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Parent reported nutritional risk and laboratory indices of cardiometabolic risk and in preschool-aged children

  • Navindra Persaud , Hedyeh Ziai , Gerald Lebovic , Jonathon L. Maguire , Marina Khovratovich , Janis A. Randall Simpson , Khosrow Adeli , Jill Hamilton , Brian W. McCrindle , Patricia C. Parkin , Catherine S. Birken EMAIL logo and on behalf of the TARGet Kids! collaboration
Published/Copyright: July 19, 2017
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 30 Issue 8

Abstract

Background:

Eating habits formed during childhood may contribute to the increasing prevalence of cardiometabolic disorders. Assessing nutritional risk in young children may help to prevent later cardiometabolic disease. The objective of this study was to determine whether parent-reported nutritional risk in preschool-aged children was associated with laboratory indices of cardiometabolic risk, namely leptin and insulin.

Methods:

In this cross-sectional study, the relationship between nutritional risk as determined by the parent-completed NutriSTEP® questionnaire was assessed and compared to the serum leptin and insulin concentrations, hormones involved in regulation of food intake and biomarkers of adiposity and cardiometabolic risk. The community-based primary care research network for children in Toronto, Canada (TARGet Kids!) was used. The participants were children aged 3–5 years recruited from TARGet Kids! A total of 1856 children were recruited from seven primary care practices. Of these, 1086 children completed laboratory testing. Laboratory data for leptin and insulin were available for 714 and 1054 of those individuals, respectively.

Results:

The total NutriSTEP® score was significantly associated with serum leptin concentrations (p=0.003); for each unit increase in the total NutriSTEP® score, there was an increase of 0.01 ng/mL (95% confidence interval [CI] 0.004–0.018) in serum leptin concentrations after adjusting for potential confounders. The total NutriSTEP® score was not significantly associated with serum insulin concentration.

Conclusions:

Parent reported nutritional risk is associated with serum leptin, but not insulin, concentrations in preschool-aged children. The NutriSTEP® questionnaire may be an effective tool for predicting future cardiometabolic risk in preschool-aged children.

Keywords: child; leptin; metabolism; nutrition assessment; preschool child
Corresponding author: Catherine S. Birken, Associate Professor, Division of Pediatric Medicine, The Hospital for Sick Children, University of Toronto, 686 Bay St, ON M5G 0X4, Canada, Phone: +416-813-4930, Fax: +416-813-5663
TARGet Kids! Collaboration Site Investigators: Jillian Baker, Tony Barozzino, Joey Bonifacio, Douglas Campbell, Sohail Cheema, Brian Chisamore, Karoon Danayan, Paul Das, Mary Beth Derocher, Anh Do, Michael Dorey, Sloane Freeman, Keewai Fung, Charlie Guiang, Curtis Handford, Hailey Hatch, Sheila Jacobson, Tara Kiran, Holly Knowles, Bruce Kwok, Sheila Lakhoo, Margarita Lam-Antoniades, Eddy Lau, Fok-Han Leung, Jennifer Loo, Sarah Mahmoud, Rosemary Moodie, Julia Morinis, Sharon Naymark, Patricia Neelands, James Owen, Michael Peer, Marty Perlmutar, Navindra Persaud, Andrew Pinto, Michelle Porepa, Nasreen Ramji, Noor Ramji, Alana Rosenthal, Janet Saunderson, Rahul Saxena, Michael Sgro, Susan Shepherd, Barbara Smiltnieks, Carolyn Taylor, Thea Weisdors, Sheila Wijayasinghe, Peter Wong, Ethel Ying, Elizabeth Young.

Acknowledgments

The authors thank all participating families for their time and involvement in TARGet Kids! and are grateful to all practitioners who are currently involved in the TARGet Kids! research network. Steering Committee: Tony Barozzino, Brian Chisamore, Mark Feldman, Moshe Ipp. Research Team: Charmaine Camacho, Diviya Elango, Julie DeGroot, Shanique Edwards, Nadia Kabir, Marina Khovratovich, Tarandeep Malhi, Juela Sejdo, Laurie Thompson, Mandy Tran. Applied Health Research Centre: Magda Melo, Patricia Nguyen. Mount Sinai Services Laboratory: Azar Azad.

  1. Author contributions: All of the authors made substantial contributions to the conception and design of the study; the acquisition, analysis and interpretation of the data; and the drafting of the manuscript or its critical revision for important intellectual content. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: This work was supported by the Canadian Institute of Health Research, Physician Services Incorporated, Paediatric Outcomes Research Team through the SickKids Foundation, and St. Michael’s Hospital Foundation (grant number MOP-119375). The funding agencies had no role in the design, analysis or writing of this article.

