Abstract
Background
Few studies have evaluated the long-term relationship between diet quality and cardiometabolic
risk factor clustering among children. The moderating effect of socio-economic status
(SES) is of interest.
Objective
To investigate the association between diet quality with cardiometabolic risk among
Chinese children and to explore the moderating effect of SES.
Design
In this cohort study, 5 waves (1997-2009) of the China Health and Nutrition Survey
were used. Diet quality was measured by a modified version of the Chinese Children
Dietary Index (mCCDI) based on Dietary Guidelines for Chinese.
Participants
Children between the ages of 7 and 17 (n = 2903) who completed at least 2 surveys
were included. Those who missed measures or had hypertension or diabetes at baseline
were excluded.
Main outcome measures
The fasting blood samples were collected in 2009. Waist circumference (WC) and blood
pressure (BP) were measured in each survey.
Statistical analysis performed
A continuous cardiometabolic risk score (MetScore) was derived by a confirmatory factor
analysis of 5 components: WC, BP, glucose, triglycerides, and high-density lipoprotein
cholesterol. Considering the latency period of the effect of behaviors, the mCCDI
was lagged by the period between surveys. Linear regression was used to analyze the
association of mCCDI with MetScore and its components. Mixed effect linear regression
and lagged mCCDI were used for WC and BP models.
Results
Higher mCCDI was independently associated with a lower MetScore at follow-up (β: −.11;
95% CI: −.18 to −.04). Higher lagged mCCDI over time was associated with a lower WC
z score overall (β: −.05; 95% CI: −.08 to −.01) and among children in the low SES group
(β: −.09; 95% CI: −.14 to −.04) but not those in the high SES group. When examining
the 15 mCDDI components separately, scores for 5 components: more grains, vegetables,
soybeans and its products; less sugar-sweetened beverages; and more diet variety were
significantly associated with a lower MetScore.
Conclusions
Among Chinese children, higher diet quality measured by mCCDI was independently associated
with a lower MetScore at follow-up.
Keywords
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Biography
M. Liu is a student, Julius Global Health, The Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Biography
Q.-t. Chen is a researcher, College of Language Intelligence, Sichuan International Studies University, Chongqing, China.
Biography
Z.-c. Li is a student, School of Health Sciences, Wuhan University, Wuhan, China; Department of Epidemiology, University of Washington School of Public Health, Seattle.
Biography
J. Zhang is a student, School of Health Sciences, Wuhan University, Wuhan, China.
Biography
P.-g. Wang is a professor, School of Health Sciences, Wuhan University, Wuhan, China.
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Q.-q. He is a professor, School of Health Sciences, Wuhan University, Wuhan, China.
Article info
Publication history
Published online: April 20, 2021
Accepted:
March 14,
2021
Received:
October 12,
2020
Footnotes
Supplementary materials: Tables 2 and 4 are available at www.jandonline.org
Reprint contact: Qi-qiang He, PhD, School of Health Sciences, Wuhan University, Wuhan, PR China. E-mail: [email protected]
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT There is no funding to disclose.
Identification
Copyright
© 2021 by the Academy of Nutrition and Dietetics.
