Prospective association between an obesogenic dietary pattern in early adolescence and metabolomics derived and traditional cardiometabolic risk scores in adolescents and young adults from the ALSPAC cohort

Abstract

Background: Dietary intake during early life may be a modifying factor for cardiometabolic risk (CMR). Metabolomic profiling may enable more precise identification of CMR in adolescence than traditional CMR scores. We aim to assess and compare the prospective associations between an obesogenic dietary pattern (DP) score at age 13 years with a novel vs. traditional CMR score in adolescence and young adulthood in the Avon Longitudinal Study of Parents and Children (ALSPAC).

Methods: Study participants were ALSPAC children with diet diary data at age 13. The obesogenic DP z-score, characterized by high energy-density, high % of energy from total fat and free sugars, and low fibre density, was previously derived using reduced rank regression. CMR scores were calculated by combining novel metabolites or traditional risk factors (fat mass index, insulin resistance, mean arterial blood pressure, triacylglycerol, HDL and LDL cholesterol) at age 15 (n = 1808), 17 (n = 1629), and 24 years (n = 1760). Multivariable linear regression models estimated associations of DP z-score with log-transformed CMR z-scores.

Results: Compared to the lowest tertile, the highest DP z-score tertile at age 13 was associated with an increase in the metabolomics CMR z-score at age 15 (β = 0.20, 95% CI 0.09, 0.32, p trend < 0.001) and at age 17 (β = 0.22, 95% CI 0.10, 0.34, p trend < 0.001), and with the traditional CMR z-score at age 15 (β = 0.15, 95% CI 0.05, 0.24, p trend 0.020). There was no evidence of an association at age 17 for the traditional CMR z-score (β = 0.07, 95% CI -0.03, 0.16, p trend 0.137) or for both scores at age 24.

Conclusions: An obesogenic DP was associated with greater CMR in adolescents. Stronger associations were observed with a novel metabolite CMR score compared to traditional risk factors. There may be benefits from modifying diet during adolescence for CMR health, which should be prioritized for further research in trials.

Keywords: ALSPAC; Adolescence; Cardiometabolic risk; Dietary pattern; Metabolomics.

Fig. 1

Flow chart of the study participants and reasons for exclusion from analyses

Fig. 2

Z-test between DP z-score and the metabolomics and traditional CMR z-scores at age 15, 17 and 24. ^a Z-test was used to compare the association of DP z-score with metabolomics z-score and with the traditional CMR z-score. The formula is z = (x – µ) / (σ√n). x = sample mean, µ = population mean, σ = population standard deviation, n = sample size. ^bEstimates were obtained from regression models between DP score at age 13 years and the metabolomics and conventional CMR score at age 15, 17, and 24 and adjusted for sex, age, dietary misreporting, maternal and paternal social class, maternal educational level, physical activity level (average minutes of moderate-to-vigorous PA per day) at age 13 for both scores, plus body mass index at each correspondent age for the metabolomics score. Abbreviations: CMR = Cardiometabolic risk