Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
J Dev Orig Health Dis. 2021 Dec;12(6):933-939. doi: 10.1017/S204017442000118X. Epub 2020 Dec 11.
The identification of early-life determinants of overweight is crucial to start early prevention. As weight gain accelerates between 2 and 6 years, we studied the association between diet quality in children aged 3 years and the change in BMI and overweight incidence in the following 7 years. From the Dutch GECKO Drenthe birth cohort, 1001 children born in 2006 or 2007 with complete data on diet (food frequency questionnaire at the age of 3 years) and growth at the age of 3 and 10 years were included. Diet quality was estimated with the evidence-based Lifelines Diet Score (LLDS). Measured height and weight at the age of 3 and 10 years were used to calculate BMI z-scores standardized for age and sex. The associations of the LLDS (in quintiles) with BMI-z change and overweight incidence were studied with linear and logistic regression analyses. Overweight prevalence in the total study population increased from 8.3% at the age of 3 years to 16.7% at the age of 10 years. The increase in overweight prevalence ranged from 14.7% in Q1 to 3.5% in Q5. Children with a better diet quality (higher quintiles of LLDS) increased significantly less in BMI-z (confounder adjusted βLLDS = -0.064 (-0.101; -0.026)). Children with a poor diet quality at the age of 3 years had a considerably higher risk for overweight at the age of 10 years (confounder adjusted OR for Q1 vs. Q5 was 2.86 (95% CI 1.34-6.13). These results show the importance of diet in healthy development in the early life following the first 1000 days when new habits for a mature diet composed of food groups with lifelong importance are developed, providing a relevant window for overweight prevention early in life.
确定超重的早期决定因素对于早期预防至关重要。由于体重在 2 至 6 岁之间加速增长，我们研究了 3 岁儿童饮食质量与接下来 7 年 BMI 变化和超重发生率之间的关系。从荷兰 GECKO 德伦特出生队列中，纳入了 2006 年或 2007 年出生且饮食数据完整（3 岁时进行食物频率问卷）和 3 岁和 10 岁时生长数据完整的 1001 名儿童。饮食质量用循证的 Lifelines 饮食评分（LLDS）来评估。在 3 岁和 10 岁时测量身高和体重，以计算年龄和性别标准化的 BMI z 分数。用线性和逻辑回归分析来研究 LLDS（五分位数）与 BMI-z 变化和超重发生率的关系。在整个研究人群中，超重的患病率从 3 岁时的 8.3%增加到 10 岁时的 16.7%。在 Q1 为 14.7%，Q5 为 3.5%，超重的患病率增加范围很广。饮食质量较好（LLDS 五分位数较高）的儿童 BMI-z 增加明显较少（调整混杂因素后的βLLDS = -0.064（-0.101；-0.026））。3 岁时饮食质量较差的儿童，10 岁时超重的风险明显更高（调整混杂因素后的 Q1 与 Q5 相比的 OR 为 2.86（95%CI 1.34-6.13））。这些结果表明，在生命的最初 1000 天，当新的饮食习惯形成，包括对终生重要的食物组，为成熟饮食做好准备时，饮食在生命早期的健康发育中非常重要，为生命早期预防超重提供了一个相关的窗口。
