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Arora A, Rahaman KS, Parmar JS, Gupta A, Evans N, Chandio N, Selvaratnam N, Manohar N. Trajectories of Sugar-Sweetened Beverage Intake in Early Life: Evidence from a Birth Cohort Study. Nutrients 2024; 16:2336. [PMID: 39064778 PMCID: PMC11279875 DOI: 10.3390/nu16142336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/08/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Infancy and early childhood are periods of dietary transition. Early exposure to specific foods and the establishment of dietary habits during this period can shape long-term food preferences and have lasting effects on health. This study aimed to examine the longitudinal trajectories of sugar-sweetened beverage (SSB) intake in Australian children from birth to age 3 years and identify early-life and socioeconomic factors influencing those trajectories. Mother-infant dyads (n = 934) from the Healthy Smiles Healthy Kids birth cohort study were interviewed on their weekly frequency of SSB intake at 4-month, 8-month, 1-year, 2-year, and 3-year age points. Group-based trajectory modelling analysis was performed to identify trajectories for SSB intake among Australian children. A multivariable logistic regression was performed to identify the maternal and child-related predictors of resulting trajectories. The intake of SSBs showed two distinct quadratic trajectories (high and low) with age. While the two trajectories remained distinctive throughout, the SSB consumption for both groups consistently increased between 4 months and 2 years of age and subsequently stabilised. Compared to low SSB consumers (75%), the high SSB consumers (25%) were significantly more likely to be living in households with three or more children (relative risk (RR): 1.59, 95%CI: 1.02-2.48), had low maternal education (left school < year 12-RR: 1.75, 95%CI: 1.09-2.81; completed year 12-RR: 1.57, 95%CI: 1.02-2.81), and resided in highly/the most socioeconomically disadvantaged areas (highly disadvantaged-RR: 1.89, 95%CI: 1.13-3.18; most disadvantaged-RR: 2.06, 95%CI: 1.25-3.38). Children's SSB intake patterns are established early in life as they transition from infancy to preschool age, and the trajectories of intake established during early childhood are strongly influenced by socioeconomic factors. Hence, interventions targeted to limit SSB intake and improve nutrition amongst children should occur in early life.
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Affiliation(s)
- Amit Arora
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (K.S.R.); (J.S.P.); (N.E.); (N.S.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia; (N.C.); (N.M.)
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW 2010, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Kh. Shafiur Rahaman
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (K.S.R.); (J.S.P.); (N.E.); (N.S.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia; (N.C.); (N.M.)
| | - Jinal Shashin Parmar
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (K.S.R.); (J.S.P.); (N.E.); (N.S.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia; (N.C.); (N.M.)
| | - Adyya Gupta
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC 3220, Australia;
| | - Nicole Evans
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (K.S.R.); (J.S.P.); (N.E.); (N.S.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia; (N.C.); (N.M.)
| | - Navira Chandio
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia; (N.C.); (N.M.)
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Navodya Selvaratnam
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (K.S.R.); (J.S.P.); (N.E.); (N.S.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia; (N.C.); (N.M.)
| | - Narendar Manohar
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia; (N.C.); (N.M.)
- Black Dog Institute, Hospital Road, Randwick, NSW 2031, Australia
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Leed A, Sheridan E, Baker B, Bamford S, Emmanouilidis E, Stewart F, Ostafe K, Sarwari M, Lim K, Zheng M, Islam SMS, Bolton KA, Grimes CA. Dietary Intake and Arterial Stiffness in Children and Adolescents: A Systematic Review. Nutrients 2023; 15:2092. [PMID: 37432233 DOI: 10.3390/nu15092092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 07/12/2023] Open
Abstract
Arterial stiffness is a risk factor for cardiovascular disease that is affected by diet. However, research understanding how these dietary risk factors are related to arterial stiffness during childhood is limited. The purpose of this review was to determine whether various dietary factors were associated with arterial stiffness in the pediatric population. Five databases were systematically searched. Intervention studies, cross-sectional and cohort studies were included that investigated nutrient or food intake and outcomes of arterial stiffness, primarily measured by pulse wave velocity (PWV) and augmentation index (AIx), in the pediatric population (aged 0-18 years). A final 19 studies (six intervention and 13 observational) were included. Only two intervention studies, including a vitamin D and omega-3 supplementation trial, found protective effects on PWV and AIx in adolescents. Findings from observational studies were overall inconsistent and varied. There was limited evidence to indicate a protective effect of a healthy dietary pattern on arterial stiffness and an adverse effect of total fat intake, sodium intake and fast-food consumption. Overall, results indicated that some dietary factors may be associated with arterial stiffness in pediatric populations; however, inconsistencies were observed across all study designs. Further longitudinal and intervention studies are warranted to confirm the potential associations found in this review.
