Callanan Sophie, Delahunt Anna, Phillips Catherine M, Wilson Zoe, Foley Hannah, McNestry Catherine, Douglass Alexander, Cody Declan, McDonnell Ciara M, Twomey Patrick J, Crowley Rachel K, McAuliffe Fionnuala M
UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
Am J Clin Nutr. 2024 Oct;120(4):891-906. doi: 10.1016/j.ajcnut.2024.07.025. Epub 2024 Jul 27.
Childhood represents a critical period of nutritional risk in the programming of later chronic disease. Few longitudinal studies have explored repeated measures of nutrition throughout the first decade of life in relation to preteen cardiometabolic outcomes.
This research aimed to explore associations of early feeding practices (human milk exposure and duration and timing of introduction to solids) and childhood dietary quality and inflammatory scores (at 5 and 9-11 y and change during childhood) on preteen cardiometabolic outcomes.
This is an analysis of children from the ROLO longitudinal birth cohort study (n = 399). Information on early feeding practices were obtained at postnatal study visits. Food frequency questionnaires collected maternal-reported dietary intakes for each child at 5 and 9-11 y of age. Healthy Eating Index (HEI)-2015 and the Children's Dietary Inflammatory Index (C-DII) scores were calculated. Anthropometry, body composition, blood pressure, heart rate, cardiorespiratory endurance, and blood biomarkers were obtained at 9-11 y. Crude and adjusted linear regression models examined nutritional exposure associations with preteen cardiometabolic outcomes.
In the adjusted model, any human milk exposure was associated with lower body fat (%) at 9-11 y (β: -2.86; 95% confidence interval [CI]: -5.46, -0.27; P = 0.03), than never receiving human milk. At 5 y, diet scores were favorably associated with lean mass at 9-11 y (P < 0.05 for both). Higher preteen HEI-2015 scores were associated with lower preteen leptin levels (tertile 3 compared with tertile 1-β: -2.92; 95% CI: -5.64, -0.21; P = 0.03). Diet quality significantly deteriorated (HEI-2015 score decreased) and became more proinflammatory (C-DII score increased) from 5 to 9-11 y of age. Diet quality/inflammation deterioration (compared with improvement) or overall change in dietary scores were not related to preteen cardiometabolic outcomes.
Exposure to human milk in early life was associated with lower preteen adiposity, irrespective of duration. Diet quality/inflammatory potential deteriorated between early childhood and the preteen years, highlighting a potential period for intervention.
儿童期是后期慢性病编程中营养风险的关键时期。很少有纵向研究探讨生命最初十年中反复测量的营养状况与青春期前心脏代谢结局之间的关系。
本研究旨在探讨早期喂养方式（母乳接触情况、固体食物引入的持续时间和时间）以及儿童期饮食质量和炎症评分（5岁和9 - 11岁时以及儿童期的变化）与青春期前心脏代谢结局之间的关联。
这是对ROLO纵向出生队列研究中的儿童（n = 399）进行的分析。在产后研究访视时获取早期喂养方式的信息。通过食物频率问卷收集母亲报告的每个孩子在5岁和9 - 11岁时的饮食摄入量。计算2015年健康饮食指数（HEI）和儿童饮食炎症指数（C - DII）得分。在9 - 11岁时获取人体测量学、身体成分、血压、心率、心肺耐力和血液生物标志物数据。采用粗线性回归模型和调整线性回归模型检验营养暴露与青春期前心脏代谢结局之间的关联。
在调整模型中，与从未接受母乳相比，任何母乳接触情况都与9 - 11岁时较低的体脂百分比相关（β： - 2.86；95%置信区间[CI]： - 5.46， - 0.27；P = 0.03）。在5岁时，饮食得分与9 - 11岁时的瘦体重呈正相关（两者P < 0.05）。青春期前较高的HEI - 2015得分与较低的青春期前瘦素水平相关（与第一三分位数相比，第三三分位数 - β： - 2.92；95% CI： - 5.64， - 0.21；P = 0.03）。从5岁到9 - 11岁，饮食质量显著下降（HEI - 2015得分降低）且炎症性增强（C - DII得分升高）。饮食质量/炎症恶化（与改善相比）或饮食得分的总体变化与青春期前心脏代谢结局无关。
生命早期接触母乳与青春期前较低的肥胖程度相关，与持续时间无关。儿童早期到青春期前饮食质量/炎症潜力下降，突出了一个潜在的干预时期。
