Department of Public and Occupational Health, Amsterdam UMC - location AMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Clin Nutr ESPEN. 2021 Jun;43:506-513. doi: 10.1016/j.clnesp.2021.02.011. Epub 2021 Feb 25.
BACKGROUND & AIMS: 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: -0.35 kg/m, p for trend = 0.016), lower WC (DASH score: Δ Q5 and Q1: -1.0 cm, p for trend = 0.028), lower systolic (DASH score: Δ Q5 and Q1: -2.7 mmHg, 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: -0.20 mmol/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.
儿童时期的特定饮食成分可能会影响心血管疾病的风险因素。整体较高的饮食质量是否能预防儿童出现不良心血管结局仍存在争议。本研究旨在探讨 5-6 岁时的饮食质量与 6 年后心血管结局之间的关系。
我们使用了阿姆斯特丹出生儿童及其发育研究（Amsterdam Born Children and their Development study）的数据，这是一个多民族的出生队列研究。饮食摄入量在 5-6 岁时使用半定量食物频率问卷进行评估，饮食质量使用膳食方法阻止高血压（Dietary Approaches to Stop Hypertension，DASH）评分和儿童饮食质量评分（child diet quality score，CDQS）来确定，CDQS 是专门为荷兰学龄儿童开发的指数。心血管结局在 6 年后（11-12 岁）进行检查（N=869）。结局包括体重指数（body mass index，BMI）、腰围（waist circumference，WC）、血压（blood pressure，BP）、血脂谱、空腹血糖和颈动脉内膜中层厚度（carotid intima-media thickness，CIMT）。使用多变量线性和逻辑回归模型，根据基线值调整，以检验饮食质量与心血管结局之间的关系。
5-6 岁时较高的饮食质量与较低的 BMI（DASH 评分：Q5 和 Q1 五分位差为-0.35kg/m，趋势 p 值=0.016）、较低的 WC（DASH 评分：Q5 和 Q1 五分位差为-1.0cm，趋势 p 值=0.028）、较低的收缩压（DASH 评分：Q5 和 Q1 五分位差为-2.7mmHg，趋势 p 值=0.046）和舒张压（DASH 评分：Q5 和 Q1 五分位差为-2.4mmHg，趋势 p 值<0.001）以及较低的血浆甘油三酯（DASH 评分：Q5 和 Q1 五分位差为-0.20mmol/L，趋势 p 值=0.032）有关。CDQS 与这些结局的关联也呈现出类似的趋势，但程度较轻。我们没有发现饮食质量与 LDL-C、HDL-C、总胆固醇、空腹血糖或 CIMT 之间存在统计学显著的关联。
5-6 岁时较高的儿童饮食质量预示着青春期前一些心血管结局的健康状况更好。