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Affiliation(s)
- Allanah Leed
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Emma Sheridan
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Brooke Baker
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Sara Bamford
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Elana Emmanouilidis
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Fletcher Stewart
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Kristen Ostafe
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Mustafa Sarwari
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Karen Lim
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Kristy A Bolton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Carley A Grimes
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
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Li DL, Zhou M, Pan CW, Chen DD, Liu MJ. Unhealthy Lifestyles and Retinal Vessel Calibers among Children and Adolescents: A Systematic Review and Meta-Analysis. Nutrients 2022; 15:nu15010150. [PMID: 36615807 PMCID: PMC9824413 DOI: 10.3390/nu15010150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/25/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Abstract
The retinal vessel caliber (RVC) is an important biomarker of cardiovascular diseases, which can be semi-automatically measured by fundus photography. This review investigated the associations between the RVCs and the life styles of early life, such as physical activity (PA), sedentary behavior (SB), dietary and sleep, by summarizing the findings from studies on children and adolescents. Two databases (Medline and Embase) were searched from their inception to 30 June 2022. The selected studies were literatures on observational designs, fundus photographs, retinal vessels and lifestyles of children or adolescents. Correlation coefficients of unhealthy life styles and RVCs were transformed to Fisher's z-scores, and the random-effects model was applied to pool data. A total of 18 observational studies were selected; the lifestyles accessed include 9 studies for PA and SB, 8 studies for dietary and 1 study for sleep. The meta-analysis on the correlation coefficients of regression models found the high level of SB (qualified by screen time, ST) was associated the narrower central retinal arteriolar equivalent (CRAE) among children (r = -0.043, 95% confidence intervals [CI] -0.078 to -0.009). By comparing the first and fourth quartiles of PA, the meta-analysis showed that more indoor PA was associated with smaller venular calibers and more outdoor PA was associated with wider CRAE (r = 0.88, 95%CI -3.33 to 0). Unhealthy lifestyles might be harmful on the retinal microcirculation among children and adolescents but their health effect seems not to be as significant as those in adults.
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Affiliation(s)
- Dan-Lin Li
- School of Public Health, Medical of Soochow University, Suzhou 215123, China
| | - Miao Zhou
- Department of Ophthalmology, Peking University People’s Hospital, Beijing 100034, China
| | - Chen-Wei Pan
- School of Public Health, Medical of Soochow University, Suzhou 215123, China
| | - Dan-Dan Chen
- School of Radiation Medicine and Protection, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
- Correspondence: (D.-D.C.); (M.-J.L.); Tel.: +86-187-0250-5070 (M.-J.L.)
| | - Meng-Jiao Liu
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China
- Correspondence: (D.-D.C.); (M.-J.L.); Tel.: +86-187-0250-5070 (M.-J.L.)
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Abstract
Studying the dynamic patterns of dietary changes or stability (otherwise known as dietary trajectories) across the life course can provide important information about when and in whom to intervene with nutritional interventions. This article reviews evidence from longitudinal studies that describe dietary trajectories through the different life stages, covering early life, adolescence to young adulthood and from mid to late adulthood. Current findings suggest that the establishment of diet patterns likely occurs before 3 years of age and allude to other potential ‘windows of change’ in the life course such as the period of 7–9 years of age and during the period of adolescence and early adulthood. Examining diets using various diet parameters appears to be valuable in elucidating different aspects of the diet that can be changed to potentially alter trajectories. In adults, examining long-term diet trends at a population level can reveal shifts in eating patterns as countries undergo epidemiological and nutrition transitions and elucidate the longer-term impact of adherence to particular diets on the development of chronic diseases. While challenges such as the availability of adequate diet data points, consistency in the dietary assessment tools used and the limitations of statistical methods for trajectory modelling remain, integrating diet data with other lifestyle behaviours, high-dimensional biomarkers and genetics data into pattern analyses and examining them from a longitudinal approach, open up potential opportunities to gain deeper insights into diet–disease relationships and support the development of more holistic lifestyle disease prevention recommendations stratified for population groups.
