Diet quality trajectories and cardiovascular phenotypes/metabolic syndrome risk by 11–12 years

Objective: To investigate associations between early-life diet trajectories and preclinical cardiovascular phenotypes and metabolic risk by age 12 years. Methods: Participants were 1861 children (51% male) from the Longitudinal Study of Australian Children. At five biennial waves from 2–3 to 10–11 years: Every 2 years from 2006 to 2014, diet quality scores were collected from brief 24-h parent/self-reported dietary recalls and then classified using group-based trajectory modeling as ‘never healthy’ (7%), ‘becoming less healthy’ (17%), ‘moderately healthy’ (21%), and ‘always healthy’ (56%). At 11–12 years: During children’s physical health Child Health CheckPoint (2015–2016), we measured cardiovascular functional (resting heart rate, blood pressure, pulse wave velocity, carotid elasticity/distensibility) and structural (carotid intima-media thickness, retinal microvasculature) phenotypes, and metabolic risk score (composite of body mass index z-score, systolic blood pressure, high-density lipoproteins cholesterol, triglycerides, and glucose). Associations were estimated using linear regression models (n = 1100–1800) adjusted for age, sex, and socioeconomic position. Results: Compared to ‘always healthy’, the ‘never healthy’ trajectory had higher resting heart rate (2.6 bpm, 95% CI 0.4, 4.7) and metabolic risk score (0.23, 95% CI 0.01, 0.45), and lower arterial elasticity (−0.3% per 10 mmHg, 95% CI −0.6, −0.1) and distensibility (−1.2%, 95% CI −1.9, −0.5) (all effect sizes 0.3–0.4). Heart rate, distensibility, and diastolic blood pressure were progressively poorer for less healthy diet trajectories (linear trends p ≤ 0.02). Effects for systolic blood pressure, pulse wave velocity, and structural phenotypes were less evident. Conclusions: Children following the least healthy diet trajectory had poorer functional cardiovascular phenotypes and metabolic syndrome risk, including higher resting heart rate, one of the strongest precursors of all-cause mortality. Structural phenotypes were not associated with diet trajectories, suggesting the window to prevent permanent changes remains open to at least late childhood.