Dietary factors associated with obesity indicators and level of sports participation in Flemish adults: a cross-sectional study

BACKGROUND: Obesity develops when energy intake continuously exceeds energy expenditure, causing a fundamental chronic energy imbalance. Societal and behavioural changes over the last decades are held responsible for the considerable increase in sedentary lifestyles and inappropriate dietary patterns. The role of dietary fat and other dietary factors in the aetiology and maintenance of excess weight is controversial. The purposes of the present study were to investigate the dietary factors associated with body mass index (BMI) and waist circumference (WC), and to analyse whether dietary intake varies between subjects with different levels of sports participation. METHODS: Data for this cross-sectional study, including anthropometric measurements, 3-day diet diary and physical activity questionnaire, were collected by the Flemish Policy Research Centre Sport, Physical Activity and Health (SPAH) between October 2002 and April 2004. Results of 485 adult men and 362 women with plausible dietary records were analysed. Analyses of covariance were performed to determine the differences in dietary intake between normal weight, overweight and obese subjects, and between subjects with different levels of sports participation. RESULTS: Total energy intake, protein and fat intake (kcal/day) were significantly higher in obese subjects compared to their lean counterparts in both genders. Percentage of energy intake from fat was significantly higher in obese men compared to men with normal weight or WC. Energy percentages from carbohydrates and fibres were negatively related to BMI and WC in men, whereas in women a higher carbohydrate and fibre intake was positively associated with obesity. Alcohol intake was positively associated with WC in men. Subjects participating in health related sports reported higher intake of carbohydrates, but lower intake of fat compared to subjects not participating in sports. CONCLUSION: This study supports the evidence that carbohydrate, fat, protein and fibre intake are closely related to BMI and WC. The sex differences for dietary intake between obese men and women might reflect the generally higher health consciousness of women. Alcohol intake was only associated with WC, emphasizing the importance of WC as an additional indicator in epidemiological studies. Besides enhancing sports and physical activity, it is necessary to improve the knowledge about nutrition and to promote the well-balanced consumption of wholesome food.