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Manohar N, Hayen A, Do L, Scott J, Bhole S, Arora A. Early life and socio-economic determinants of dietary trajectories in infancy and early childhood - results from the HSHK birth cohort study. Nutr J 2021; 20:76. [PMID: 34493286 PMCID: PMC8424821 DOI: 10.1186/s12937-021-00731-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/09/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Early childhood is a period when dietary behaviours are established. This study aimed to examine the longitudinal intake of core and discretionary foods and identify early life and socio-economic factors influencing those intakes. METHODS Mother-infant dyads (n = 934) from the Healthy Smiles Healthy Kids study, an ongoing birth cohort study, were interviewed. The information on 'weekly frequency of core and discretionary foods intake' using a food frequency questionnaire was collected at 4 months, 8 months, 1 year, 2 years and 3 years age points. Group-based trajectory modelling analyses were performed to identify diet trajectories for 'core' and 'discretionary' foods respectively. A multinomial logistic regression was performed to identify the maternal and child-related predictors of resulting trajectories. RESULTS The intake of core and discretionary foods each showed distinct quadratic (n = 3) trajectories with age. Overall, core foods intake increased rapidly in the first year of life, followed by a decline after age two, whereas discretionary foods intake increased steadily across the five age points. Multiparity (Relative Risk (RR): 0.46, 95%CI: 0.27-0.77), non-English speaking ethnicity of mother (RR: 0.66, 95%CI: 0.47-0.91) and having a single mother (RR: 0.40, 95%CI: 0.18-0.85) were associated with low trajectories of core foods intake whereas older maternal age (RR: 1.05, 95%CI: 1.01-1.08) and longer breastfeeding duration (RR: 1.02, 95%CI: 1.00-1.03) were associated with higher trajectories of core foods intake. Also, multiparity (RR 2.63, 95%CI: 1.47-4.70), low maternal education (RR 3.01, 95%CI: 1.61-5.65), and socio-economic disadvantage (RR 2.69, 95%CI: 1.31-5.55) were associated with high trajectories of discretionary foods intake. Conversely, longer duration of breastfeeding (RR 0.99, 95%CI: 0.97-0.99), and timely introduction of complementary foods (RR 0.30, 95%CI: 0.15-0.61) had a protective effect against high discretionary foods consumption in infancy and early childhood. CONCLUSION Children's frequency of discretionary foods intake increases markedly as they transition from infancy to preschool age, and the trajectories of intake established during early childhood are strongly influenced by socio-demographic factors and infant feeding choices. Hence, there is a need for targeted strategies to improve nutrition in early childhood and ultimately prevent the incidence of chronic diseases in children.
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Affiliation(s)
- Narendar Manohar
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia
- Australian College of Physical Education, Sydney Olympic Park, NSW, 2127, Australia
| | - Andrew Hayen
- Faculty of Health, School of Public Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Loc Do
- Faculty of Health and Behavioural Sciences, School of Dentistry, University of Queensland, Brisbane, QLD, 4072, Australia
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Jane Scott
- Discipline of Nutrition and Dietetics, School of Population Health, Curtin University, Perth, WA, 6102, Australia
| | - Sameer Bhole
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW, 2010, Australia
- Faculty of Medicine and Health, Sydney Dental School, The University of Sydney, Surry Hills, NSW, 2010, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia.
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia.
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW, 2010, Australia.
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2560, Australia.
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, Westmead, NSW, 2145, Australia.
