Meghan McGee1,2, Sharon Unger1,3,4,5, Jill Hamilton1,3,6, Catherine S Birken1,2,3,7,8, Zdenka Pausova1,2,9, Alex Kiss10,11, Nicole Bando2, Deborah L O'Connor1,2,4. 1. Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada. 2. Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada. 3. Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada. 4. Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada. 5. Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada. 6. Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada. 7. Division of Pediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada. 8. Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada. 9. Department of Physiology, University of Toronto, Toronto, Ontario, Canada. 10. Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada. 11. Evaluative and Clinical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada.
Abstract
BACKGROUND: Very low birth weight (VLBW; <1500 g) infants have increased adiposity and metabolic disease risk in adulthood. Limited evidence suggests low-quality childhood diets are a predisposing risk factor. Despite this, to our knowledge no study has yet examined associations between diet quality and body composition in VLBW individuals. OBJECTIVE: The objective of this study was to determine associations between Healthy Eating Index-2010 (HEI-2010) scores and consumption of fruits/vegetables, added sugars, and macronutrients with body composition in 5.5-y-old children born VLBW. We hypothesized HEI-2010 scores were inversely associated with adiposity. METHODS: This cohort study leveraged the 5.5-y follow-up to the Donor Milk for Improved Neurodevelopmental Outcomes randomized controlled trial. From June 2016 to July 2018, participants attended a follow-up visit at The Hospital for Sick Children, Canada, or were visited in their home. All 316 surviving infants from the trial were eligible, and the caregivers of 158 children (50%; 53% male) consented to follow-up. Diet quality (HEI-2010) and usual intake of fruits/vegetables, added sugars, and macronutrients were determined from two 24-h dietary recalls (ASA24). Linear regressions evaluated associations of diet with BMI (kg/m2) and waist circumference z-scores, total fat, fat-free mass (air displacement plethysmography), and skinfolds. RESULTS: Mean ± SD age at follow-up was 5.7 ± 0.2 y, birth weight was 1013 ± 264 g, and gestational age was 27.9 ± 2.5 wk. Dietary data and BMI z-scores were available for all children; 123 completed air displacement plethysmography. HEI-2010 score was 58.2 ± 12.4 out of 100, and 27% of children had poor quality diets (scores ≤50). HEI-2010 scores were inversely associated with BMI z-score, but only in children with obese mothers. A 10-point increase in HEI-2010 score was associated with reduced BMI (β: -0.5 SD; 95% CI: -0.7, -0.2) and subscapular (-0.3 SD; 95% CI: -0.6, -0.06) z-scores. CONCLUSIONS: Improving diet quality in children born VLBW with obese mothers may be an important strategy to prevent excess adiposity. This trial was registered at clinicaltrials.gov as Optimizing Mothers' Milk for Preterm Infants (OptiMoM) Program of Research: Study 1-Impact of Donor Milk at Kindergarten, NCT02759809.
BACKGROUND: Very low birth weight (VLBW; <1500 g) infants have increased adiposity and metabolic disease risk in adulthood. Limited evidence suggests low-quality childhood diets are a predisposing risk factor. Despite this, to our knowledge no study has yet examined associations between diet quality and body composition in VLBW individuals. OBJECTIVE: The objective of this study was to determine associations between Healthy Eating Index-2010 (HEI-2010) scores and consumption of fruits/vegetables, added sugars, and macronutrients with body composition in 5.5-y-old children born VLBW. We hypothesized HEI-2010 scores were inversely associated with adiposity. METHODS: This cohort study leveraged the 5.5-y follow-up to the Donor Milk for Improved Neurodevelopmental Outcomes randomized controlled trial. From June 2016 to July 2018, participants attended a follow-up visit at The Hospital for Sick Children, Canada, or were visited in their home. All 316 surviving infants from the trial were eligible, and the caregivers of 158 children (50%; 53% male) consented to follow-up. Diet quality (HEI-2010) and usual intake of fruits/vegetables, added sugars, and macronutrients were determined from two 24-h dietary recalls (ASA24). Linear regressions evaluated associations of diet with BMI (kg/m2) and waist circumference z-scores, total fat, fat-free mass (air displacement plethysmography), and skinfolds. RESULTS: Mean ± SD age at follow-up was 5.7 ± 0.2 y, birth weight was 1013 ± 264 g, and gestational age was 27.9 ± 2.5 wk. Dietary data and BMI z-scores were available for all children; 123 completed air displacement plethysmography. HEI-2010 score was 58.2 ± 12.4 out of 100, and 27% of children had poor quality diets (scores ≤50). HEI-2010 scores were inversely associated with BMI z-score, but only in children with obese mothers. A 10-point increase in HEI-2010 score was associated with reduced BMI (β: -0.5 SD; 95% CI: -0.7, -0.2) and subscapular (-0.3 SD; 95% CI: -0.6, -0.06) z-scores. CONCLUSIONS: Improving diet quality in children born VLBW with obese mothers may be an important strategy to prevent excess adiposity. This trial was registered at clinicaltrials.gov as Optimizing Mothers' Milk for Preterm Infants (OptiMoM) Program of Research: Study 1-Impact of Donor Milk at Kindergarten, NCT02759809.
Authors: Mercedes de Onis; Adelheid W Onyango; Elaine Borghi; Amani Siyam; Chizuru Nishida; Jonathan Siekmann Journal: Bull World Health Organ Date: 2007-09 Impact factor: 9.408
Authors: Charles T Wood; Olivia Linthavong; Eliana M Perrin; Alan Leviton; Elizabeth N Allred; Karl C K Kuban; T Michael O'Shea Journal: Pediatrics Date: 2018-10-05 Impact factor: 7.124
Authors: Sharon I Kirkpatrick; Anne M Gilsing; Erin Hobin; Nathan M Solbak; Angela Wallace; Jess Haines; Alexandra J Mayhew; Sarah K Orr; Parminder Raina; Paula J Robson; Jocelyn E Sacco; Heather K Whelan Journal: Nutrients Date: 2017-01-31 Impact factor: 5.717
Authors: Anke Raaijmakers; Lotte Jacobs; Maissa Rayyan; Theun Pieter van Tienoven; Els Ortibus; Elena Levtchenko; Jan A Staessen; Karel Allegaert Journal: PLoS One Date: 2017-03-09 Impact factor: 3.240