such as fruits, are effective for body weight management.
Dietary fiber content is another factor that may help to mediate the inverse association between fruit intake and abdominal adiposity. Existing evidence suggests that dietary fiber-rich fruits can reduce weight gain by exerting beneficial effects on the gut microbiota.
Furthermore, the high amounts of vitamins, antioxidants, flavonoids, and phytochemicals present in fruits can help reduce inflammation, increase insulin sensitivity, regulate hunger hormones (leptin and ghrelin), and improve weight management.
In the United States, about 80% of the population does not meet the fruit intake recommendations proposed by the 2020–2025 Dietary Guidelines for Americans. Given this deficit and the current study findings, Professor Larry A. Tucker advises that healthcare professionals, educators, and parents should encourage children to consume more fruit to reduce the risk of obesity and other health complications.
However, because this study used a cross-sectional design, it cannot determine cause and effect. Additional prospective or experimental research would be needed to confirm that high fruit intake directly leads to reduced abdominal adiposity. The study also notes that the racial distributions of participants were influenced by NHANES sampling procedures, which intentionally oversample certain ethnic groups, such as Mexican Americans.
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