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. 2025 Jan 29;24(1):18.
doi: 10.1186/s12937-025-01080-1.

Association between early dietary patterns and cardiometabolic health at age 8: a confirmatory analysis of the European Childhood Obesity Project

Mariona Gispert-Llauradó  1   2 , Joaquin Escribano  3   4 , Natalia Ferré  1   2 , Veit Grote  5   6 , Berthold Koletzko  5   6 , Gina Ambrosini  7 , Elvira Verduci  8   9 , Dariusz Gruszfeld  10 , Annick Xhonneux  11 , Veronica Luque  12   13
Affiliations

Association between early dietary patterns and cardiometabolic health at age 8: a confirmatory analysis of the European Childhood Obesity Project

Mariona Gispert-Llauradó et al. Nutr J. .

Abstract

Background & aim: Metabolic and cardiovascular health outcomes are strongly influenced by diet. Dietary habits established in early childhood may persist into adulthood. This study aimed to examine the association between dietary patterns at both 2 and 8 years of age, explaining the maximum variability of high- and low-quality fats, sugars, and fibre, and cardiometabolic markers at age 8 years.

Methods: This was a secondary analysis of the European Childhood Obesity Project, formerly a randomized clinical trial across five European countries performed in healthy term newborns. Children in the study were categorized at ages 2 and 8 years into two groups based on cluster analysis of dietary patterns (DP) derived from Reduction Rank Regression (RRR). A cross-sectional and prospective analysis was conducted to evaluate the associations between these DPs and cardiometabolic outcomes, including body mass index (BMI), blood pressure (BP), and biochemical markers. Triglycerides, HDL cholesterol and insulin resistance index (HOMA-IR) were also categorized as altered versus normal values. Asociations between dietary patterns and health outcomes were assessed using linear and logistic regression models, adjusting for covariates based on a step-wise approach.

Results: A total of 336 children were classified based on quality of nutrient intakes into either a "Poor-Quality dietary pattern" (PQ-DP) (48% and 66% of infants at 2 and 8 years, respectively) or the "Health-Conscious dietary pattern" (HC-DP) (52% and 34% of infants at 2 and 8 years, respectively). Following a PQ-DP at both ages 2 and 8 was associated with higher triglycerides (β = 0.061, p = 0.049), systolic and diastolic BP (β = 13.019, p < 0.001 & β = 7.612, p = 0.014, respectively) and altered levels of HOMA-IR (OR = 3.1, p = 0.037, 95% CI = 1.1-9.1) at 8 years, compared to children with an HC-DP at both ages, after adjusting for confounders.

Conclusion: Adherence to a dietary pattern with a poorer nutritional profile in early childhood and school age is associated with worse cardiometabolic risk markers at 8 years old.

Keywords: Cardiometabolic health; Cluster; Early childhood nutrition; Poor quality dietary pattern; Prospective analyses; Reduction rank regression.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was performed following the principles of the Helsinki Declaration [37]. The project was accepted by the corresponding Ethics committees responsible in each study centre: Ethik-Kommission der Bayerishen Landersäzrtekammer, Comité d’Ethique d’Hopital Universitarie des Enfants Reine Fabiola, Brussels (CEH 1402), Comité d’Ethique du Clinique Saint Vincent (0905/DrMM/IS), Comitato Etico Azienda Ospedaliera San Paolo Polo Universitario (1172), Komiscja Bioetyczna Pomnik-Centrum Zdrowia Dziecka ((Code/ID: n°11/2009), Comitè d’Ètica d’Investigació Clínica de l’Hospital Universitari Sant Joan de Reus (09-12-17/12obs1), Comitè d’Ètica d’Investigació Clínica de l’Hospital Universitari de Tarragona Joan XXIII (4/2002). All parents or legal guardians received written information and provided signed consent for their child to participate in the study at recruitment and in the following visits. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Loading factors of the four major extracted factors at 4 years
Fig. 2
Fig. 2
Differences in predictor scores from each extracted factor between dietary patterns groups at 2 (A) and 8 (B) years old. Note: “Median (centre line)”, “Mean (cross)”, “Interquartile Range (Q1-Q3 box)”, “Whiskers (range of acceptable values)”
Fig. 3
Fig. 3
Differences in nutrient intake adjusted by energy between dietary patterns groups at 2 (A) and 8 (B) years old. Note: P value for Mann-Whitney U test between dietary pattern clusters. At 2 years, p < 0.001 in all cases; at 8 years, p < 0.001 in all cases except for fibre. “Median (centre line)”, “Mean (cross)”, “Interquartile Range (Q1-Q3 box)”, “Whiskers (range of acceptable values)”
See this image and copyright information in PMC

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