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Kerr JA, Liu RS, Gasser CE, Mensah FK, Burgner D, Lycett K, Gillespie AN, Juonala M, Clifford SA, Olds T, Saffery R, Gold L, Liu M, Azzopardi P, Edwards B, Dwyer T, Wake M. Diet quality trajectories and cardiovascular phenotypes/metabolic syndrome risk by 11-12 years. Int J Obes (Lond) 2021; 45:1392-1403. [PMID: 33824404 DOI: 10.1038/s41366-021-00800-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 02/03/2021] [Accepted: 03/04/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To investigate associations between early-life diet trajectories and preclinical cardiovascular phenotypes and metabolic risk by age 12 years. METHODS Participants were 1861 children (51% male) from the Longitudinal Study of Australian Children. At five biennial waves from 2-3 to 10-11 years: Every 2 years from 2006 to 2014, diet quality scores were collected from brief 24-h parent/self-reported dietary recalls and then classified using group-based trajectory modeling as 'never healthy' (7%), 'becoming less healthy' (17%), 'moderately healthy' (21%), and 'always healthy' (56%). At 11-12 years: During children's physical health Child Health CheckPoint (2015-2016), we measured cardiovascular functional (resting heart rate, blood pressure, pulse wave velocity, carotid elasticity/distensibility) and structural (carotid intima-media thickness, retinal microvasculature) phenotypes, and metabolic risk score (composite of body mass index z-score, systolic blood pressure, high-density lipoproteins cholesterol, triglycerides, and glucose). Associations were estimated using linear regression models (n = 1100-1800) adjusted for age, sex, and socioeconomic position. RESULTS Compared to 'always healthy', the 'never healthy' trajectory had higher resting heart rate (2.6 bpm, 95% CI 0.4, 4.7) and metabolic risk score (0.23, 95% CI 0.01, 0.45), and lower arterial elasticity (-0.3% per 10 mmHg, 95% CI -0.6, -0.1) and distensibility (-1.2%, 95% CI -1.9, -0.5) (all effect sizes 0.3-0.4). Heart rate, distensibility, and diastolic blood pressure were progressively poorer for less healthy diet trajectories (linear trends p ≤ 0.02). Effects for systolic blood pressure, pulse wave velocity, and structural phenotypes were less evident. CONCLUSIONS Children following the least healthy diet trajectory had poorer functional cardiovascular phenotypes and metabolic syndrome risk, including higher resting heart rate, one of the strongest precursors of all-cause mortality. Structural phenotypes were not associated with diet trajectories, suggesting the window to prevent permanent changes remains open to at least late childhood.
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Affiliation(s)
- Jessica A Kerr
- Murdoch Children's Research Institute, Parkville, VIC, Australia. .,The University of Melbourne, Parkville, VIC, Australia.
| | - Richard S Liu
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Constantine E Gasser
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia.,Australian Institute of Family Studies, Southbank, VIC, Australia
| | - Fiona K Mensah
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia.,Monash University, Clayton, VIC, Australia
| | - Kate Lycett
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia.,Deakin University, Burwood, VIC, Australia
| | - Alanna N Gillespie
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Markus Juonala
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Internal Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Susan A Clifford
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Tim Olds
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Lisa Gold
- Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Mengjiao Liu
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Peter Azzopardi
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia.,Maternal and Child Health Program, International Development Discipline, Burnet Institute, Melbourne, Australia
| | - Ben Edwards
- Australian National University Centre for Social Research and Methods, Canberra, ACT, Australia
| | - Terence Dwyer
- The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Melissa Wake
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
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Impact of Dietary Trajectories on Obesity and Dental Caries in Preschool Children: Findings from the Healthy Smiles Healthy Kids Study. Nutrients 2021; 13:nu13072240. [PMID: 34209914 PMCID: PMC8308427 DOI: 10.3390/nu13072240] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/25/2021] [Accepted: 06/25/2021] [Indexed: 12/15/2022] Open
Abstract
This study examines the impact of longitudinal dietary trajectories on obesity and early childhood caries (ECC) in preschool children in Australia. Mother–infant dyads from the Healthy Smiles Healthy Kids study were interviewed at 4 and 8 months, and 1, 2, and 3 years of age. Children underwent anthropometric and oral health assessments between 3 and 4 years of age. Multivariable logistic regression and negative binomial regression analysis were performed for the prevalence of overweight and obesity, and the number of tooth surfaces with dental caries, respectively. The intake of core, discretionary, and sugary foods showed distinct quadratic (n = 3) trajectories with age. The prevalence of overweight or obesity was 10% (n = 72) and that of early childhood caries (ECC) was 33% (mean decayed, missing, and filled tooth surfaces (dmfs) score: 1.96). Children with the highest trajectories of discretionary foods intake were more likely to be overweight or obese (adjusted OR: 2.51, 95 %CI: 1.16–5.42). Continued breastfeeding beyond 12 months was associated with higher dmfs scores (adjusted IRR: 2.17, 95 %CI: 1.27–3.73). Highest socioeconomic disadvantage was the most significant determinant for overweight or obesity (adjusted OR: 2.86, 95 %CI: 1.11–7.34) and ECC (adjusted IRR: 2.71, 95 %CI: 1.48–4.97). Targeted health promotion interventions should be designed to prevent the incidence of two highly prevalent conditions in preschool children.
