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Pediatrics

Diet quality trajectories and cardiovascular phenotypes/metabolic syndrome risk by 11–12 years

International Journal of Obesity volume 45, pages 1392–1403 (2021)Cite this article

Subjects

Abstract

Objective

To investigate associations between early-life diet trajectories and preclinical cardiovascular phenotypes and metabolic risk by age 12 years.

Methods

Participants were 1861 children (51% male) from the Longitudinal Study of Australian Children. At five biennial waves from 2–3 to 10–11 years: Every 2 years from 2006 to 2014, diet quality scores were collected from brief 24-h parent/self-reported dietary recalls and then classified using group-based trajectory modeling as ‘never healthy’ (7%), ‘becoming less healthy’ (17%), ‘moderately healthy’ (21%), and ‘always healthy’ (56%). At 11–12 years: During children’s physical health Child Health CheckPoint (2015–2016), we measured cardiovascular functional (resting heart rate, blood pressure, pulse wave velocity, carotid elasticity/distensibility) and structural (carotid intima-media thickness, retinal microvasculature) phenotypes, and metabolic risk score (composite of body mass index z-score, systolic blood pressure, high-density lipoproteins cholesterol, triglycerides, and glucose). Associations were estimated using linear regression models (n = 1100–1800) adjusted for age, sex, and socioeconomic position.

Results

Compared to ‘always healthy’, the ‘never healthy’ trajectory had higher resting heart rate (2.6 bpm, 95% CI 0.4, 4.7) and metabolic risk score (0.23, 95% CI 0.01, 0.45), and lower arterial elasticity (−0.3% per 10 mmHg, 95% CI −0.6, −0.1) and distensibility (−1.2%, 95% CI −1.9, −0.5) (all effect sizes 0.3–0.4). Heart rate, distensibility, and diastolic blood pressure were progressively poorer for less healthy diet trajectories (linear trends p ≤ 0.02). Effects for systolic blood pressure, pulse wave velocity, and structural phenotypes were less evident.

Conclusions

Children following the least healthy diet trajectory had poorer functional cardiovascular phenotypes and metabolic syndrome risk, including higher resting heart rate, one of the strongest precursors of all-cause mortality. Structural phenotypes were not associated with diet trajectories, suggesting the window to prevent permanent changes remains open to at least late childhood.

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Fig. 1: Diet trajectories for LSAC’s B-Cohort, age 2–11 years.
Fig. 2: Standardised mean differences (i.e. effect size) for preclinical cardiovascular functional phenotypes by diet trajectory.

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Acknowledgements

This paper uses data from Growing Up in Australia, the Longitudinal Study of Australian Children (LSAC). The study is conducted in partnership between the Department of Social Services (DSS), the Australian Institute of Family Studies (AIFS) and the Australian Bureau of Statistics (ABS). The authors thank all families, senior researchers, research assistants, students, and interns who assisted in LSAC and CheckPoint data collection and management. The findings and views reported in this paper are those of the authors and should not be attributed to DSS, AIFS, or the ABS. REDCap (Research Electronic Data Capture) electronic data capture tools were used in this study. More information about this software can be found at: www.project-redcap.org. We thank the LSAC and CheckPoint study participants, staff, and students for their contributions.

Funding

The Child Health CheckPoint was supported by the National Health and Medical Research Council (NHMRC) of Australia (Project Grants 1041352, 1109355), The Royal Children’s Hospital Foundation (2014-241), the Murdoch Children’s Research Institute (MCRI), The University of Melbourne, the National Heart Foundation of Australia (100660), Financial Markets Foundation for Children (2014-055, 2016-310) and the Victorian Deaf Education Institute. The following authors were supported by the NHMRC: MW (Principal Research Fellowship 1160906), DB (Senior Research Fellowship 1064629); FKM (Career Development Fellowship 1111160); KL (Early Career Fellowship 1091124). The following authors were supported by the National Heart Foundation of Australia: Honorary Future Leader Fellowship to DB (100369); Postdoctoral Fellowship to KL (101239). The MCRI administered the research grants for the study and provided infrastructural support to its staff and the study, but played no role in the conduct or analysis of the study. DSS played a role in study design; however, no other funding bodies had a role in the study design and conduct; data collection, management, analysis and interpretation; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Murdoch Children’s Research Institute, Parkville, VIC, Australia

    Jessica A. Kerr, Richard S. Liu, Constantine E. Gasser, Fiona K. Mensah, David Burgner, Kate Lycett, Alanna N. Gillespie, Markus Juonala, Susan A. Clifford, Tim Olds, Richard Saffery, Lisa Gold, Mengjiao Liu, Peter Azzopardi & Melissa Wake

  2. The University of Melbourne, Parkville, VIC, Australia

    Jessica A. Kerr, Richard S. Liu, Constantine E. Gasser, Fiona K. Mensah, David Burgner, Kate Lycett, Alanna N. Gillespie, Susan A. Clifford, Richard Saffery, Mengjiao Liu, Peter Azzopardi & Melissa Wake

  3. Australian Institute of Family Studies, Southbank, VIC, Australia

    Constantine E. Gasser

  4. Monash University, Clayton, VIC, Australia

    David Burgner

  5. Deakin University, Burwood, VIC, Australia

    Kate Lycett

  6. Department of Internal Medicine, University of Turku, Turku, Finland

    Markus Juonala

  7. Division of Medicine, Turku University Hospital, Turku, Finland

    Markus Juonala

  8. Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia

    Tim Olds

  9. Maternal and Child Health Program, International Development Discipline, Burnet Institute, Melbourne, Australia

    Peter Azzopardi

  10. Australian National University Centre for Social Research and Methods, Canberra, ACT, Australia

    Ben Edwards

  11. The George Institute for Global Health, University of Oxford, Oxford, UK

    Terence Dwyer

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Contributions

JAK planned and conducted the analyses, drafted the initial manuscript, and reviewed and revised the manuscript. CEG created the diet trajectories, and reviewed and revised the manuscript. FKM, DB, MJ, TO, RS, LG, PA, BE, and TD are study investigators involved in the conception and oversight of the Child Health CheckPoint, and provided expert advice and critical review of this manuscript. RSL, KL, and SAC and ANG and ML are study staff, students, and postdoctoral fellows and contributed to data creation and critical review of the manuscript. MW is the principal investigator of the Child Health CheckPoint and provided critical review of this manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Jessica A. Kerr.

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Kerr, J.A., Liu, R.S., Gasser, C.E. et al. Diet quality trajectories and cardiovascular phenotypes/metabolic syndrome risk by 11–12 years. Int J Obes 45, 1392–1403 (2021). https://doi.org/10.1038/s41366-021-00800-x

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