ObjectivesCharacterize relationships between dietary patterns and the cardiometabolic profile of Peruvian children at risk of undernutrition. MethodsThe study was nested in the Peru site of the ‘MAL-ED’ study, a longitudinal birth cohort to evaluate relationships between diet, enteric exposures and child growth and development. Dietary recalls were collected from 9–24 months of age. At 3–5 years, we conducted a follow-up. Three additional dietary recalls were collected, and blood pressure, height, weight, subscapular skinfolds, and fasting plasma glucose, insulin, and lipid profiles were assessed. Nutrient intakes were expressed as average density per 100 kcals i) from 9–24 months, and ii) at follow-up. Reduced rank regression (RRR) was used to identify the combination of nutrient intakes explaining the greatest variation in the outcome variables. Multiple linear regression models adjusting for subscapular skinfold-for-age Z-scores (SSFZ) were used to test whether observed relationships were mediated by body composition. ResultsOf the 153 children included, 26% were stunted at follow-up. RRR extracted 2 factors explaining 7% of the variation in infant nutrient intakes and 12% of the variation in response variables. The first factor had higher loadings for vitamin D, calcium, and cholesterol, while the second had higher loadings for non-animal source protein and iron. RRR also extracted 2 factors from the child intake data. These factors had higher loadings for sugar and fats, and sugar and protein, respectively. The first infant RRR factor was associated with lower plasma triglycerides and higher high-density lipoprotein, whereas the second was associated with higher homeostatic model assessment-insulin resistance (HOMA-IR) and weight-for-height Z-scores (WHZ). The first child RRR factor was associated with higher triglycerides, HOMA-IR, and WHZ, and the second was related to higher blood pressure. Associations with glucose and insulin, but not blood pressure or cholesterol, were attenuated after adjusting for SSFZ. ConclusionsNutrient densities of the diet in each childhood are associated with cardiometabolic profile in a chronically undernourished population. Funding SourcesThe project was supported by the Thrasher Foundation and the BMGF.
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