Are the EAT-Lancet dietary recommendations associated with future cardiometabolic health? - Insights from the Generation XXI cohort from childhood into early adolescence

Abstract

Background: The prospective effect of healthy and planetary diets on cardiometabolic health at young ages remains unclear.

Objectives: This study aims to investigate the prospective associations between adherence to the EAT-Lancet dietary recommendations at age 7 and the prevalence of obesity and Metabolic Syndrome (MetS) at 7, 10, and 13 y old.

Methods: Participants are children from the Generation XXI birth cohort who completed 3-d food diaries at age 7, with complete data in variables of interest (n = 3564). Adherence to the EAT-Lancet dietary recommendations was evaluated using the World Index for Sustainability and Health (WISH); a higher score indicates a healthier and environmentally sustainable diet. At 7, 10, and 13 y, anthropometrics (weight, height, and waist circumference), blood pressure, serum-fasting triglycerides, high-density lipoprotein cholesterol, and glucose were measured. Obesity and MetS prevalence were determined by the World Health Organization and the International Diabetes Federation criteria, respectively. Adjusted custom binomial log-linear models were used to calculate prevalence ratios (PR) and the respective 95% confidence intervals (95% CI) (covariates: mother's age, education, prepregnancy body mass index (BMI), gestational diabetes, child's sex, age, Tanner stage, sports practice and total grams of the remaining food).

Results: From 7 to 13 y, obesity decreased from 14.1% to 9.3% and MetS increased from 1.0% to 5.1%. Higher WISH scores at 7 y were associated with a lower prevalence of obesity, measured by both BMI (≥97th percentile: PR = 0.912; 95% CI: 0.839, 0.991; PR = 0.882; 95% CI: 0.79, 0.938, respectively at 10 and 13 y) and waist circumference (≥90th percentile: PR = 0.899; 95% CI: 0.830, 0.974; PR = 0.858; 95% CI: 0.782, 0.942, respectively at 10 and 13 y). For each 10-point increase in the WISH, a reduction of 16% in MetS prevalence at 13 y was observed (PR = 0.837; 95% CI: 0.732, 0.957). No significant effects were found at younger ages.

Conclusions: Adherence to the EAT-Lancet diet from an early age may help reduce cardiometabolic risk in early adolescence.

Keywords: adolescents; cardiometabolic health; children; cohort studies; feeding behavior; metabolic syndrome; obesity.