Abstract
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. 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. Higher diet quality at age 5-6 was associated with lower BMI (DASH score: Δ quintile (Q) 5 and Q1:-0.35kg/m2, p for trend=0.016), lower WC (DASH score: Δ Q5 and Q1:-1.0cm, p for trend=0.028), lower systolic (DASH score: Δ Q5 and Q1:-2.7mmHg, 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:-0.20mmol/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. Higher diet quality in childhood at age 5-6 years predicted better health on some cardiovascular outcomes in preadolescence.
Highlights
Higher Dietary Approaches to Stop Hypertension (DASH) score was associated with higher body mass index (BMI) and larger waist circumference (WC) and with lower scores on other cardiovascular outcomes at baseline, differences were rather small
We found no associations between diet quality at age 5e6 and risk of overweight, high risk carotid intima-media thickness (CIMT) or metabolic syndrome in preadolescents
We demonstrated that higher diet quality at age 5e6 was associated with modest differences in several risk factors for cardiovascular diseases (CVD) at age 11e12
Summary
In recent decades, cardiovascular diseases (CVD) became a leading cause of health loss and premature death worldwide [1]. Several individual foods, like dairy products and sugar-sweetened beverages, have been associated with CVD risk factors in cross-sectional studies [6,7]. One method to define dietary patterns is using dietary quality indices, which determine the degree of adherence to, for example, specific dietary guidelines or the Mediterranean Diet. Such ‘a priori’-derived dietary pattern approaches make it possible to evaluate whether adherence to a particular diet reduces the risk of certain diseases, like CVD [8,9]. We aimed to examine the associations between diet quality at age 5e6 years and cardiovascular outcomes after a 6-year follow-up. Multivariable linear and logistic regression models adjusted for baseline value were used to examine associations between diet quality and cardiovascular outcomes
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