Clusters of food preferences and aversions in a sample of Spanish schoolchildren and their association with nutritional status, cardiometabolic risk and diet quality

Introduction Dietary habits acquired in childhood often persist into adulthood, and food preferences play a key role in dietary habits and health. The objective of this study was to analyse food preferences and aversion patterns in Spanish schoolchildren, and their association with nutritional status, cardiometabolic risk and diet quality. Methods A cross-sectional analysis was conducted with 792 Spanish children aged 8 to 13 years, using data from questionnaires on food preferences and aversions, diet quality, physical activity, anthropometric and socioeconomic variables. K-means cluster analysis was used to identify preferences clusters, and adjusted logistic regressions were used to examine associations between belonging to the clusters and anthropometric, biochemical, and dietary variables. Results Schoolchildren identified cereals, meat, vegetables, and pizza as their favourite food group or dish, while their aversions were mainly directed towards vegetables, fish or seafood, and legumes. Taste was the main factor influencing food preferences. Two clusters were identified: one that preferred meat and vegetables (Meat-Veg Cluster), and another that preferred cereals and pizza, rejecting vegetables and legumes (Cereal-Pizza Cluster). Being in the Cereal-Pizza Cluster was associated with a lower quality diet, and boys in this cluster showed a higher atherogenic risk [OR (95% CI): 2.966 (1.415-6.220), p = 0.004, q = 0.025], with no association observed with nutritional status. Conclusion Children, specifically boys, in Cereal-Pizza Cluster show higher probability of atherogenic risk and poorer diet quality. Further studies analysing the association between food preferences, diet quality and health in children, including the culinary treatment of food as a possible determinant of food preferences are needed.