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Metabolic markers in relation to nutrition and growth in healthy 4-y-old children in Sweden^1,2,3

¹ From the Department of Paediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden

Background: The worldwide increase in overweight and obesity probably involves dietary factors, and early indicators of risk must be identified.

Objective: We aimed to analyze metabolic markers in relation to dietary intake and anthropometry in healthy 4-y-old children.

Design: A cross-sectional study of nutritional intake was performed in 95 children by use of 7-d food records. Fasting blood samples were analyzed for glucose, insulin, and lipids.

Results: The study population was representative of Swedish children except that more parents than the average had a university education. The boys’ mean energy intake was higher (6.6 ± 0.75 MJ) than the girls’ (5.7 ± 0.79 MJ). Significant associations were found between the percentage of energy from carbohydrates and that from fat (r = –0.91) and sucrose (r = 0.59). High body mass index was associated with a low percentage of energy from fat (r = –0.32). Serum triacylglycerol, insulin, and the HOMA (homeostatic model assessment) index were higher in girls than in boys. In girls, HOMA ß-cell function was significantly negatively associated with fat intake and serum fasting insulin, and HOMA insulin resistance indexes were significantly associated with the increment in z scores for height and weight from birth to age 4 y. Compared with children with fasting insulin concentrations below the group mean + SD, the children with concentrations above that value were smaller as newborns and had larger increments in growth z scores from birth to age 4 y.

Conclusion: In healthy Swedish 4-y-olds from well-educated families, low fat intake was related to high body mass index. Upward weight and height percentile crossings were related to insulin resistance, especially in girls.

Key Words: Body mass index • BMI • fat • HOMA indexes • insulin • preschool children

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