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Published on: February 2, 2017
Childhood Nutritional Factors and Cardiometabolic Outcomes at 9-11 y of Age: Findings from the ROLO Longitudinal
Sophie Callanan1, Anna Delahunt1, Catherine M Phillips2
1UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.
Insights
Early human milk exposure is linked to lower childhood body fat. However, diet quality declines by preteen years, indicating a crucial window for nutritional interventions to improve long-term cardiometabolic health.
Area of Science:
- Pediatric Nutrition
- Cardiometabolic Health
- Longitudinal Cohort Studies
Background:
- Childhood nutrition significantly influences long-term chronic disease risk.
- Longitudinal data on early nutrition and preteen cardiometabolic outcomes are limited.
Purpose of the Study:
- To investigate associations between early feeding practices (human milk, solids introduction) and childhood diet quality/inflammation with preteen cardiometabolic health.
- To analyze changes in diet quality and inflammatory scores from early childhood to preteen years.
Main Methods:
- Analysis of 399 children from the ROLO longitudinal birth cohort study.
- Assessment of early feeding practices, dietary intake (food frequency questionnaires), and calculation of Healthy Eating Index (HEI)-2015 and Children's Dietary Inflammatory Index (C-DII) scores at ages 5 and 9-11 years.
- Evaluation of preteen cardiometabolic outcomes including anthropometry, body composition, blood pressure, and biomarkers using regression models.
Main Results:
- Any human milk exposure was associated with reduced body fat percentage at 9-11 years (adjusted β: -2.86, P=0.03).
- Favorable diet quality at age 5 was linked to higher lean mass at 9-11 years (P<0.05).
- Higher preteen HEI-2015 scores correlated with lower leptin levels (tertile 3 vs. 1, adjusted β: -2.92, P=0.03), despite overall deterioration in diet quality and increased inflammation from age 5 to 9-11 years.
Conclusions:
- Early life human milk exposure is associated with lower preteen adiposity, regardless of duration.
- Diet quality and inflammatory potential worsen between early childhood and preteen years, suggesting a critical period for intervention.
Background:
Childhood represents a critical period of nutritional risk in the programming of later chronic disease. Few longitudinal studies have explored repeated measures of nutrition throughout the first decade of life in relation to preteen cardiometabolic outcomes.
Objectives:
This research aimed to explore associations of early feeding practices (human milk exposure and duration and timing of introduction to solids) and childhood dietary quality and inflammatory scores (at 5 and 9-11 y and change during childhood) on preteen cardiometabolic outcomes.
Methods:
This is an analysis of children from the ROLO longitudinal birth cohort study (n = 399). Information on early feeding practices were obtained at postnatal study visits. Food frequency questionnaires collected maternal-reported dietary intakes for each child at 5 and 9-11 y of age. Healthy Eating Index (HEI)-2015 and the Children's Dietary Inflammatory Index (C-DII) scores were calculated. Anthropometry, body composition, blood pressure, heart rate, cardiorespiratory endurance, and blood biomarkers were obtained at 9-11 y. Crude and adjusted linear regression models examined nutritional exposure associations with preteen cardiometabolic outcomes.
Results:
In the adjusted model, any human milk exposure was associated with lower body fat (%) at 9-11 y (β: -2.86; 95% confidence interval [CI]: -5.46, -0.27; P = 0.03), than never receiving human milk. At 5 y, diet scores were favorably associated with lean mass at 9-11 y (P < 0.05 for both). Higher preteen HEI-2015 scores were associated with lower preteen leptin levels (tertile 3 compared with tertile 1-β: -2.92; 95% CI: -5.64, -0.21; P = 0.03). Diet quality significantly deteriorated (HEI-2015 score decreased) and became more proinflammatory (C-DII score increased) from 5 to 9-11 y of age. Diet quality/inflammation deterioration (compared with improvement) or overall change in dietary scores were not related to preteen cardiometabolic outcomes.
Conclusions:
Exposure to human milk in early life was associated with lower preteen adiposity, irrespective of duration. Diet quality/inflammatory potential deteriorated between early childhood and the preteen years, highlighting a potential period for intervention.
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