Vingrys Kristina, Hébert James R, Chen Ling-Wei, Crozier Sarah, Duijts Liesbeth, Harvey Nicholas C, Jaddoe Vincent W V, Kelleher Cecily, McAuliffe Fionnuala M, Polanska Kinga, Suderman Matthew, Jerzynska Joanna, Bottai Matteo, Segurado Ricardo, Phillips Catherine M
School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin, Ireland; Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia; VU First Year College®, Victoria University, Melbourne, Victoria, Australia.
Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA.
Clin Nutr. 2025 Feb;45:223-233. doi: 10.1016/j.clnu.2024.12.023. Epub 2025 Jan 6.
BACKGROUND & AIMS: Childhood adiposity and inflammation impact long-term health. However, associations between dietary inflammation and childhood adiposity are unclear. We investigated if more pro-inflammatory diets are associated with greater adiposity in early-, mid-, and late-childhood.
We pooled individual participant data (IPD) from 13,978 children in six European birth cohorts in the ALPHABET consortium: Lifeways Cross-Generation Cohort Study (Lifeways), the Randomised cOntrol trial of LOw glycaemic index diet during pregnancy study (ROLO), the Avon Longitudinal Study of Parents and Children (ALSPAC), the Southampton Women's Survey (SWS), the Polish Mother and Child Cohort (REPRO_PL), and The Generation R Study (Generation R). Dietary inflammation was determined using the Children's Dietary Inflammatory Index (C-DII™). Adiposity-related outcomes included BMI z-score (primary outcome), abdominal circumference, skinfolds, fat-mass- and fat-free-mass-indices (secondary outcomes). Two-stage random effects IPD meta-analysis (IPD-MA), with adjusted linear and logistic regression models, was conducted. Quantile regression (QR) examined C-DII associations with BMI z-score percentiles.
Median, 25th and 75th percentile C-DII scores trended upwards from early 0.18 (-0.65, 1.03) to late-childhood 0.51 (-0.40, 1.49). Pooled QR revealed positive C-DII associations across BMI z-score percentiles, particularly in late-childhood unadjusted β (95 % CI) 75th (0.075 (0.046, 0.105), p < 0.001); 85th (0.077 (0.045, 0.108), p < 0.001); and 95th (0.051 (0.011, 0.091), p = 0.01). Adjusted cohort-specific QR identified contrasting associations at early-childhood (ALSPAC and SWS) and late-childhood (Generation R). Pooled adjusted IPD-MA showed C-DII associations with late-childhood obesity [OR (95 % CI) 0.89 (0.81, 0.97), p = 0.01].
C-DII associations across BMI z-score distribution varied by cohort, quantile, and time-point, with some potentially explained by adiposity rebound, reverse causation and questionnaire response biases, highlighting insights not evident with linear regression.
儿童肥胖和炎症会影响长期健康。然而，饮食炎症与儿童肥胖之间的关联尚不清楚。我们调查了促炎作用更强的饮食是否与儿童早期、中期和晚期的更高肥胖程度相关。
我们汇总了ALPHABET联盟中六个欧洲出生队列的13978名儿童的个体参与者数据（IPD）：生活方式跨代队列研究（Lifeways）、孕期低血糖指数饮食随机对照试验（ROLO）、雅芳亲子纵向研究（ALSPAC）、南安普顿妇女调查（SWS）、波兰母婴队列（REPRO_PL）和R代研究（Generation R）。使用儿童饮食炎症指数（C-DII™）来确定饮食炎症。与肥胖相关的结果包括BMI z评分（主要结果）、腹围、皮褶厚度、脂肪量和去脂体重指数（次要结果）。进行了两阶段随机效应IPD荟萃分析（IPD-MA），采用调整后的线性和逻辑回归模型。分位数回归（QR）研究了C-DII与BMI z评分百分位数之间的关联。
C-DII评分的中位数、第25和第75百分位数从儿童早期的0.18（-0.65，1.03）到儿童晚期的0.51（-0.40，1.49）呈上升趋势。汇总的QR显示，C-DII与BMI z评分百分位数之间存在正相关，特别是在儿童晚期，未调整的β（95%CI）在第75百分位数（0.075（0.046，0.105），p<0.001）；第85百分位数（0.077（0.045，0.108），p<0.001）；以及第95百分位数（0.051（0.011，0.091），p=0.01）。调整后的特定队列QR在儿童早期（ALSPAC和SWS）和儿童晚期（R代）发现了相反的关联。汇总的调整后IPD-MA显示，C-DII与儿童晚期肥胖相关[OR（95%CI）0.89（0.81，0.97），p=0.01]。
C-DII与BMI z评分分布之间的关联因队列、分位数和时间点而异，其中一些可能由肥胖反弹、反向因果关系和问卷回答偏差来解释，这突出了线性回归中不明显的见解。