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Diet quality at age 5-6 and cardiovascular outcomes in preadolescents. Clin Nutr ESPEN 2021; 43:506-513. [PMID: 34024563 DOI: 10.1016/j.clnesp.2021.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 12/09/2020] [Accepted: 02/12/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND & AIMS Specific dietary components during childhood may affect risk factors for cardiovascular disease. Whether overall higher diet quality prevents children from adverse cardiovascular outcomes remains contradictive. We aimed to examine the associations between diet quality at age 5-6 years and cardiovascular outcomes after a 6-year follow-up. METHODS We used data from the Amsterdam Born Children and their Development study, a multi-ethnic birth cohort. Dietary intake was assessed at age 5-6 using a semi-quantitative food frequency questionnaire and diet quality was ascertained with the Dietary Approaches to Stop Hypertension (DASH) score and the child diet quality score (CDQS), an index specifically developed for Dutch school-age children. Cardiovascular outcomes were examined after 6-years follow-up (age 11-12, N = 869). Outcomes were body mass index (BMI), waist circumference (WC), blood pressure (BP), lipid profile, fasting glucose and carotid intima-media thickness (CIMT). Multivariable linear and logistic regression models adjusted for baseline value were used to examine associations between diet quality and cardiovascular outcomes. RESULTS Higher diet quality at age 5-6 was associated with lower BMI (DASH score: Δ quintile (Q) 5 and Q1: -0.35 kg/m2, p for trend = 0.016), lower WC (DASH score: Δ Q5 and Q1: -1.0 cm, p for trend = 0.028), lower systolic (DASH score: Δ Q5 and Q1: -2.7 mmHg, p for trend = 0.046) and diastolic BP (DASH score: Δ Q5 and Q1: -2.4, p for trend < 0.001) and with lower plasma triglycerides (DASH score: Δ Q5 and Q1: -0.20 mmol/L, p for trend = 0.032) after 6-years follow-up. Associations of the CDQS with these outcomes showed similar trends, but less pronounced. We found no statistically significant associations between diet quality and LDL-C, HDL-C, total cholesterol, fasting glucose or CIMT. CONCLUSIONS Higher diet quality in childhood at age 5-6 years predicted better health on some cardiovascular outcomes in preadolescence.
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Lukomskyj N, Shi Y, Allman‐Farinelli M, Rangan A. Associations between breakfast consumption from childhood to adulthood and cardiometabolic health: A systematic review. Nutr Diet 2021. [DOI: 10.1111/1747-0080.12647] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Natalya Lukomskyj
- Charles Perkins Centre The University of Sydney Camperdown New South Wales Australia
| | - Yumeng Shi
- Charles Perkins Centre The University of Sydney Camperdown New South Wales Australia
| | | | - Anna Rangan
- Charles Perkins Centre The University of Sydney Camperdown New South Wales Australia
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Lukomskyj N, Allman-Farinelli M, Shi Y, Rangan A. Dietary exposures in childhood and adulthood and cardiometabolic outcomes: a systematic scoping review. J Hum Nutr Diet 2021; 34:511-523. [PMID: 33406314 DOI: 10.1111/jhn.12841] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/30/2020] [Accepted: 10/27/2020] [Indexed: 02/07/2023]
Abstract
Associations between diet and cardiometabolic outcomes are often based on a single measurement of diet in adulthood. Dietary exposures in childhood are thought to influence cardiometabolic disease development and individuals' diets can change over time, therefore dietary exposure in childhood and over long periods are both important to consider. This scoping review aimed to identify and characterise the literature on associations between diet measured in both childhood and adulthood and cardiometabolic outcomes. Seven databases were searched; eligible evidence sources were original analyses published as a journal article in English. Exposures included measures of dietary intake, diet quality and eating behaviours measured in both childhood and adulthood with at least five years between first and last measurements. Cardiometabolic outcomes included measures of anthropometry, biochemistry, vascular structure/function and disease states/scores. We identified 37 eligible articles from nine cohort studies. Dietary exposures were measured between two and eight times and most often assessed by food frequency questionnaire or diet history. The dietary exposures most frequently examined were protein, fat, carbohydrate, fruit, vegetables, sugar-sweetened beverages and breakfast. Cardiometabolic outcomes were predominantly based on risk markers. Authors utilised a variety of analytical approaches to transform and analyse repeated measures of diet, providing insights relevant to different lifespan nutrition concepts. The literature on associations between diet in childhood and adulthood and cardiometabolic outcomes is limited, but such studies have great potential to extend our knowledge in ways only possible with repeated measures of diet over time. Further research is needed to develop the evidence base for diet-disease relationships from a life course perspective, accounting for diet in both childhood and adulthood.
