Browsing by Subject "diet quality"

Background and aims: Childhood obesity has increased worldwide and is a public health concern. Overweight and obese children have a higher risk of being obese and having adverse health outcomes also later in life. Obesity can also have an adverse effect on the quality of life in children and can reduce life expectancy. One of the main risk factors for childhood obesity is lifestyle such as poor diet quality and lack of physical activity. Maternal lifestyle factors, obesity and gestational diabetes (GDM) during pregnancy are also associated with a higher risk of obesity and adverse health outcomes in the offspring. One potential explanation is the theory of developmental programming and epigenetic mechanisms. There is a need for effective methods for preventing childhood obesity in the society. The aim of this thesis was to examine the association between overall diet quality and adiposity in children aged 4—6 years in a cross-sectional analysis. The other aim was to explore in a prospective analysis if maternal pre-pregnancy BMI modifies this association. Material and methods: The data used in this thesis is from the RADIEL-study (The Finnish Gestational Diabetes Prevention Study). It was a multi-center randomized intervention study that recruited women at high risk for GDM before or in early pregnancy. The 720 women that participated had a BMI≥30 kg/m2 and/or a history of GDM. The study also includes a follow-up cohort study five years after delivery with 379 participating mother-child pairs. The follow-up visit included measurements of anthropometrics and body composition, as well as laboratory analyses from both mothers and children. Food records and background questionnaires were also collected. In this thesis, diet was measured with 3-day food records. The overall diet quality of the children was measured with the Finnish Children Healthy Eating Index (FCHEI). The indicators describing offspring adiposity were body fat percentage ((BF%) measured with bioimpedance method), ISO-BMI, and waist circumference (WC). The association between FCHEI and variables for adiposity were tested with multivariate linear regression models. To examine if the maternal pre-pregnancy BMI modifies this association the interaction between maternal BMI and FCHEI for the adiposity indicators were examined. If an interaction was found, the associations were analysed in two groups based on the BMI of the mother (BMI<30 and BMI≥30 kg/m2). The models were adjusted for age, sex, education of the mother, total family income, and energy intake. The association between the separate food groups included in the FCHEI and indicators of adiposity were also analysed in the whole group and adjusted for covariates. Results: A positive association between the FCHEI-score (points) and BF% (β 0,11; 95 % CI 0,01, 0,21) was found. There was also a positive association between FCHEI (points) and ISO-BMI (no unit) (β 0,08; 95 % CI 0,02, 0,14) and between FCHEI (points) and WC (cm) (β 0,08; 95 % CI 0,01, 0,15). Maternal BMI modified the association between FCHEI and BF% (p for interaction = 0,048). A positive association between FCHEI (points) and BF% was found in the group with maternal BMI≥30 kg/m2 (β 0,18; 95 % CI 0,05, 0,30) but not in the group with maternal BMI <30 kg/m2 (p>0,05). The consumption of skimmed milk (food group, points) was associated with higher BF% (standardized β 0,12; 95 % CI 0,00, 0,54), ISO-BMI (no unit) (standardized β 0,18; 95 % CI 0,10, 0,43), and WC (cm) (standardized β 0,13; 95 % CI -0,41, 1,75) in the whole group. No other associations were found between food groups and adiposity indicators. Conclusion: A higher FCHEI score was associated with higher BF%, ISO-BMI, and WC in 4-6-year-old children. The association between FCHEI and BF% was modified by maternal BMI before pregnancy. The consumption of skimmed milk was associated with higher adiposity.