Relação entre crononutrição e fatores de risco cardiometabólico em crianças pré-púberes com e sem excesso de peso

Abstract

This study investigated the relationship between the dietary profile, based on chrononutrition, and cardiometabolic risk parameters in prepubertal children with and without excess body weight. A cross-sectional observational study was carried out, including 93 children (5-12 years old) classified as eutrophic (EU, n=34), overweight (OV, n=10), obese (OB, n=23) and severely obese (SOB, n=26), by WHO BMI/A standards of 2007. The averages of two or three 24-hour dietary recalls for each child were analyzed to identify energy and macronutrient intake in total and by day shift. Cardiovascular risk assessment included blood biochemical profile, abdominal fat distribution and carotid intima-media thickness (CIMT) assessed by ultrasound, and relation waist circunference/height was gauged. The reliability of the recalls was measured by the Intraclass Correlation Coefficient. Children with excess weight, especially the OB and SOB groups, showed significantly higher values (p<0.001) vs. EU in terms of BMI (z-score), waist-to-height ratio, insulin, HOMA-IR, triglycerides, abdominal subcutaneous fat and intra-abdominal fat. The reproducibility of the recordings in triplicate showed better results for daily calories (0.449; 95%CI:0.221-0.618), and total calories (0.462; 95%CI:0.24-0.627) and protein (0.471; 95%CI:0.253-0.633) consumed during the morning shift. In duplicate, calories, daily carbohydrates and carbohydrate consumption in the morning showed greater inter-rater reliability (0.634;95%CI:0.448-0.765/0.629;95%CI:0.44-0.762; 0.753;95%CI:0.621-0.845, respectively). As for the daily dietary profile, there was a higher protein intake in SOB vs. EU (p<0.05). Significant correlations (p<0.05) were found between food intake in the different shifts of the day and cardiometabolic risk factors, with an inversely proportional relationship being observed between carbohydrate consumption in the morning shift and plasma levels of total cholesterol (r=-0.21). In the afternoon, lower insulin levels correlated (p<0.05) to higher consumption of total calories, carbohydrates and lipids (r=-0.33;r=-0.35;r=-0.23, respectively). Higher lipid consumption correlated (p<0.05) to HDL-c (r=-0.22), while protein consumption correlated to z-BMI (r=0.25) and glycemia (r=0.23). During the night, positive correlations (p<0.05) were found between protein consumption and z-BMI (r=0.24), insulinemia (r=0.24), HOMA-IR (r=0.27), triglycerides (r=0.25), abdominal fat (r=0.25) and CIMT (r=0.27). It is concluded that distribution of food intake throughout the day can have a significant impact on cardiovascular risk factors in prepubertal children, highlighting the importance of chrononutrition being considered as an intervention for the cardiovascular health of this population.