Association Between Change in the Global Diet Quality Score (GDQS) and Adiposity Change From 2 to 7 Years of Age Among Mexicans

Overweight and obesity affects approximately 20%-30% of preschool- and school-aged children in Mexico. The GDQS has been proposed as a global metric for monitoring nutrient adequacy in populations, but data for its association with adiposity measures in Mexican children are scarce. We evaluated the association between the Global Diet Quality Score (GDQS) and changes in adiposity outcomes in Mexican children between ages 2 years to 4-5 years, 2 years to 6-7 years, and 4-5 years to 6-7 years. We analyzed data from 715 children from the Programming Research in Obesity, Growth, Environment, and Social Stressors (PROGRESS) cohort study in Mexico City. Children’s dietary intakes were collected using a semi-quantitative food frequency questionnaire, and diet quality was calculated using the GDQS. We assessed 3 adiposity outcomes at 2 years, 4-5 years, and 6-7 years: body mass index (BMI) Z-score, waist circumference to height ratio (WHTr), and body fat mass to height ratio (BFMHTr). We ran separate multiple linear regression models to evaluate associations between changes in GDQS and changes in adiposity outcomes between each pair of visits. We evaluated whether the associations differed by sex, or baseline BMI status. We found that the average GDQS score was generally low at each visit. Between 4-5 years and 6-7 years, we found statistically significant inverse associations between change in GDQS and change in BMI Z-score among all children. We also found inverse associations between changes in GDQS and WHTr only for children with risk of overweight/obesity at baseline and for girls. For BFMHTr, we found statistically significant associations among girls. In conclusion, longitudinal changes in the GDQS were inversely associated with changes in adiposity outcomes among Mexican children. Our results suggest that the GDQS is a useful metric for capturing dietary quality related to obesity for children from middle-income countries, such as Mexico.