Meal Patterns and Changes in Cardiometabolic Risk Factors in Children: A Longitudinal Analysis.

Xianwen Shang,Qian Zhang,Songming Du,Yanping Li,Ailing Liu,Haiquan Xu,Guansheng Ma

doi:10.3390/nu12030799

Abstract

We examined whether energy and macronutrient intake from different meals was associated with changes in cardiometabolic risk (CMR) factors in children. CMR score (CMRS) was computed by summing Z-scores of waist circumference, the average of systolic and diastolic blood pressure, fasting glucose, high-density lipoprotein cholesterol (multiplying by −1), and triglycerides. We included 5517 children aged 6–13 years from six major cities in China. Five meal patterns were identified according to energy intake: balanced, breakfast dominant, lunch dominant, dinner dominant, and snack dominant patterns. These patterns were not significantly associated with changes in CMR factors. Carbohydrate intake (% energy) at lunch was positively associated with the change in CMRS (beta coefficient (95% CI): (0.777 (0.509, 1.046) in quintile 5 versus quintile 1). A positive association between carbohydrate intake at dinner and change in CMRS was observed. High protein intake at both lunch and dinner was associated with a favorable change in CMRS. Moderate fat intake at lunch was associated with a lower increase in CMRS. Meal patterns driven by energy were not significantly associated with CMR factors; however, a low carbohydrate-high protein-moderate fat lunch and low carbohydrate-high protein dinner were associated with favorable changes in CMRS in children.

Highlights

There is a high prevalence of cardiometabolic risk (CMR) factors in both children and adults globally [1,2,3], which imposes tremendous burdens on health care and economic systems
We examined whether energy, carbohydrate, protein, and fat consumed at breakfast, lunch, dinner, and as a snack was associated with the change in CMR
Children excluded from the analysis because of missing or abnormal diet data were more likely to be boys and have higher Body mass index (BMI), Waist circumference (WC), fasting glucose, insulin, and lower SBP and DBP compared with those included in the analysis

Summary

Introduction

There is a high prevalence of cardiometabolic risk (CMR) factors in both children and adults globally [1,2,3], which imposes tremendous burdens on health care and economic systems. Evidence from recent studies in adults has shown that meal patterns play an important role in the development of CMR factors [12,13]. Previous studies have shown that skipping meals, especially breakfast, was associated with a higher prevalence of CMR factors [15,16,17], whereas a higher meal frequency was associated with a lower risk of obesity, high cholesterol, and diabetes in adults [18,19,20]. The meal composition of macronutrients may play an important role in metabolic health, given that diets high in protein and low in carbohydrates are associated with lower

Methods

Results

Conclusion