Associations between Diet Quality and Body Composition in Young Children Born with Very Low Body Weight

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.

Diet Quality and Cognitive Performance in Children Born Very Low Birth Weight

“…HEI-2010 diet quality scores ranged from 19.2 to 87.1, with a mean (SD) of 58.2 (12.4). As previously reported ( 28 ), most children had diet scores that fell within the “poor” (43/158 children) or “needs improvement” (106/158 children) diet quality categories. Only 6% of our cohort had HEI-2010 scores that were above 80, indicative of a good quality diet meeting recommended age-specific guidelines.…”

“…Fifty percent of mothers in our sample had an education level of university or above and 20% had incomes below the poverty line. As reported previously, except for maternal education, no statistically significant differences in baseline characteristics were found between children who participated in the 5-year follow-up and those who did not ( 28 ). Mothers of children who participated in the follow-up study were more educated than mothers of children who did not ( p = 0.02).…”

“…A 24-h dietary recall was completed with parents during the study visit and parents were contacted 1 week later to complete a second recall by phone or email as described in detail previously ( 28 ). Briefly, the 24-h dietary recall asks parents to detail everything their child ate and drank in the previous day using the Automated Self-Administered 24-h (ASA24) Dietary Assessment tool, Canadian version (2016).…”

The Influence of Relative Reinforcing Value of Food, Sensitization, Energy Intake and Diet Quality on zBMI Change over Two Years in Adolescents: A Longitudinal Cohort Study

“…Lower diet quality scores are associated with food insecurity [15] and higher metabolic disease risk [16]. The relationship between diet quality score and weight status, however, is equivocal, with some studies showing no association [17,18] and others showing an inverse association [19,20]. Previous studies have not explored relationships between diet quality and the RRV of HED or LED food.…”

The association between the Healthy Eating Index (HEI-2015) score and body composition among Iranian soccer players and referees: a cross-sectional study

“…Several studies have been published on the association of single nutrients or energy and macronutrient intake and the performance of athletic populations (20)(21)(22) . Although several studies investigated the association between the HEI and body composition among children (23,24) and healthy nonathletic adults (25)(26)(27)(28) , to the best of our knowledge, no single study has investigated the association of the HEI-2015 score with body composition among both male and female soccer players and referees before. Different genetics of Iranians, Iranian traditional dishes and differences in their cooking methods and also higher physical activity level and nutritional knowledge among athletic v. non-athletic populations (29)(30)(31) are among key determinants that can affect body composition and distinguish athletic and non-athletic populations and these differences clarify the novelty of the present study.…”