Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Vanderbilt University School of Nursing, Nashville, Tennessee, USA.
Pediatr Obes. 2023 Aug;18(8):e13037. doi: 10.1111/ijpo.13037. Epub 2023 Apr 18.
To evaluate the association between baseline ultra-processed food consumption in early childhood and child BMI Z-score over 36 months.
We conducted a prospective cohort analysis as a secondary data analysis of the Growing Right Onto Wellness randomised trial. Dietary intake was measured via 24-h diet recalls. The primary outcome was child BMI-Z, measured at baseline and at 3-, 9-, 12-, 24- and 36-month timepoints. Child BMI-Z was modelled using a longitudinal mixed-effects model, adjusting for covariates and stratifying by age.
Among 595 children, median (Q1-Q3) baseline age was 4.3 (3.6-5.0) years, 52.3% of the children were female, 65.4% had normal weight, 33.8% were overweight, 0.8% were obese and 91.3% of parents identified as Hispanic. Model-based estimates suggest that, compared with low ultra-processed consumption (300 kcals/day), high ultra-processed intake (1300 kcals/day) was associated with a 1.2 higher BMI-Z at 36 months for 3-year-olds (95% CI = 0.5, 1.9; p < 0.001) and a 0.6 higher BMI-Z for 4-year-olds (95% CI = 0.2, 1.0; p = 0.007). The difference was not statistically significant for 5-year-olds or overall.
In 3- and 4-year-old children, but not in 5-year-old children, high ultra-processed food intake at baseline was significantly associated with higher BMI-Z at 36-month follow-up, adjusting for total daily kcals. This suggests that it might not be only the total number of calories in a child's daily intake that influences child weight status, but also the number of calories from ultra-processed foods.
评估幼儿期基础超加工食品消费与儿童 BMIZ 分数超过 36 个月的关联。
我们进行了一项前瞻性队列分析，作为 Growing Right Onto Wellness 随机试验的二次数据分析。饮食摄入量通过 24 小时饮食回忆来测量。主要结局是儿童 BMI-Z，在基线和 3、9、12、24 和 36 个月时进行测量。使用纵向混合效应模型对儿童 BMI-Z 进行建模，调整协变量并按年龄分层。
在 595 名儿童中，中位数（Q1-Q3）基线年龄为 4.3（3.6-5.0）岁，52.3%的儿童为女性，65.4%体重正常，33.8%超重，0.8%肥胖，91.3%的父母为西班牙裔。基于模型的估计表明，与低超加工食品摄入量（300 千卡/天）相比，高超加工食品摄入量（1300 千卡/天）与 3 岁儿童 36 个月时 BMI-Z 增加 1.2 相关（95%CI=0.5，1.9；p<0.001），与 4 岁儿童 BMI-Z 增加 0.6 相关（95%CI=0.2，1.0；p=0.007）。对于 5 岁儿童或整体而言，差异无统计学意义。
在 3 岁和 4 岁儿童中，但在 5 岁儿童中，基线超高加工食品摄入量与 36 个月随访时更高的 BMI-Z 显著相关，调整了总每日热量。这表明，可能不仅是儿童每日摄入的总热量会影响儿童的体重状况，而且超加工食品的热量数量也会影响。
