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Canadian Journal of Cardiology

EVALUATING THE ASSOCIATIONS BETWEEN BUYING LUNCH AT SCHOOL, EATING AT RESTAURANTS, AND EATING TOGETHER AS A FAMILY AND CARDIOMETABOLIC RISK IN ADOLESCENTS

      Background

      Purchasing lunch at school, eating at restaurants, and infrequently eating dinner as a family may be associated with increased cardiometabolic risk. We sought to evaluate these associations in adolescents undergoing universal school-based screening.

      Methods

      We performed a cross-sectional study of grade 9 students over 4 school years (2009-2013) undergoing universal school-based screening through the Heart Niagara Inc. Healthy Heart Schools’ Program. Questionnaires assessed frequency of buying lunch at school, eating at restaurants, and eating dinner with at least one family member, amongst other behaviours. Height, weight, waist circumference, blood pressure, and non-fasting lipid profiles were measured.

      Results

      N=14,280 (52% male, 14.6+0.6 years old). Seventeen percent (2,289) were overweight (BMI 85-<95th percentile) and 14% (1,863) were obese (BMI >95th percentile). Nine percent (1,097) reported almost always/always buying lunch at school. Eating out at a restaurant at least twice per week was reported in 27% (3,327). Dinner with a family member <1 time per week was reported in 8% (963). Buying lunch more frequently at school was associated with a 0.029mmol/L (LCL 0.007, UCL 0.051) increase in non-HDL-C (Table). There were no clinically significant associations between frequency of eating at restaurants and BMI, lipid profile, or blood pressure (Table). Increased weekly frequency of eating dinner with at least 1 family member was significantly associated with a decreased BMI percentile, waist-to-height ratio, total cholesterol, non-HDL cholesterol and systolic BP Z-score (Table and Figure). Eating with at least one person 0-1 times per week had 1.5 (1.34-1.65, p<0.001) times increased odds of being in a higher frequency category of buying lunch at school compared with children who eating with a family member more than once per week. Children who reported almost always/always buying lunch at school had 1.84 (1.77-1.92, p<0.001) times increased odds of eating at restaurants more frequently and 7.3 (6.3-8.4, p<0.001) times increased odds of eating at restaurants >3 times per week compared with children who reported sometimes or never buying lunch at school.

      Conclusion

      Eating dinner as a family more frequently was associated with decreased cardiometabolic risk factors. There were no clinically significant associations between buying lunch at school or eating at restaurants and cardiometabolic risk. There were significant associations between infrequently eating together as a family and buying lunch at school and buying lunch at school and more frequently eating at restaurants. These associations may help identify potentially modifiable risk factors regarding adolescent eating behaviours and cardiometabolic risk.
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