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Background  Understanding dietary patterns in the study of diet-disease relationships is crucial for designing dietary behaviour interventions. This study aimed to determine associations between dietary patterns and background characteristics among school age children (9–15 years) in Ghana.    Methods  A cross-sectional sample of 487 urban-dwelling children age 9–15 years was recruited using simple random sampling from 24 schools (12 private and 12 public) in the Ga-East Municipality in Southern Ghana. A 7-day food frequency questionnaire was used to record children’s consumption of over 100 unique food items. Principal component analyses based on 14 food groups was used to describe emerging dietary patterns (DP). BMI-for-age z-scores segregated by sex were derived using WHO Anthro plus software. Linear regression was used to test associations between ‘diet factor’ scores, and weight status controlling for age.    Results  Four DPs were identified that explained 53.2% of variation in the diets of children: (1) energy dense; (2) starchy root staple and vegetables; (3) cereal-grain staples and poultry; and (4) fish & seafoods. Energy dense DP characterised by processed meat, fried foods, and sugary foods was associated with child overweight/obese status after controlling for age, sex, SES and school type [F(5, 484) = 6.868,  p  < 0.001]. Starchy root with vegetable DP was negatively associated with overweight/obese status, private school attendance and higher SES after controlling for age at bivariate level. However, relationship between ‘starchy root staples and vegetables’ DP and overweight/obese status lost significance after controlling for other covariates.    Conclusion  Our data identified energy-dense dietary pattern to be significantly associated with childhood overweight and obesity. Targeted dietary messages are required to address energy-dense dietary patterns among school-age children.    Electronic supplementary material  The online version of this article (10.1186/s40795-018-0230-2) contains supplementary material, which is available to authorized users.

Dietary patterns and associated risk factors among school age children in urban Ghana