School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, Australia.
Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia.
Eur J Clin Nutr. 2023 Jun;77(6):677-683. doi: 10.1038/s41430-023-01274-y. Epub 2023 Feb 16.
Cardio-metabolic risk factors, including hypertension, are increasingly appearing in childhood. The aims of this study were to examine the associations between dietary trajectories across childhood and subsequent blood pressure (BP) at age 10/11, and to further determine whether these associations were explained by BMI or fat mass.
Data from 4360 participants from the Longitudinal Study of Australian Children were analysed. Dietary scores were computed based on similarity of intake to the Australian Dietary Guidelines. Group-based trajectory modelling was used to identify distinct dietary trajectories based on participant's individual dietary scores at up to four timepoints between age 4 and 11. Linear regression models examined the associations between dietary trajectories and BP measured at age 10/11. Models were adjusted for relevant covariates, and BMI or fat mass.
Four dietary trajectories were identified: "never healthy" (4.3%); "moderately healthy" (23.1%); "becoming less healthy" (14.2%); and "always healthy" (58.4%). Children in the "always healthy" trajectory had a lower systolic (-2.19 mmHg; 95% CI -3.78, -0.59) and diastolic BP (-1.71; -2.95, -0.47), compared with children in the "never healthy" trajectory after covariate adjustment. These associations were attenuated after additional adjustment for BMI or fat mass, but remained significant for diastolic BP.
A dietary trajectory mostly aligned with the Australian Dietary Guidelines across childhood was associated with slightly lower BP at age 10/11, which was not fully explained by BMI or fat mass. These findings support the need to encourage and enable healthy dietary habits early in childhood to attenuate the increasing burden of cardio-metabolic disease.
包括高血压在内的心血管代谢危险因素在儿童期日益出现。本研究的目的是检验儿童期不同的膳食轨迹与 10/11 岁时血压（BP）的后续变化之间的相关性，并进一步确定这些相关性是否可以通过 BMI 或体脂肪量来解释。
对来自澳大利亚儿童纵向研究的 4360 名参与者的数据进行了分析。膳食评分是根据摄入量与澳大利亚膳食指南的相似性计算得出的。采用基于群组的轨迹建模，根据参与者在 4 至 11 岁之间最多四个时间点的个体膳食评分，确定不同的膳食轨迹。线性回归模型检验了在调整了相关协变量、BMI 或体脂肪量后，膳食轨迹与 10/11 岁时测量的 BP 之间的关联。
确定了四种膳食轨迹：“从不健康”（4.3%）；“中度健康”（23.1%）；“变得不那么健康”（14.2%）；“一直健康”（58.4%）。在调整了协变量后，与“从不健康”轨迹相比，“一直健康”轨迹的儿童收缩压（-2.19mmHg；95%CI-3.78，-0.59）和舒张压（-1.71mmHg；-2.95，-0.47）更低。在进一步调整 BMI 或体脂肪量后，这些相关性减弱，但舒张压的相关性仍然显著。
儿童期整体上与澳大利亚膳食指南一致的膳食轨迹与 10/11 岁时的 BP 略低相关，而 BMI 或体脂肪量并不能完全解释这一相关性。这些发现支持需要在儿童早期鼓励和促进健康的饮食习惯，以减轻心血管代谢疾病负担的增加。
