TY - JOUR
T1 - Diet Quality and Cardiometabolic Risk Factors in Adolescents with Down Syndrome
AU - Anand, Neha S.
AU - Zemel, Babette S.
AU - Pipan, Mary
AU - Kelly, Andrea
AU - Magge, Sheela N.
N1 - Funding Information:
FUNDING/SUPPORT This study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD071981-01) and supported by Clinical and Translational Science Awards: (Children's Hospital of Philadelphia: UL1TR001878; Children's National Health System: UL1TR000075). N. Anand was funded by the Johns Hopkins Institute for Clinical and Translational Research (ICTR) which is funded in part by grant no. TL1 TR003100 from the National Center for Advancing Translational Sciences (NCATS) a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the Johns Hopkins ICTR or University of Maryland, Baltimore, NCATS or NIH.
Funding Information:
FUNDING/SUPPORT This study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development ( R01HD071981-01 ) and supported by Clinical and Translational Science Awards: (Children’s Hospital of Philadelphia: UL1TR001878; Children’s National Health System: UL1TR000075). N. Anand was funded by the Johns Hopkins Institute for Clinical and Translational Research (ICTR) which is funded in part by grant no. TL1 TR003100 from the National Center for Advancing Translational Sciences (NCATS) a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the Johns Hopkins ICTR or University of Maryland, Baltimore, NCATS or NIH.
Publisher Copyright:
© 2023 Academy of Nutrition and Dietetics
PY - 2023/2
Y1 - 2023/2
N2 - Background: Youth with Down syndrome (DS) have a high prevalence of obesity and dyslipidemia. Diet quality may influence cardiometabolic risk (CMR) in youth. Objective: The aim of this secondary analysis was to investigate the relationship between diet quality (Healthy Eating Index [HEI-2015]) with CMR factors in youth with DS compared with age, sex, race, ethnicity, and body mass index percentile matched, typically developing controls. Design: Adolescents (aged 10 to 20 years) with DS and controls of comparable age, sex, race, ethnicity, and body mass index percentile were recruited from 2012 to 2017 for a cross-sectional study from two large children's hospitals (Children's Hospital of Philadelphia and the Children's National Health System in Washington, DC). Participants and setting: CMRs in 143 adolescents with DS were compared with 100 controls. Exclusion criteria consisted of major organ-system illnesses. Main outcome measures: The average of three 24-hour dietary recalls was used to calculate the HEI-2015. Anthropometrics, blood pressure, and fasting labs were collected. Statistical analyses performed: Group differences were tested using Wilcoxon rank-sum tests. Relationships of CMR factors with HEI-2015 score within DS and controls were tested using linear regression models adjusted for sex, age, race, and body mass index z score. Results: Compared with controls (n = 100, median age = 14.8 years [interquartile range = 12.2 to 17.3 years]; 41% male; 24% African American; 65% with body mass index ≥85th percentile), adolescents with DS (n = 143, median age = 14.7 years [interquartile range = 11.4 to 17.4 years]; 44% male; 18% African American; 62% with body mass index ≥85th percentile) had higher scores (more aligned with dietary recommendations) for total HEI-2015 (DS: 52.7 [interquartile range = 46.8 to 58.6] vs controls: 45.1 [interquartile range = 39.5 to 55.0]; P < 0.0001). Youth with DS also had higher HEI-2015 component scores for fruits, greens/beans, dairy, refined grains, and saturated fats, but lower whole grains and sodium scores. Within the group with DS, total HEI-2015 was not significantly associated with CMR measures. Whereas HEI-2015 in the DS group was negatively associated with fasting glucose levels, the difference did not meet the set level of statistical significance (–0.14, 95% CI –0.29 to 0.00; P = 0.053). Conclusions: Adolescents in both the control and DS groups reported low-quality diets, although the DS group had HEI-2015 scores more closely aligned with recommendations. In the DS group, diet quality was not significantly associated with CMR factors. Although further research is needed, these results suggest that dyslipidemia in youth with DS may not be related to dietary intake.
AB - Background: Youth with Down syndrome (DS) have a high prevalence of obesity and dyslipidemia. Diet quality may influence cardiometabolic risk (CMR) in youth. Objective: The aim of this secondary analysis was to investigate the relationship between diet quality (Healthy Eating Index [HEI-2015]) with CMR factors in youth with DS compared with age, sex, race, ethnicity, and body mass index percentile matched, typically developing controls. Design: Adolescents (aged 10 to 20 years) with DS and controls of comparable age, sex, race, ethnicity, and body mass index percentile were recruited from 2012 to 2017 for a cross-sectional study from two large children's hospitals (Children's Hospital of Philadelphia and the Children's National Health System in Washington, DC). Participants and setting: CMRs in 143 adolescents with DS were compared with 100 controls. Exclusion criteria consisted of major organ-system illnesses. Main outcome measures: The average of three 24-hour dietary recalls was used to calculate the HEI-2015. Anthropometrics, blood pressure, and fasting labs were collected. Statistical analyses performed: Group differences were tested using Wilcoxon rank-sum tests. Relationships of CMR factors with HEI-2015 score within DS and controls were tested using linear regression models adjusted for sex, age, race, and body mass index z score. Results: Compared with controls (n = 100, median age = 14.8 years [interquartile range = 12.2 to 17.3 years]; 41% male; 24% African American; 65% with body mass index ≥85th percentile), adolescents with DS (n = 143, median age = 14.7 years [interquartile range = 11.4 to 17.4 years]; 44% male; 18% African American; 62% with body mass index ≥85th percentile) had higher scores (more aligned with dietary recommendations) for total HEI-2015 (DS: 52.7 [interquartile range = 46.8 to 58.6] vs controls: 45.1 [interquartile range = 39.5 to 55.0]; P < 0.0001). Youth with DS also had higher HEI-2015 component scores for fruits, greens/beans, dairy, refined grains, and saturated fats, but lower whole grains and sodium scores. Within the group with DS, total HEI-2015 was not significantly associated with CMR measures. Whereas HEI-2015 in the DS group was negatively associated with fasting glucose levels, the difference did not meet the set level of statistical significance (–0.14, 95% CI –0.29 to 0.00; P = 0.053). Conclusions: Adolescents in both the control and DS groups reported low-quality diets, although the DS group had HEI-2015 scores more closely aligned with recommendations. In the DS group, diet quality was not significantly associated with CMR factors. Although further research is needed, these results suggest that dyslipidemia in youth with DS may not be related to dietary intake.
KW - Adolescents
KW - Cardiometabolic risk
KW - Diet
KW - Down syndrome
KW - Obesity
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U2 - 10.1016/j.jand.2022.07.017
DO - 10.1016/j.jand.2022.07.017
M3 - Article
C2 - 35940494
AN - SCOPUS:85138146784
SN - 2212-2672
VL - 123
SP - 253
EP - 262
JO - Journal of the Academy of Nutrition and Dietetics
JF - Journal of the Academy of Nutrition and Dietetics
IS - 2
ER -