TOP 68 - Early Childhood Eating Behaviors and Serum Lipids in School-Aged Children: A Longitudinal Cohort Study

Publication Number: 4772.TOP 68

Joseph Jamnik, The Hospital for Sick Children, Toronto, ON, Canada; Charles DG. Keown-Stoneman, Unity Health Toronto, Toronto, ON, Canada; Xuedi Li, The Hospital for Sick Children, Toronto, ON, Canada; Jonathon Maguire, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada; Catherine Birken, The Hospital for Sick Children, toronto, ON, Canada

Background: Eating behaviors, including patterns related to meal timing, portion size, and responsiveness to hunger cues, are established in early childhood, persist into adulthood, and play a critical role in supporting healthy growth and body weight. Child eating behaviors have also been associated with other markers of cardiometabolic health including dyslipidemia; however, robust, long-term longitudinal data remain limited.

Objective: To determine whether eating behaviors in early childhood are associated with circulating serum lipids, including total, LDL, HDL and non-HDL cholesterol; triglycerides, apolipoprotein A1, and apolipoprotein B in later childhood.

Design/Methods: Methods:
A prospective cohort study will be conducted with healthy children from TARGet Kids!, Canada’s largest ongoing children’s cohort study embedded in community health care. Cohort enrolment began in 2008 and over 13,000 children have been enrolled to date. Children with at least one assessment of eating behaviors and serum lipids will be included in the present study. Eating behaviors were measured between 18mo to 5y using parent responses to the validated Nutritional Screening for Toddlers and Preschoolers (NutriSTEP) questionnaire. Lipid profiles were measured from non-fasting blood samples collected at time of initial recruitment and at follow up visits using an enzymatic colorimetric assay. Multivariable linear mixed effects models will be used to examine the association between eating behaviors at 18mo-5y and serum lipids after 5y accounting for repeated measures of the outcome and temporal ordering of the exposure and outcome. Secondary exposures, including dietary intake (NutriSTEP subscore) and overall nutritional risk (total score), will be explored using similar models. Models will be adjusted for child age, sex, birthweight, breastfeeding duration, BMI-z score; maternal ethnicity, education, BMI; family income, parental cardiometabolic history, physical activity, screen time, dietary intake, and fasting time. IRB approval has been obtained for the TARGet Kids! cohort and data collection for the current study has been completed.

Significance:
This study will evaluate how early childhood eating behaviors influence lipid profiles later in childhood. As dyslipidemia often persists into adulthood and contributes to cardiovascular disease risk, clarifying the role of early behavioral factors can support evidence-based lifestyle interventions. Findings may ultimately guide clinicians and policymakers in shaping prevention strategies to improve long-term cardiometabolic health.