  3. Employment or leadership: Navindra Persaud is an Associate Editor for CMAJ. Janis Randall Simpson has received grant funding from the Canadian Institutes of Health Research (CIHR); she is a board member for the Danone Institute of Canada; she is a consultant for Dietitians of Canada; she receives royalties for NutriSTEP© licences; and she has been reimbursed for travel expenses by the CIHR. Brian McCrindle is a board member for Medpace; he has been a consultant for Eli Lilly, Merck and Bristol-Myers-Squibb; and he has received grant funding from AstraZeneca. Patricia Parkin and Catherine Birken work for institutions that have received grants from the CIHR. No other competing interests were declared. The other authors have no financial relationships relevant to this article to declare.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2016-8-17
Accepted: 2017-5-12
Published Online: 2017-7-19
Published in Print: 2017-8-28

©2017 Walter de Gruyter GmbH, Berlin/Boston

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  1. Frontmatter
  2. Editorial
  3. Endocrine aspects in cystic fibrosis
  4. Original Articles
  5. A retrospective analysis of longitudinal changes in bone mineral content in cystic fibrosis
  6. Cystic-fibrosis related-diabetes (CFRD) is preceded by and associated with growth failure and deteriorating lung function
  7. Partial clinical remission in type 1 diabetes: a comparison of the accuracy of total daily dose of insulin of <0.3 units/kg/day to the gold standard insulin-dose adjusted hemoglobin A1c of ≤9 for the detection of partial clinical remission
  8. Concentrations of leptin, adiponectin and other metabolic parameters in non-obese children with Down syndrome
  9. Parent reported nutritional risk and laboratory indices of cardiometabolic risk and in preschool-aged children
  10. Multinodular goiter in children: treatment controversies
  11. Atopy as a risk factor for subclinical hypothyroidism development in children
  12. Mutation analysis of the NKX2.5 gene in Iranian pediatric patients with congenital hypothyroidism
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  15. Clinical features and genotyping of patients with primary carnitine deficiency identified by newborn screening
  16. Letter to the Editor
  17. Sensitivity and specificity of cystic fibrosis-related diabetes screening methods: which test should be the reference method?
  18. Case Reports
  19. Type 1 rhizomelic chondrodysplasia punctata with a homozygous PEX7 mutation
  20. Severe hypertriglyceridemia at new onset type 1 diabetes mellitus
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https://doi.org/10.1515/jpem-2016-0328
Keywords for this article
child; leptin; metabolism; nutrition assessment; preschool child

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Endocrine aspects in cystic fibrosis
  4. Original Articles
  5. A retrospective analysis of longitudinal changes in bone mineral content in cystic fibrosis
  6. Cystic-fibrosis related-diabetes (CFRD) is preceded by and associated with growth failure and deteriorating lung function
  7. Partial clinical remission in type 1 diabetes: a comparison of the accuracy of total daily dose of insulin of <0.3 units/kg/day to the gold standard insulin-dose adjusted hemoglobin A1c of ≤9 for the detection of partial clinical remission
  8. Concentrations of leptin, adiponectin and other metabolic parameters in non-obese children with Down syndrome
  9. Parent reported nutritional risk and laboratory indices of cardiometabolic risk and in preschool-aged children
  10. Multinodular goiter in children: treatment controversies
  11. Atopy as a risk factor for subclinical hypothyroidism development in children
  12. Mutation analysis of the NKX2.5 gene in Iranian pediatric patients with congenital hypothyroidism
  13. Health-related quality of life among children with Turner syndrome: controlled cross-sectional study
  14. Growth and pubertal patterns in young survivors of childhood acute lymphoblastic leukemia
  15. Clinical features and genotyping of patients with primary carnitine deficiency identified by newborn screening
  16. Letter to the Editor
  17. Sensitivity and specificity of cystic fibrosis-related diabetes screening methods: which test should be the reference method?
  18. Case Reports
  19. Type 1 rhizomelic chondrodysplasia punctata with a homozygous PEX7 mutation
  20. Severe hypertriglyceridemia at new onset type 1 diabetes mellitus
  21. 45,X/46,XY ovotesticular disorder of sex development revisited: undifferentiated gonadal tissue may be mistaken as ovarian tissue
  22. MRI in medium-chain acyl-coenzyme a dehydrogenase deficiency: neuroimaging during the first month
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