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Affiliation(s)
- Natalya Lukomskyj
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | | | - Yumeng Shi
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Anna Rangan
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
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Zhao W, Su D, Mo L, Chen C, Ye B, Qin S, Liu J, Pang Y. Lifestyle Clusters and Cardiometabolic Risks in Adolescents: A Chinese School-Based Study Using a Latent Class Analysis Approach. Front Pediatr 2021; 9:728841. [PMID: 34976884 PMCID: PMC8716941 DOI: 10.3389/fped.2021.728841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Unhealthy dietary and lifestyle behaviors are associated with a higher prevalence of non-communicable chronic diseases and higher mortality in adults. However, there remains some uncertainty about the magnitude of the associations between lifestyle behaviors and cardiovascular factors in adolescents. Methods: We conducted a school-based cross-sectional study of 895 Chinese adolescents aged 15-19 years. They participated in a questionnaire survey, physical examination, and blood sample collection. Latent class analysis (LCA) was used to identify heterogeneous subgroups of lifestyle behaviors. A set of 12 latent class indicators, which reflected lifestyle behaviors including dietary habits, physical activity, sleep duration, screen time, and pressure perception, were included in the analysis. Logistic regression analysis was performed to determine whether the derived classes were related to a cardiometabolic risk. Results: In total, 13.7 and 5.6% of the participants were overweight and obese, respectively, and 8.4 and 14.1% reported having pre-hypertension and hypertension, respectively. A two-class model provided the best fit with a healthy lifestyle pattern (65.8%) and a sub-healthy lifestyle pattern (34.2%). There were more female participants with a healthy lifestyle (56.2 vs. 43.8%), whereas there were more males with a sub-healthy lifestyle (45.4 vs. 54.6%), (all P = 0.002). Increased risk of cardiometabolic abnormality (BMI categories, blood pressure and lipids) was not significant across lifestyle patterns, except for waist circumference (70.5 vs 69.1 cm, P = 0.044). There was no significant difference in physical activity and intake of fruit and vegetable between the two patterns. Conclusion: Primary prevention based on lifestyle modification should target patterns of behaviors at high risk in adolescents. Due to the complex effect of lifestyle clusters on cardiometabolic risks, well-designed and prospective studies in adolescents are needed in the future.
