Early life events, dietary patterns and its association with cardiometabolic profile in youngsters

Author(s)

Ilana Eshriqui Oliveira

• Document type: Doctoral Thesis
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Saúde Pública (FSP/CIR)
• Defense date: 2020-05-29

Examining board members

Sandra Roberta Gouvea Ferreira Vivolo; Alexandre Archanjo Ferraro; Patricia Helen de Carvalho Rondó; Ana Carolina Junqueira Vasques

• Advisor: Sandra Roberta Gouvea Ferreira Vivolo

Abstract

Introduction: Maternal pre-pregnancy body mass index (BMI) and breastfeeding seem to influence offspring cardiometabolic profile throughout life, interfering on gut microbiota composition and development of eating habits. Aim: To examine associations of maternal pre-pregnancy BMI and breastfeeding, as well as of current dietary patterns with long-term cardiometabolic profile. Specific aims, described in thesis manuscripts, were: I) to evaluate association of maternal pre-pregnancy BMI with female offspring body composition at adulthood; II) to identify dietary patterns of young women and analyse if adherence was influenced by breastfeeding duration; III) to evaluate association of breastfeeding and of current dietary patterns with biomarkers of glucose and lipid metabolism; IV) to verify if type of feeding during the first 6 months of life was associated with oral microbiota diversity and composition of adolescents. Methods: The aims I, II and III were evaluated using Nutritionists\' Health Study baseline data, in which nutrition students and nutritionists <=45 years old were eligible. Those with cancer, diabetes, or missing information for variables of interest were excluded, resulting in 587 participants. Maternal pre-pregnancy BMI, total and predominant breastfeeding, as well as current sociodemographic, lifestyle and health aspects were obtained through online questionnaires. Validated food frequency questionnaire was applied, and dietary patterns were identified using factor analysis by principal components. A sub-sample visited the clinic for determinations of plasma glucose and lipid parameters (n=200) and body composition assessment by DXA (n=150). Multiple linear and logistic regression models were constructed considering minimum sufficient adjustments suggested by directed acyclic graphs. The aim IV was assessed with data from 423 adolescents from the Finnish Health in Teens Study Cohort. The type of breastfeeding (No Formula vs. Formula, combined or not with breastfeeding) was retrospectively obtained. Saliva microbiota was analysed by 16S rRNA sequencing. ANCOVA and PERMANOVA were used to compare diversity and generalized linear models to verify differential abundance between groups. Results: NutriHS participants had median age of 22 (IQR 20; 27) years, BMI of 22.2 (IQR 20.4; 25.0) kg/m2 and metabolic parameters were in average within normal range. I) Maternal pre-pregnancy BMI was directly associated with general (% body fat and fat mass index) and central (android-to-gynoid ratio and visceral adipose tissue) adiposity measures of their daughters, but not with appendicular muscle mass and bone mass. II) Four dietary patterns were identified (Processed, Prudent, Brazilian and Lacto-vegetarian), representing 27% of diet explained variance. Women who were breastfed for <6 months had lower chance to have moderate-tohigh adherence to the Prudent pattern compared to those who were breastfed for at least 12 months. Breastfeeding was not associated to other patterns. III) Women breastfed for <6 months had higher chance of being classified into the highest tertile of insulin compared to those breastfed for at least 6 months. Predominant breastfeeding <3 months was directly associated with insulin concentration and HOMA-IR. Regarding current dietary patterns, the Processed pattern was directly associated with LDL-c concentration, while the Prudent pattern was inversely associated with LDL-c and LDL-c/HDLc ratio. IV) Mean age and BMI of participants were 11.7 and 18.0 kg/m2. Diversity of oral microbiota was not different according to type of feeding during the first 6 months of life. Three Operational Taxonomic Units (OTU) belonging to Eubacteria and Veilonella genera (phylum Firmicutes) were more abundant in only breastfeeding group compared to participants who received infant formula. Conclusion: Maternal pre-pregnancy nutritional status and dietary habits since early life have potential to influence the cardiometabolic profile in the long term. Evidence obtained in young and healthy participants reinforce necessity of prevention and early assessment of cardiometabolic risk factors. (AU)

• FAPESP's process: 17/13087-8 - Breastfeeding and other early life events and its association with dietary patterns, body composition e cardiometabolic profile during adult life
• Grantee: Ilana Eshriqui Oliveira
• Support Opportunities: Scholarships in Brazil - Doctorate