Association between dietary patterns and cardiometabolic health in children: findings from the Childhood Obesity Risk Assessment Longitudinal Study (CORALS) cohort

Background: Dietary habits influence health from childhood, with effects that may persist throughout life. This study aimed to investigate the association between dietary patterns and cardiometabolic risk markers in early childhood. Methods: A cross-sectional analysis was performed within the Childhood Obesity Risk Assessment Longitudinal Study (CORALS) cohort. Diet was assessed by a validated food frequency questionnaire. Dietary patterns were extracted using exploratory factor analysis. Cardiometabolic risk was analysed through internal z-scores, body mass index (BMIz), systolic blood pressure, HDL cholesterol (HDLz), triglycerides and HOMA-IR, and multi-adjusted linear regression models were performed. Results: The analysis included 1426 participants (median age 4.95 years). Two dietary patterns (DPs) were identified: “Core-foods DP” (high in vegetables, fruits, nuts, legumes, fish and white meat) and “Poor-quality DP” (rich in flavoured dairy products, processed meat, pastries, sweets, snacks, precooked foods, other oils and soft drinks). Core-foods DP was inversely associated with BMIz (B = -0.07, p = 0.034), meanwhile the Poor-quality DP was directly associated with triglycerides (B = 0.09, p = 0.015) and higher overweight odds (OR:1.33; 95% CI:1.13–1.56), and inversely with HDLz (B = −0.08, p = 0.036). Conclusion: Poor-quality DP was directly associated with cardiometabolic risk markers in preschool-aged children, emphasizing the importance of diet in preventing the early onset of obesity and cardiometabolic disorders. Impact: This study highlights the impact of dietary patterns on cardiometabolic health in preschool children. A poor-quality dietary pattern is directly associated with BMI and triglycerides and inversely associated with HDL cholesterol, which may contribute to a worse cardiometabolic profile. In contrast, adherence to a core-foods pattern is inversely associated with BMI. These findings reinforce the importance of early nutrition education in preventing obesity and cardiometabolic disorders. This article provides evidence of diet-related metabolic risks in early life to limited existing literature and the need for interventions that promote healthier eating habits from an early age to improve long-term health outcomes.