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Affiliation(s)
- Weiying Zhao
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Danyan Su
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Luxia Mo
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Cheng Chen
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Bingbing Ye
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Suyuan Qin
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jie Liu
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yusheng Pang
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Short Sleep Duration is Associated with Central Arterial Stiffness in Children Independent of Other Lifestyle Behaviors. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s42978-020-00062-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Abrignani MG, Lucà F, Favilli S, Benvenuto M, Rao CM, Di Fusco SA, Gabrielli D, Gulizia MM. Lifestyles and Cardiovascular Prevention in Childhood and Adolescence. Pediatr Cardiol 2019; 40:1113-1125. [PMID: 31342115 DOI: 10.1007/s00246-019-02152-w] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 07/10/2019] [Indexed: 02/05/2023]
Abstract
Pathology studies demonstrated that coronary fatty streaks develop early in life and that even more advanced fibrous plaques are present in a proportion of adolescents. The presence and extent of atherosclerosis in children and adolescents can be correlated with the same risk factors present in adults; as well as, childhood levels of these risk factors predict adult cardiovascular diseases. Children are born with ideal cardiovascular health but, unfortunately, most of them develop over time modifiable behavioral risk factors. Achieving sustained lifestyle changes initiated too late in adults is difficult, and pharmacologic risk factor control cannot fully restore a low-risk state. Therefore, it seems eminently reasonable to initiate healthful lifestyle training as early in life, decreasing the prevalence of cardiovascular risk factors to retard atherogenic processes and reduce the future burden of cardiovascular diseases. Many guideline recommendations encourage universal adoption of healthier lifestyles, identification of children with cardiovascular risk factors, and their treatment using targeted lifestyle modification and, rarely, pharmacotherapy. Major gains will likely accrue from public health strategies targeting incorrect diet, physical activity, and cigarette smoking. Individualized strategies, however, will initially focus on the highest risk children such as those with familial hyperlipidaemia, diabetes, hypertension, and obesity. The primary purpose of this article is to provide a broad overview on the long-term cardiovascular effects of risk factors in children and youth and to outline various lines of evidence for the efficacy of primordial and primary prevention in young people, as well as recommendations for population- and individual-level strategies and evidence-based interventions.
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Affiliation(s)
| | - Fabiana Lucà
- O.U. of Cardiology, Grande Ospedale Metropolitano, Azienda Ospedaliera Bianchi Melacrino Morelli, Reggio Calabria, Italy
| | | | | | - Carmelo Massimiliano Rao
- O.U. of Cardiology, Grande Ospedale Metropolitano, Azienda Ospedaliera Bianchi Melacrino Morelli, Reggio Calabria, Italy
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Akbari-Sedigh A, Asghari G, Yuzbashian E, Dehghan P, Imani H, Mirmiran P. Association of dietary pattern with carotid intima media thickness among children with overweight or obesity. Diabetol Metab Syndr 2019; 11:77. [PMID: 31528207 PMCID: PMC6740019 DOI: 10.1186/s13098-019-0472-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/27/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Since there is no evidence demonstrating the relationship between dietary patterns and subclinical atherosclerosis in children and adolescents, we aimed to examine the association between dietary patterns and carotid intima-media thickness (cIMT) in children and adolescents with overweight and obesity. METHODS Data were collected on individuals, aged 6-13 years (n = 339) recruited from primary schools with age- and sex-specific body mass index (BMI) Z-score > 1, based on WHO criteria. Dietary intake was assessed using a valid and reliable food frequency questionnaire and dietary patterns were derived by factor analysis. Measurement of cIMT was performed by means of ultrasonography for the wall of common carotid artery. RESULTS The mean ± SD age, BMI Z-score and cIMT of study participants were 9.3 ± 1.7 years, 2.5 ± 0.7 and 0.403 ± 0.057 mm, respectively. Three dietary patterns were identified, which accounted for 23.0% of the total variance, including the healthy, the traditional, and the unhealthy patterns. After adjusting for age, sex, pubertal status, smoking exposure, physical activity, body fat percentage, and intake of magnesium and energy, a significant inverse association was observed between the healthy dietary pattern and cIMT (β = - 0.131, P = 0.019), whereas none were found between cIMT and the traditional (β = - 0.004, P = 0.932) and the unhealthy dietary (β = 0.004, P = 0.942) patterns. CONCLUSIONS Results of the present study indicate that adherence to healthy dietary pattern could prevent increased cIMT in children and adolescents with overweight and obesity. Further cohort design research is required to elucidate the association between dietary patterns and cIMT in children and adolescents.
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Affiliation(s)
- Assa Akbari-Sedigh
- Department of Nutrition, School of Nutritional Science Dietetics, Tehran University of Medical Sciences, P.O. Box: 141664-3931, Tehran, Iran
| | - Golaleh Asghari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
| | - Emad Yuzbashian
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
| | - Pooneh Dehghan
- Department of Imaging, Research Development Center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Imani
- Department of Nutrition, School of Nutritional Science Dietetics, Tehran University of Medical Sciences, P.O. Box: 141664-3931, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
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