Nutrition, body composition, and cardiometabolic health in children

In the research described in this thesis we studied nutrition in early life, particularly in early childhood, and its association with body composition and cardiometabolic health. Nutritional factors of interest were protein intake, fatty acid intake and blood levels, vitamin D status, and dietary patterns. Studies include systematic reviews of the literature and analyses in the Generation R Study, a population-based prospective cohort from fetal life onward in Rotterdam, the Netherlands. Overall, our results suggest that diet quality and vitamin D status in early childhood are suboptimal. Furthermore, our results show that a lower protein intake in early childhood, a fatty acid pattern characterized by high levels of n-3 fatty acids during fetal life, and an overall healthy dietary pattern in early childhood may be beneficial for later body composition and for certain cardiometabolic markers. Although effect sizes were small, our findings may be important for early prevention of obesity and cardiometabolic diseases on a population level. Public health interventions and future scientific research should therefore put more focus on nutrition quality in early childhood

Time spent in physical activity, sedentary behavior, and sleep:Associations with self-rated sleep quality in middle-aged and older adults

Objectives: We examined the associations of estimated allocations of time spent in physical activity, sedentary behavior and sleep with self-rated sleep quality. Methods: Between 2011 and 2016, 1918 participants (mean age 71 ± 9 years, 51% women) from the population-based Rotterdam Study were included. Durations of light physical activity, moderate-to-vigorous physical activity, sedentary behavior, and sleep were assessed by accelerometry, self-rated sleep quality with the Pittsburgh Sleep Quality Index. Associations were assessed with compositional isotemporal substitution analyses. Results: Spending 30 minutes more in sedentary behavior (adjusted mean difference in PSQI score: 0.21, 95% confidence interval [0.15; 0.28] or in light physical activity (adjusted mean difference in PSQI score: 0.25 [0.03; 0.46], and 30 minutes less in sleep, was associated with poorer sleep quality. Conclusions: Our findings suggest reducing sedentary behavior and increasing sleep duration might be a potential intervention target to improve sleep quality in this population of middle-aged and older adults.</p

Dairy products and kidney function decline after myocardial infarction:A prospective analysis in the Alpha Omega Cohort

Background &amp; aims: Population-based studies have shown both beneficial and neutral associations between dairy consumption and kidney function outcomes. We investigated the association between dairy products and kidney function decline in drug-treated post-myocardial infarction (MI) patients. Methods: We analysed data of 2169 post–MI patients (aged 60–80 years, 81% male) of the Alpha Omega Cohort. Dietary data were collected at baseline (2002–2006) using a validated 203-item food frequency questionnaire. The 2021 Chronic Kidney Disease Epidemiology (CKD-EPI) equation was used to estimate 40-months change in creatinine-cystatin C based glomerular filtration rate (eGFRcr-cysC, mL/min per 1.73 m2). Beta coefficients and 95% confidence intervals (CIs) for dairy products in relation to annual eGFRcr-cysC change were obtained from multivariable linear regression, adjusted for age, sex, energy intake, and other lifestyle and dietary factors. Results: Baseline energy-adjusted median intakes were 64 g/day for total milk, 20 g/day for hard cheeses, 18 g/day for plain yogurt, and 70 g/day for dairy desserts. Mean ± SD eGFRcr-cysC was 84 ± 20 (13% with CKD), and annual eGFRcr-cysC change was −1.71 ± 3.85. In multivariable models, high vs. low intakes of total milk, cheese, and dairy desserts were not associated with annual eGFRcr-cysC change (βtotal milk: −0.21 [−0.60; 0.19], βcheese: −0.08 [−0.52; 0.36], βdairy desserts: −0.24 [−0.72; 0.24]). High vs. low intake of yogurt was adversely associated with annual eGFRcr-cysC change (βtotal yogurt: −0.50 [−0.91;-0.09]), but subsequent spline analyses showed no clear dose–response association. Conclusions: Intakes of milk, cheese or dairy desserts were not associated with a delayed kidney function decline after MI. The observed adverse association for yogurt should be interpreted with caution. Our findings require confirmation in other cohorts of coronary heart disease patients.</p

Body composition and plasma total-tau, neurofilament light chain, and amyloid-β:A population-based study

A higher body mass at older age has been linked to a lower risk of dementia. This unexpected trend may be explained by age-related lean mass depletion, or methodological issues such as the long preclinical phase of dementia or competing risks. Focusing on preclinical markers of dementia may overcome these issues. Between 2002 and 2005, body composition and plasma total-tau, neurofilament light chain (NfL), amyloid-β40, and amyloid-β42 were measured in 3408 dementia-free participants from the population-based Rotterdam Study. The cross-sectional associations between body composition and plasma markers were determined using linear regression models. Whole body and fat mass, but not lean mass, were positively associated with total-tau, while all these measures were inversely associated with NfL. Apart from an inverse association between lean mass and amyloid-β40, body composition measures were not associated with plasma amyloid-β. Our findings suggest distinct effects of body composition on neurodegeneration.</p