Teixeira Beatriz, Afonso Cláudia, Severo Milton, Oliveira Andreia
Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto (Institute of Public Health, University of Porto), Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (Laboratory for Integrative and Translational Research in Population Health), Porto, Portugal.
Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto (Institute of Public Health, University of Porto), Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (Laboratory for Integrative and Translational Research in Population Health), Porto, Portugal.
Am J Clin Nutr. 2024 Dec;120(6):1344-1353. doi: 10.1016/j.ajcnut.2024.09.023. Epub 2024 Sep 27.
The prospective effect of healthy and planetary diets on cardiometabolic health at young ages remains unclear.
This study aims to investigate the prospective associations between adherence to the EAT-Lancet dietary recommendations at age 7 and the prevalence of obesity and Metabolic Syndrome (MetS) at 7, 10, and 13 y old.
Participants are children from the Generation XXI birth cohort who completed 3-d food diaries at age 7, with complete data in variables of interest (n = 3564). Adherence to the EAT-Lancet dietary recommendations was evaluated using the World Index for Sustainability and Health (WISH); a higher score indicates a healthier and environmentally sustainable diet. At 7, 10, and 13 y, anthropometrics (weight, height, and waist circumference), blood pressure, serum-fasting triglycerides, high-density lipoprotein cholesterol, and glucose were measured. Obesity and MetS prevalence were determined by the World Health Organization and the International Diabetes Federation criteria, respectively. Adjusted custom binomial log-linear models were used to calculate prevalence ratios (PR) and the respective 95% confidence intervals (95% CI) (covariates: mother's age, education, prepregnancy body mass index (BMI), gestational diabetes, child's sex, age, Tanner stage, sports practice and total grams of the remaining food).
From 7 to 13 y, obesity decreased from 14.1% to 9.3% and MetS increased from 1.0% to 5.1%. Higher WISH scores at 7 y were associated with a lower prevalence of obesity, measured by both BMI (≥97th percentile: PR = 0.912; 95% CI: 0.839, 0.991; PR = 0.882; 95% CI: 0.79, 0.938, respectively at 10 and 13 y) and waist circumference (≥90th percentile: PR = 0.899; 95% CI: 0.830, 0.974; PR = 0.858; 95% CI: 0.782, 0.942, respectively at 10 and 13 y). For each 10-point increase in the WISH, a reduction of 16% in MetS prevalence at 13 y was observed (PR = 0.837; 95% CI: 0.732, 0.957). No significant effects were found at younger ages.
Adherence to the EAT-Lancet diet from an early age may help reduce cardiometabolic risk in early adolescence.
健康饮食和地球饮食对年轻人心脏代谢健康的前瞻性影响尚不清楚。
本研究旨在调查7岁时遵循《柳叶刀》饮食建议与7岁、10岁和13岁时肥胖和代谢综合征（MetS）患病率之间的前瞻性关联。
参与者来自二十一世纪出生队列的儿童，他们在7岁时完成了3天的食物日记，且在感兴趣的变量方面有完整数据（n = 3564）。使用世界可持续发展与健康指数（WISH）评估对《柳叶刀》饮食建议的遵循情况；分数越高表明饮食越健康且对环境可持续。在7岁、10岁和13岁时，测量人体测量指标（体重、身高和腰围）、血压、空腹血清甘油三酯、高密度脂蛋白胆固醇和血糖。肥胖和MetS患病率分别根据世界卫生组织和国际糖尿病联盟的标准确定。使用调整后的定制二项式对数线性模型计算患病率比（PR）和相应的95%置信区间（95%CI）（协变量：母亲年龄、教育程度、孕前体重指数（BMI）、妊娠期糖尿病、儿童性别、年龄、坦纳分期、体育锻炼和剩余食物的总克数）。
从7岁到13岁，肥胖率从14.1%降至9.3%，MetS患病率从1.0%升至5.1%。7岁时较高的WISH分数与较低的肥胖患病率相关，通过BMI（≥第97百分位数：PR = 0.912；95%CI：0.839，0.991；10岁和13岁时分别为PR = 0.882；95%CI：0.79，0.938）和腰围（≥第90百分位数：PR = 0.899；95%CI：0.830，0.974；10岁和13岁时分别为PR = 0.858；95%CI：0.782，0.942）衡量。WISH每增加10分，13岁时MetS患病率降低16%（PR = 0.837；95%CI：0.732，0.957）。在较小年龄时未发现显著影响。
从小坚持《柳叶刀》饮食可能有助于降低青春期早期的心脏代谢风险。
