ORIGINAL ARTICLE Associations between dietary patterns and obesity phenotypes A-M Paradis 1,2,3 , G Godin 4 , L Pe ´russe 2,5 and M-C Vohl 1,2,3 1 Department of Food Science and Nutrition, Laval University, Que´bec, Canada; 2 Lipid Research Center, CHUQ-CHUL Pavilion, Que´bec, Canada; 3 Institute of Nutraceuticals and Functional Foods (INAF), Laval University, Que´bec, Canada; 4 Faculty of Nursing, Laval University, Que´bec, Canada and 5 Department of Social and Preventive Medicine, Laval University, Que´bec, Canada Objective: To examine whether dietary patterns are associated with obesity phenotypes. Design: Cross-sectional study. Subjects: We recruited 664 participants aged between 18 and 55 years. Dietary data were collected from a food frequency questionnaire. A factor analysis was performed to derive dietary patterns. Body mass index (BMI), weight and waist girth were recorded using standard procedures. Fat mass and fat-free mass were assessed by electrical bioimpedance. Obesity was defined as having a BMIX30 kg m 2 and a positive FHO (FHO þ ) as having at least one obese first-degree relative. Results: Two dietary patterns were identified; Western and Prudent. The Western pattern was mainly characterized by a higher consumption of refined grains, French fries, red meats, condiments, processed meats and regular soft drinks whereas the Prudent pattern was mainly characterized by a higher consumption of non-hydrogenated fat, vegetables, eggs and fish and seafood. Subjects in the top tertile of the Western pattern had higher BMI, weight, waist girth, waist-to-hip ratio and fat mass than those in the lower tertile. In contrast, subjects in the top tertile of the Prudent pattern had lower BMI, weight, waist girth, fat mass, HDL-cholesterol levels, and lower triglyceride levels than those in the lowest tertile. Individuals in the upper tertile of the Western pattern were more likely to be obese (obesity was defined as having a BMIX30 kg m 2 ) (OR ¼ 1.82, 95% CI 1.16– 2.87) whereas those in the upper tertile of the Prudent pattern were less likely to be obese (OR ¼ 0.62, 95% CI 0.40–0.96). These latter significant associations were only observed among those with FHO þ . No such association was observed among FHO individuals. Conclusion: Individuals having a high score of Western pattern were more likely to be obese and those having a high score of the Prudent pattern were less likely to be obese, and this is particularly among individuals with an FHO þ . International Journal of Obesity (2009) 33, 1419–1426; doi:10.1038/ijo.2009.179; published online 8 September 2009 Keywords: dietary patterns; factor analysis; familial history of obesity; prudent pattern; western pattern Introduction The prevalence of obesity is increasing world-wide. 1 There is thus a clear need to understand the etiology of obesity, which is a condition associated with an increased risk of coronary heart disease, dyslipidemia, hypertension and stroke, certain types of cancer, non-insulin-dependent diabetes mellitus, gallbladder disease, osteoarthritis, gout and pulmonary diseases. 1 Genetic and environmental factors are likely to be involved in the development of obesity. On the one hand, it was observed that the presence of a positive familial history of obesity (FHO) increases the risk of the offspring being obese. 2–7 On the other hand, it is well known that environmental factors, such as dietary intakes, are important precursors of health and diseases. 8 The role of individual dietary components has been the focus of considerable research in the field of obesity. 9–11 However, given the complexity of human diets, several authors have proposed to analyze dietary intakes as dietary patterns. 12–14 A factor analysis approach used to derive dietary patterns reduces the complexity of diets to a few important foods and has the ability to integrate complex and subtle interactive effects of many dietary exposures. 14,15 Relationships between dietary patterns derived from factor analysis and obesity have not been extensively studied. A literature review showed inconsistent findings between BMI and dietary patterns, as assessed by diet index, factor analysis Received 13 March 2009; revised 24 July 2009; accepted 26 July 2009; published online 8 September 2009 Correspondence: Dr M-C Vohl, Lipid Rsearch Center, Laval University, CHUQ- CHUL, Room TR-93, 2705 Laurier Blvd, Que ´bec, QC, Canada G1V 4G2. E-mail: marie-claude.vohl@crchul.ulaval.ca International Journal of Obesity (2009) 33, 1419–1426 & 2009 Macmillan Publishers Limited All rights reserved 0307-0565/09 $32.00 www.nature.com/ijo