ObjectivesBody fat distribution is a strong risk factor for metabolic dysfunction in childhood and may be a target for lifestyle interventions. Prospective studies linking childhood dietary intake and future body fat deposition are needed to develop optimal therapeutic strategies. Our objective was to examine associations of childhood nutrient intakes with hepatic fat (HF), abdominal visceral (VAT) and subcutaneous adipose tissue (SAT) in adolescence. MethodsData were from 302 participants in the Exploring Perinatal Outcomes among Children (EPOCH) study in Colorado. Visits were completed in childhood (T1, ∼10yrs) and adolescence (T2, ∼16yrs). Diet was assessed by Block Kids Food Questionnaire at T1. HF (%) and abdominal SAT and VAT (mm2) were assessed by magnetic resonance imaging at T1 (abdominal fats only) and T2. Two types of models (energy partition and isocaloric substitution) were constructed to examine associations of nutrient intakes at T1 with HF and abdominal VAT and SAT at T2. ResultsIn energy partition models adjusted for other macronutrients and confounders (sex, age, race/ethnicity, puberty), higher starch and total fat intake at T1 were associated with higher log-HF and SAT, respectively, at T2 [β (95% CI) = 0.07 (0.01,0.14) for log-HF per 100 kcal/d starch, 17.0 mm2 (4.3,29.7) for SAT per 100 kcal/d fat]. In isocaloric substitution models holding total energy intake (TEI) constant, replacing protein with starch was marginally associated with log-HF at T2 [0.12 (–0.02,0.26) per 5% TEI/d starch at the expense of protein], and replacing carbohydrates (CHO) with total fat was associated with SAT at T2 [19.3 mm2 (3.1,35.5) per 5% TEI/d fat at the expense of CHO]. There were no associations of nutrient intakes with VAT at T2. Adjusting for abdominal SAT at T1 attenuated associations between fat intake at T1 and SAT at T2 to the null [4.6 mm2 (–3.7,12.9) in energy partition models; 10.5 mm2 (–0.01,21.0) in isocaloric substitution models with CHO]. ConclusionsOur results suggest that higher starch intake in childhood, especially at the expense of protein, is associated with higher adolescent HF. We also found that higher fat intake in childhood, especially at the expense of CHO, was associated with higher adolescent abdominal SAT, and that this may reflect an association that was already present earlier in childhood. Funding SourcesNIDDK; NIH/NCATS Colorado CTSA.